von Luckner · Headache 2018 · systematic review of randomized controlled trials · n=5 studies

Magnesium in Migraine Prophylaxis-Is There an Evidence-Based Rationale? A Systematic Review.

Cited 74 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review of randomized double-blind placebo-controlled trials

PubMed 29131326 · doi:10.1111/head.13217 · record verified 2026-08-29

What was done

Authors searched PubMed and EMBASE (1990–2016) for randomized, double-blind, placebo-controlled trials evaluating magnesium prophylaxis in adults aged 18 to 65 with migraine. Studies were evaluated according to International Headache Society trial guidelines, Cochrane risk of bias tools, and American Academy of Neurology evidence classification schemes, focusing on migraine days and attack frequency. The review protocol was not prospectively registered.

What was found

Five trials were identified from 204 screened records. One of two Class I trials demonstrated a statistically significant reduction in migraine attacks compared to placebo. Two of three Class III trials demonstrated statistically significant reductions in primary efficacy parameters versus placebo. The abstract reports no exact numeric effect sizes, sample sizes, or p-values, and assigns an overall Grade C (possibly effective) rating.

Why it matters

This review establishes that while magnesium dicitrate (600 mg) is a safe and inexpensive prophylactic option, the randomized trial evidence supporting its efficacy is limited and conflicting.

Limits

The total evidence base comprises only five clinical trials, with conflicting outcomes in high-quality (Class I) studies. The abstract lacks pooled numerical data, confidence intervals, adverse effect rates, and total participant counts. Lack of prior registration introduces potential risk of methodological bias.

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