Schoenen · Neurology 1998 · Randomized placebo-controlled trial · n=55

Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial.

Cited 549 times in the scientific literature.

Level 2 - randomized trial

Individual randomized controlled trial

PubMed 9484373 · doi:10.1212/wnl.50.2.466 · record verified 2026-08-29

What was done

In a 3-month randomized controlled trial, 55 patients with migraine received either high-dose riboflavin (400 mg daily) or placebo. Efficacy was evaluated via intention-to-treat analysis for changes in attack frequency, headache days, 50% responder rates, and adverse events.

What was found

Riboflavin was superior to placebo in reducing attack frequency (p = 0.005) and headache days (p = 0.012). The proportion of patients achieving at least a 50% reduction in headache days was 59% with riboflavin compared to 15% with placebo (p = 0.002), corresponding to a number-needed-to-treat of 2.3. Minor adverse events were reported in three patients (diarrhea and polyuria with riboflavin; abdominal cramps with placebo), with no serious adverse events.

Why it matters

High-dose riboflavin provides a low-cost, well-tolerated, and effective non-pharmacologic option for migraine prophylaxis.

Limits

The study had a small sample size (n = 55) and a short follow-up duration of 3 months. It lacked an active comparator arm using an established prophylactic medication, and baseline migraine characteristics or long-term outcomes beyond 3 months were not reported.

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