Omega-3 supplementation in migraine prophylaxis: An updated systematic review and meta-analysis

Abstract

Objective

To assess the efficacy of omega-3 fatty acids in migraine prophylaxis by examining their impact on migraine frequency, severity, duration, and quality of life, measured using the headache impact test-6 (HIT-6) score.

Methods

A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Cochrane CENTRAL until June 2024. Clinical trials evaluating the effect of omega-3 in migraine prevention were included. The risk of bias was assessed using RoB-1 for RCTs and ROBINS-1 for non-RCTs. Meta-analysis was performed using RevMan software, with heterogeneity assessed using chi-square and I² statistics. Subgroup analyses and leave-one-out analyses were conducted.

Results

Fourteen clinical trials involving 1944 patients were included, with nine studies in the meta-analysis. The overall results of omega-3 supplementation revealed a significant reduction in the migraine frequency (MD: -1.74 days per month, 95% CI: [-3.45, -0.03], P = 0.05) and severity of migraine attacks (SMD: -0.28, 95% CI: [-0.54, -0.02], P = 0.04 when compared to various comparators (placebo, sodium valproate, diet low in omega-6 fatty acids, and average US omega-3 and omega-6 intake). However, its effect on HIT-6 was not significant (MD: -8.9, 95 % CI: [-20.47, 2.67], P = 0.13), and its impact on migraine duration was also not significant (MD: -1.94 hours per episode, 95 % CI: [-4.24, 0.37], P = 0.1).

Conclusions

Omega-3 fatty acids effectively reduced the frequency and severity of migraine attacks but did not significantly reduce migraine duration and HIT-6. Further research is needed to explore the long-term effects and optimize dosing for migraine prevention.