A nonprescription treatment regimen involving a nutraceutical supplement and modest lifestyle changes can improve vertigo symptoms in more than half of patients with vestibular migraine, according to results from a preliminary Australian study.
Sydney neurologists conducted a clinic-based observational study of 104 patients diagnosed with vestibular migraine at two outpatient clinics between November 2019 and August 2021.
Patients were advised on optimising sleep, hydration, exercise and nutrition as well as instructed to use the over-the-counter supplement Migraine Care (from BioCeuticals Australia) twice daily, which contains riboflavin 200 mg, magnesium 150 mg, coenzyme Q10 75 mg and feverfew 200 µg. The study was conducted independently of the marketers of the product.
Eight patients reported likely side effects of the product, including allergic rash, gastric reflux, nausea, diarrhoea and headaches, that led to supplement cessation.
Findings from the 82 participants (mean age 44, 78% female) who completed questionnaires following three to four months of taking the product showed a decrease across all study outcome measures.
These included the Dizziness Handicap Inventory (DHI) (mean reduction 16.8), Vertigo Symptom Score short-form (VSS-sf) (mean 9.3), visual analogue scales for severity (mean 3.0) and frequency (mean 2.8), equating to an improvement of 44.1%, 44.9%, 44.1% and 38.9% respectively.
On the DHI and VSS-sf, more than half of patients (50% and 53.7% respectively) showed improvement in their symptoms, 47.6% and 43.9% patients noted no change and two patients in each group reported significant worsening of symptoms.
The supplement was also mostly well-tolerated, said the researchers led by the Institute of Clinical Neurosciences at Royal Prince Alfred Hospital, Sydney, and the University of Sydney.
“Patients with mild to moderate vestibular migraine symptoms or for whom adverse effects are the most important aspect in choosing a preventive treatment may prefer trialling nonprescriptive therapies before embarking on a prescribed medicine regimen,” they wrote in the Internal Medicine Journal [link here].
“In the present study, only 7.7% experienced minor adverse effects leading to cessation of the supplement and 22 patients progressed to a conventional migraine preventative medication by the study’s end.
“Our study was prompted by anecdotal evidence received in our neuro-otology clinics over the past five years. These findings corroborate those reports and provide support for clinicians to offer patients the choice of combined nutraceutical with lifestyle changes as an initial prophylactic treatment for vestibular migraine.”
Some of the limitations of the study included that a placebo effect was possible with neither patient nor doctor blinded to the product. There was also the possibility of symptoms clearing up on their own, the authors said.
BioCeuticals Australia had no part in the study.