Abstract
BackgroundMigraine and tension-type headaches impose a tremendous economic drain upon the healthcare system. Intravenous and oral niacin has been employed in the treatment of acute and chronic migraine and tension-type headaches, but its use has not become part of contemporary medicine, nor have there been randomized controlled trials further assessing this novel treatment. We aimed to systematically review the evidence of using intravenous and/or oral niacin as a treatment for migraine headaches, tension-type headaches, and for headaches of other etiologic types.MethodsWe searched English and non-English language articles in the following databases: MEDLINE (1966–February 2004), AMED (1995–February 2004) and Alt HealthWatch (1990–February 2004).ResultsNine articles were found to meet the inclusion criteria and were included in this systematic review. Hypothetical reasons for niacin's effectiveness include its vasodilatory properties, and its ability to improve mitochondrial energy metabolism. Important side effects of niacin include flushing, nausea and fainting.ConclusionAlthough niacin's mechanisms of action have not been substantiated from controlled clinical trials, this agent may have beneficial effects upon migraine and tension-type headaches. Adequately designed randomized trials are required to determine its clinical implications.
Highlights
Migraines and tension-type headaches impose an important burden upon society and the working public
Articles were searched with the key search terms "Migraine" combined with the Boolean Operator "AND "Niacin" OR "Nicotinic Acid." Additional searches were conducted with the search terms "Headache" and "Tension." To supplement the search, we searched through the references of the articles we found from the databases
Five articles were excluded in total; three because niacin was not the sole therapeutic agent used for the treatment of headache [16], histaminic cephalgia [17], and migraine [20]; and two because the reports were opinion pieces without any objective or subjective data to support the assertions made [13,19]
Summary
Migraines and tension-type headaches impose an important burden upon society and the working public. Even though advances have been made with regard to the treatment of acute migraine headaches (i.e., the triptan (page number not for citation purposes). Migraine and tension-type headaches impose a tremendous economic drain upon the healthcare system. Intravenous and oral niacin has been employed in the treatment of acute and chronic migraine and tension-type headaches, but its use has not become part of contemporary medicine, nor have there been randomized controlled trials further assessing this novel treatment. We aimed to systematically review the evidence of using intravenous and/or oral niacin as a treatment for migraine headaches, tension-type headaches, and for headaches of other etiologic types
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