Melatonin and Migraine 🌙
When most people think of melatonin, they think of sleep. But research is increasingly showing that melatonin may play a role in migraine prevention — with evidence suggesting it could work as well as some prescription medications, with fewer side effects.
What the Research Shows
A 2024 systematic review published in Cureus analyzed 11 randomized controlled trials including over 1,200 patients with migraine. The findings were striking:
3 mg of melatonin nightly significantly reduced the number of monthly migraine days compared with placebo.
In some trials, melatonin performed as effectively as amitriptyline, a commonly prescribed migraine preventive, but with fewer side effects such as weight gain and drowsiness.
Melatonin was generally well tolerated, with a favorable safety profile.
These results build on earlier work:
Gelfand & Goadsby (2016) highlighted melatonin’s biological roles in circadian rhythm, pain modulation, and anti-inflammatory effects in headache disorders.
Puliappadamb et al. (2022) conducted a meta-analysis confirming melatonin’s safety and efficacy in reducing migraine frequency.
Leite Pacheco et al. (2018) found that melatonin was particularly beneficial in adults with primary headache disorders, supporting its use as a preventive option.
Together, these studies suggest that melatonin is more than a sleep aid — it may be a valuable tool for people struggling with migraines.
How Melatonin May Work in Migraine
Melatonin has multiple actions that make it especially relevant for migraine prevention:
Regulates circadian rhythm → stabilizing sleep, a common migraine trigger.
Reduces inflammation → lowering pro-inflammatory cytokines.
Modulates CGRP (calcitonin gene-related peptide) → a key pain pathway targeted by modern migraine drugs.
Improves vascular function & stress response → both central to migraine pathophysiology.
This unique combination makes melatonin stand out compared to other natural or prescription preventives.
Important Caveats
Unlike prescription medications, dietary supplements are not FDA-regulated to the same standard. That means:
What’s on the label may not always match what’s inside the bottle.
Potency, purity, and contaminants can vary between brands.
👉 If you’re considering melatonin, look for USP-verified or third-party tested supplements to ensure safety and accurate dosing.
Practical Takeaway
For many patients, especially those looking for a low-cost, low-risk option, melatonin (typically 3 mg at night) may be a reasonable preventive to discuss with a healthcare provider. It’s not a cure-all, and it may not work for everyone, but the growing evidence base suggests it deserves a place in the migraine prevention conversation.
References
Nelakuditi B, Dandamudi BJ, Dimaano KAM, et al. Efficacy of Melatonin as a Promising Intervention for Migraine Prevention: A Systematic Review of Randomized Control Trials. Cureus. 2024;16(10):e72559. doi:10.7759/cureus.72559
Gelfand AA, Goadsby PJ. The Role of Melatonin in the Treatment of Primary Headache Disorders. Headache. 2016;56(8):1257–1266. doi:10.1111/head.12862
Puliappadamb HM, Maiti R, Mishra A, Jena M, Mishra BR. Efficacy and Safety of Melatonin as Prophylaxis for Migraine in Adults: A Meta-analysis. J Oral Facial Pain Headache. 2022;36(3-4):207–219. doi:10.11607/ofph.3211
Leite Pacheco R, et al. Melatonin for preventing primary headache: A systematic review. Int J Clin Pract. 2018;72(7):e13203. doi:10.1111/ijcp.13203
