Background:  Circumstantial evidence points to be possible role of magnesium (Mg⁺²) deficiency in the pathogenesis of migraine and has raised questions about the clinical utility of magnesium as a therapeutic regimen in migraine. This was a prospective, randomized, double blind, placebo controlled trial comparing the efficacy and tolerability of 400mg magnesium hydroxide once daily (23 patients), 10 mg Propranolol 3 times daily (22 patients), 200 mg Na-valproate twice daily (20 patients), and placebo (22 patients) in the prophylaxis of migraine diagnosed according to the criteria of the International Headache Society. Patients were evaluated for attack frequency, severity, drug side effects monthly for 3 months. Magnesium, Propranolol and Na-valproate were all superior to placebo (p<0.001) in reducing both attack frequency and severity after the first month. There was no significant difference between the three active drugs in reduction of attack frequency and severity. No serious side effects were observed and the frequency of side effects were not significantly different in all treatment groups. Our results show that oral magnesium is an effective and well tolerated drug in the prophylaxis of migraine and compares well to established drugs like Propranolol and Na-valproate both in effectiveness and occurrence of side effects. Magnesium may be an alternative drug in migraine prophylaxis, but more larger comparative trials are needed to confirm this results.

Aim: To find out the role of magnesium in migraine prophylaxis and compare it with two established drug Propranolol and Na-valproate on some diagnosed case of migraine.

Method: This was a prospective, randomized, double blind, placebo controlled trial conducted in the outpatient department of Neurology, Dhaka medical college & Hospital from July 2015 to June 2016. Sample size was 87.

Result: There was no statistically significant difference between the Magnesium, Propranolol and Na-valproate in reduction of migraine attack frequency and severity with ( P- value >0.05; which is not significant). Our result shows that magnesium significantly reduced the frequency of migraine attack and severity with no serious side effects compares well to established drugs like Propranolol and Na-valproate.

Conclusion: The study was conducted to find out the role of magnesium in migraine prophylaxis. The present study found that magnesium significantly lowers the frequency of attack & severity of migraine. So magnesium can be used as an alternative agent for migraine prophylaxis for its effectiveness, well tolerability and less side effects.

Keywords: Migraine prophylaxis, Propranolol, Na-valproate , Magnesium.

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