Loyal readers (such as there are) will have noted a long pause between this post and the last on this blog. Well, I was promoted to a new faculty position with a dizzying array of new responsibilities. And I also bought a house and moved. And I got engaged. All of which, my friends, are rather time-consuming activities that forced me to put blabbing about cluster headache on the back burner. But now I’m back.
As it happens, not much goes on in the field of cluster headache research, so we will ease back into the present with a paper fifteen years old, prompted by a conversation I had with Dr. Alexander Mauskop at the recent meeting of the American Headache Society in Los Angeles. He was peddling a new headache remedy he’s invented called “Migralex”, a combination of magnesium sulfate and aspirin, which he is convinced is a revolutionary new treatment for headaches. He is a big proponent of magnesium as a treatment for headache. “Does Migralex work for cluster headache?” I asked him. “Oh yes!” he told me.
I was instantly suspicious. “What manner of quackery is this?” I thought. But then, Mauskop does run the New York Headache Center, so perhaps he knows a thing or two. A search of the scientific literature for the effects of magnesium on cluster headache yielded pretty slim pickings: there was only one relevant paper in fact, written fifteen years ago by—perhaps unsurprisingly—Dr. Mauskop.
Having observed previously that episodic cluster headache patients had normal magnesium levels but lower ionized magnesium levels, Dr. Mauskop decided to see whether raising the low levels to normal by giving magnesium intravenously would help. For a short time, all the cluster headache patients who arrived at the New York Headache Center during their cluster period were asked if they were willing to be given one or two grams of intravenous magnesium sulfate. If they were pain-free for two days and skipped two or more expected attacks, Dr Mauskop gave them more.
Twenty-two people participated—seven women and fifteen men; 20 with episodic cluster headache and two with chronic. Fourteen of the 22 (64%) had two days of relief; seven (32%) had complete sustained remission. Even more interesting, most of the patients who responded had magnesium levels below 0.54 mmol/L, suggesting that the infusions were in fact treating some sort of deficiency.
So does this mean that Maukop’s Migralex will treat cluster headache? Hard to know. Oral medication does not act the same way as intravenous medication, and there did not seem to be any studies beyond this one. However, if low ionized magnesium levels predispose towards cluster attacks, and you have low ionized magnesium level and are having cluster attacks, it seems worth a try to me. Best of all, it’s over-the-counter, making this remedy accessible to the home experimental psychopharmacologist. If any cluster headache patient has experience with Migralex, please post it here!