Evidence map›Paper›PMID 41627537›Full record

SynthesisCurrent pain and headache reports2026

Efficacy and Safety of Melatonin in Migraine Prophylaxis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Moaz Elsayed Abouelmagd, Mohamed A Aldemerdash, Abdallah Ahmad Khatatbeh, Ahmed S A Osman, Abdallah Abbas, Salma Allam, Esraa M AlEdani, Ahmed Aldemerdash, Teshamae S Monteith

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Current pain and headache reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Moaz Elsayed AbouelmagdKasr-Alainy Faculty of Medicine, Cairo University, Cairo, Egypt. moaz_s_sayed@students.kasralainy.edu.eg.ORCID http://orcid.org/0000-0002-0511-2429
Mohamed A Aldemerdash *Faculty of Medicine, Sohag University, Sohag, Egypt.
Abdallah Ahmad Khatatbeh *Faculty of Medicine, Ain Shams University, Cairo, Egypt.ORCID http://orcid.org/0000-0001-8299-6945
Ahmed S A Osman *Faculty of Medicine, Minia University, Minya, Egypt.ORCID http://orcid.org/0009-0002-2871-9925
Abdallah AbbasFaculty of Medicine, Al-Azhar University, Damietta, Egypt.
Salma AllamFaculty of Medicine, Galala University, Suez, Egypt.ORCID http://orcid.org/0009-0005-2749-8982
Esraa M AlEdaniFaculty of Medicine, University of Basra, Basrah, Iraq.ORCID http://orcid.org/0009-0005-0001-9830
Ahmed AldemerdashFaculty of Medicine, Sohag University, Sohag, Egypt.
Teshamae S MonteithDepartment of Neurology, Headache Division, Miami, FL, USA. tmonteith@med.miami.edu.ORCID http://orcid.org/0000-0001-8912-252X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMigraine is a chronic, disabling brain disorder. Melatonin, a circadian regulator with anti-inflammatory and antinociceptive actions, has been proposed for migraine prevention. We evaluated the efficacy and safety of melatonin for prophylaxis.

methodsWe systematically searched PubMed, Cochrane, Scopus, Embase, and Web of Science (September 29, 2024) for randomised controlled trials (RCTs) comparing melatonin with placebo or other active drugs. Outcomes were analysed as change from baseline to last follow-up using mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI).

resultsNine RCTs (n = 788) were included. Versus placebo, melatonin reduced attack duration (MD -4.98 h; 95% CI -9.30 to -0.67; p = 0.02), headache days (MD -1.54 days; 95% CI -2.50 to -0.58; p < 0.01), headache severity (MD -2.08; 95% CI -2.91 to -1.26; p < 0.01), and analgesic use (MD -1.38; 95% CI -2.41 to -0.36; p < 0.01). Melatonin also increased the response rate (≥ 50% reduction in monthly headache frequency) (RR 1.38; 95% CI 1.11-1.70; p < 0.01) and improved sleep quality (PSQI: MD -1.64; 95% CI -2.85 to -0.42; p = 0.008) and disability (MIDAS: SMD - 4.07; 95% CI -5.45 to -2.69; p < 0.001). Compared with amitriptyline, melatonin was generally less effective for attack duration and severity, with no consistent advantage on analgesic use or response; however, melatonin showed a more favourable tolerability profile, including lower risk of sleepiness (RR 0.49; 95% CI 0.28-0.87; p = 0.01).

conclusionsMelatonin demonstrates benefits over placebo for reducing migraine burden and improving patient-reported outcomes, with a favourable safety profile. While amitriptyline remains more potent for several efficacy endpoints, melatonin represents a reasonable preventive option, particularly as an adjunct during titration of first-line agents. Further head-to-head trials with standardised dosing and longer follow-up are warranted.

Indexed as

MelatoninMigraine DisordersAnalgesicsHumansRandomized Controlled Trials as TopicTreatment OutcomeAnalgesicsMelatoninAmitriptylineMelatoninMeta-analysisMigrainePlaceboSystematic review

Identifiers

PMID41627537
PMCPMC12864225

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.