Magnesium is an essential cation involved in a wide range of physiological processes, including cellular energy production and the synthesis of DNA and RNA. Two of its roles are particularly relevant to the pathophysiology of migraine and tension‑type headaches: the regulation of nitric oxide synthesis and the modulation of the N‑methyl‑D‑aspartate receptor.
The aim of this study was to systematically review the available literature on the effectiveness of magnesium salts in alleviating headache. Outcomes of interest included the frequency of migraine days, the number of migraine attacks, changes in pain intensity, and the occurrence of adverse effects.
A structured search was conducted in the PubMed and Web of Science databases following a predefined search strategy and PRISMA guidelines. Of the 307 records identified, 25 studies met the inclusion criteria.
Most randomized trials investigating oral magnesium formulations reported a reduction in the frequency and/or intensity of migraine attacks, whereas findings from studies combining magnesium with other active substances were inconsistent. All studies examining intravenous magnesium sulfate demonstrated effective pain relief in patients with migraine with aura. Comparisons with other therapeutic agents generally did not yield statistically significant differences, although some results may still hold clinical relevance.
Overall, additional randomized, placebo‑controlled trials are needed before magnesium salts can be confidently integrated into routine clinical practice.
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