Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Eicosapentaenoic acid (EPA), an omega-3 polyunsaturated fatty acid found in fish oil, has been investigated for its potential role in migraine management, primarily due to its anti-inflammatory properties. The scientific rationale is based on the role of neuroinflammation in migraine pathophysiology and EPA's ability to alter inflammatory mediators. Several small clinical studies and randomized controlled trials have explored the effects of omega-3 supplementation (usually EPA combined with DHA, another omega-3) on migraine frequency and intensity. Some trials have reported modest reductions in migraine frequency and duration, but results are inconsistent and often limited by small sample sizes, short durations, and varying dosages and formulations.

A 2021 study published in BMJ (Ramsden et al.) found that diets higher in omega-3 fatty acids (EPA and DHA) reduced the frequency and severity of headaches in chronic migraine sufferers compared to control diets. However, the effect sizes were moderate, and the intervention included both EPA and DHA, making it difficult to isolate EPA’s specific contribution. Systematic reviews and meta-analyses acknowledge potential benefits but conclude that the overall evidence remains limited and of low quality. No major guidelines currently recommend EPA specifically for migraine, and more robust, well-powered research is needed.

In summary, while there is some scientific investigation and plausible biological rationale for EPA's use in migraine, the clinical evidence is weak to moderate at best (rated 2/5). EPA is not a standard treatment, but ongoing research may clarify its role in the future.

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