There is some scientific interest in the use of alpha-lipoic acid (ALA) for migraine prevention, but the evidence is limited and not robust. Alpha-lipoic acid is an antioxidant involved in mitochondrial energy metabolism, and since mitochondrial dysfunction and oxidative stress have been implicated in migraine pathophysiology, researchers have explored ALA as a potential treatment.

A few small clinical trials have investigated ALA for migraine prophylaxis. For example, a 2007 double-blind, randomized, placebo-controlled pilot study (Magis et al., Cephalalgia, 2007) found that 600 mg/day of ALA for three months led to a reduction in migraine frequency and severity compared to placebo, but the sample size was small and the study duration limited. Another trial (Hershey et al., Headache, 2007) in pediatric migraine did not find significant benefit. A 2021 systematic review (Tóth et al., Nutrients, 2021) noted that while preliminary results are promising, the overall quality and quantity of evidence is low, and larger, high-quality randomized controlled trials are needed.

There is no established traditional use of lipoic acid for migraine, and its use is based on its biological plausibility and limited clinical research. Current evidence does not support widespread recommendation, but it may be considered in select cases where conventional treatments are inadequate and with medical supervision.