Riboflavin (vitamin B2) is supported by scientific evidence for use in migraine prevention, though the evidence is moderate rather than strong. Several randomized controlled trials and systematic reviews have suggested that high-dose riboflavin (typically 400 mg daily) can reduce the frequency and duration of migraine attacks in adults. The proposed mechanism is related to riboflavin's role in mitochondrial energy production; some migraine sufferers may have mitochondrial dysfunction, and riboflavin supplementation may help improve cellular energy metabolism in the brain. The most frequently cited study is a 1998 randomized, placebo-controlled trial by Schoenen et al., which demonstrated that riboflavin significantly reduced headache frequency compared to placebo. Meta-analyses and guidelines, such as those from the American Academy of Neurology and the Canadian Headache Society, list riboflavin as a treatment option with moderate evidence for efficacy and a favorable safety profile.

However, the quality and quantity of evidence are less robust compared to some pharmaceutical options, and most studies focus on prevention rather than acute treatment. The benefit appears most notable in adults; evidence in children and adolescents is less consistent. Adverse effects are rare and generally limited to minor gastrointestinal disturbances and harmless yellow discoloration of urine. Overall, riboflavin is considered a reasonable, evidence-based option for migraine prophylaxis, particularly for patients seeking non-pharmacological approaches.