Vitamin B2 (Riboflavin) is supported by scientific evidence for use in migraine prevention. Several randomized controlled trials (RCTs) have demonstrated that high-dose riboflavin (typically 400 mg/day) can significantly reduce the frequency and duration of migraine attacks in adults. The proposed mechanism is that riboflavin improves mitochondrial energy metabolism in brain cells, addressing a hypothesized bioenergetic deficit in migraine sufferers. One of the pivotal studies, published in Neurology (Schoenen et al., 1998), found that 59% of patients receiving riboflavin experienced a ≥50% reduction in migraine days compared to 15% in the placebo group. Subsequent meta-analyses and systematic reviews have confirmed these findings, though the effect size is modest and primarily preventive rather than abortive.

Riboflavin is considered safe, with minimal side effects (mainly harmless yellow discoloration of urine). Guidelines from organizations such as the American Academy of Neurology and the Canadian Headache Society include riboflavin as a potentially effective, evidence-based option for migraine prevention, especially for individuals seeking non-pharmacological interventions. Evidence for use in children is less robust, with mixed results from clinical trials. Overall, the use of riboflavin for migraine prophylaxis is justified by moderate to strong scientific evidence, though it should be noted that it is not effective for acute migraine treatment.