CoQ10 May Support Symptom Resolution in Pediatric New Daily Persistent Headache

Coenzyme Q10 (CoQ10) supplementation is significantly associated with headache resolution in pediatric patients diagnosed with new daily persistent headache (NDPH), according to study results presented at the 2025 American Headache Society (AHS) Annual Scientific Meeting, held from June 19-22, in Minneapolis, Minnesota, and virtually.

NDPH is a treatment-refractory primary headache disorder characterized by the sudden onset of daily, unremitting head pain lasting longer than 3 months, often with features overlapping tension-type headache and migraine. Given the chronicity of symptoms and limited effectiveness of current treatment options, researchers sought to identify potential therapeutic strategies associated with headache resolution.

Researchers conducted a retrospective analysis using a standardized registry of patients diagnosed with NDPH at Children’s National Hospital between 2016 and 2021. The study included 182 pediatric patients (mean age, 15.5 years; girls, 78%) who met International Classification of Headache Disorders, 10th edition (ICD-10), criteria for NDPH. Medical records were reviewed to extract clinical characteristics, lifestyle habits, and preventative treatments.

The researchers compared outcomes between patients who achieved complete headache resolution (n=47; 25.8%) and those with persistent symptoms (n=135). CoQ10 was the only preventative therapy significantly associated with resolution, utilized by 17% of resolved patients compared with 4% of unresolved patients (P =.010).

Topiramate, magnesium, and OnabotulinumtoxinA were also more frequently used among patients whose headaches resolved, with each showing a non-significant trend toward benefit (P =.112, P =.086, and P =.179, respectively).

Lifestyle data revealed that patients who reported aerobic exercise 5 times per week approached statistical significance for resolution (P =.058), suggesting a possible role for physical activity in recovery. No significant differences were observed in daily water intake, sleep duration, or frequency of meal skipping between the resolution and non-resolution groups.

This study was limited by its retrospective design.

“Further prospective studies and randomized controlled trials are needed to establish causality and to optimize treatment strategies for pediatric NDPH,” the researchers concluded.