Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 10 3 2025 09 07 228 240 Emna Ellouz Neurology Department, University Hospital of Gabes, 6014 Gabes, Tunisia AND Sfax University, Sfax Faculty of Medicine, 3029 Sfax, Tunisia Imen Ketata Neurology Department, University Hospital of Gabes, 6014 Gabes, Tunisia AND Sfax University, Sfax Faculty of Medicine, 3029 Sfax, Tunisia 2024 08 28 2024 10 01 We aimed to evaluate the influence of coenzyme Q10 alone (CoQ10) or in association with other nutraceuticals (CoQ10+) on the frequency, severity, duration of migraine attacks, and quality of life. We conducted a meta-analysis and a network meta-analysis (NMA) according to PRISMA 2020. We searched PubMed, Web of Science, Google Scholar, and Europe PMC for eligible studies up to January 2024. We used R software for pooled outcomes. This meta-analysis was registered in PROSPERO (CRD42024499733). Five studies were included, with a total of 326 individuals with confirmed migraine. CoQ10/CoQ10+ was shown to be associated with significant improvement in migraine frequency per month, and migraine duration and severity. NMA indicated that CoQ10 combined with L-carnitine appeared to be more effective than CoQ10 on migraine frequency and severity (SMD= -0.99 [95% CI: -1,68 to -0,29]; SMD= -3.05 [95% CI: -4.05 to -2.04], respectively). CoQ10 associated with L-carnitine yielded the greatest significant decrease in migraine duration compared with placebo; NMA revealed no significant difference between CoQ10, CoQ10 with multivitamin, and CoQ10 with L-carnitine. Our findings suggest that for optimal effectiveness, the use of CoQ10/CoQ10+ should be prolonged for at least 3 months. Using CoQ10 had a significant effect on the improvement of the quality of life of patients with migraine. Our meta-analysis suggested a beneficial effect of CoQ10/CoQ10+ for reducing monthly migraine frequency, severity, and duration, notably when it was associated with L-carnitine. Additionally, CoQ10 significantly improved the quality of life. https://jtim.tums.ac.ir/index.php/jtim/article/view/1728