Feverfew is another alternative to the traditional prescription
drugs to prevent migraines.
Botany
A common garden flower (Tanacetum
parthenium) sometimes called a “summer daisy,” feverfew has been used as a
medicinal plant since medicine began and is one of the most interesting and potentially
valuable of herbs. It’s been used to treat headaches, menstrual irregularity, and
fever. Pharmacologists say it is likely that the sesquiterpene lactones in feverfew
inhibit prostaglandin and histamine released during the inflammatory process, preventing
the vascular spasms that cause migraines.
History
Currently feverfew is a popular herbal remedy
for prevention and treatment of migraine. In traditional and folk use, feverfew is touted
for multiple ailments. Its use as a febrifuge (that which reduces fever) gave rise to the
common name feverfew.
Clinical Trials
There are two randomized, placebo-controlled
trials of feverfew for prevention of migraine. In one London clinic, Johnson et al
enrolled patients with a diagnosis of common or classic migraine, a history of at least
two years duration, not more than eight attacks per month, and self-prescribed continuous
daily use of feverfew for at least three months. Seventeen of 20 patients
agreed to participate. The group taking placebo showed significant increase in migraine
attacks, while the group using feverfew showed no significant change in frequency or
severity of attacks. Two patients in the placebo group discontinued the study before
completion because their symptoms increased.
Murphy et al conducted a prospective
randomized, double-blind, placebo-controlled trial of feverfew for migraine prophylaxis.
There was a 24% reduction in the number of attacks during feverfew treatment, but no
significant change in the duration of individual attacks. There was a significant
reduction in associated nausea and vomiting and a non-significant trend toward reduction
in attack severity. Assessments showed that feverfew was better than placebo.
It should be noted that these studies are at
times cited as support for feverfew treatment of migraine, but neither study involves an
arm of active treatment for acute attacks. Also of note is that routine hematological and
blood chemistry, urine analysis, blood pressure, and pulse revealed no abnormalities in
either clinical trial described above.
Adverse Effects
Occasional mouth ulcerations have been reported with the use of fresh leaves,
but have not been reported with the use of dried leaves in capsules. When asked
specifically about mouth ulcerations, those in the Murphy et al treatment group reported
this effect less often than the placebo group. Other reported adverse effects
include contact dermatitis, palpitations, indigestion, colicky abdominal pain,
weight gain, and inflammation of the lips, mouth, and tongue. Adverse effects reported at
or below the frequency of placebo include dizziness, light-headedness, slightly heavier
periods, heartburn, skin rash, and diarrhea. Abrupt discontinuation of feverfew after
several years of use has led to the recurrence of incapacitating migraine.
Contraindications
Feverfew is contraindicated in individuals
with known hypersensitivity to other members of the Asteraceae
family, such as chamomile, ragweed, and yarrow. Feverfew is contraindicated during
pregnancy. There is no information on feverfew excretion in breast milk. There are no data
for use in children.
Herb-Drug Interaction
Feverfew may interact with aspirin and other
blood-thinners to increase their blood thinning capabilities. If you take a blood thinner,
your blood counts will need closer monitoring so be sure and let your doctor know if you
plan to try feverfew.
Recommendation
To attain the maximum benefit from Feverfew,
it should be taken daily as a migraine preventive. For migraine prevention, parthenolide
plays an important role. The parthenolide content in feverfew is highly variable in
different populations grown in different locations or harvested at different times of the
year.
Dosage/Formulation
The average dosage is 125 mg. of
freeze-dried powdered leaf (standardized to 0.2% parthenolide) per day.
Alternatively, you could try the fresh leaves:
one fresh leaf taken two to three times daily with food (swallow whole,
don't chew the leaf) is the dose recommended by herb experts.
So, this is one of the few cases where a standardized extract may be more
desirable than the whole plant, with a lot to be said for fresh or freeze-dried
preparations. If you want to use the fresh plant, the flowers have a higher parthenolide
content than do the leaves. If you are picking the leaves, they are best just before
flowering.
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