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Feverfew for Migraine

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Adverse effects
Comment
A systematic review [1] reports evidence that feverfew is effective for prophylaxis against migraine attacks.

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Randomised, double-blind placebo-controlled trials were sought using feverfew for the prevention of migraine. Searching was comprehensive, included asking manufacturers for unpublished studies, and papers were included only if feverfew was used alone.

Results


Five studies were found, one of which was published only as an abstract.

Two crossover trials (70 patients total, one an abstract looking at serotonin uptake and platelet activity) showed no effects over 2-4 months. Three other trials, (146 patients, one parallel group, the other two crossover trials) found significant reductions in the attack frequency, pain intensity, and incidence and/or severity of nausea and vomiting.

No meta-analysis was possible because of the disparate outcome measures used in the trials. The level of statistical significance reported in the positive trials was usually high, and often beyond 1 chance in 50.

Adverse effects


Adverse effects were mild and reversible.

Comment


Such information as is available from high-quality trials favours feverfew over placebo for the prevention of migraine headaches. The effectiveness of feverfew has not been established beyond reasonable doubt. The very high levels of statistical significance found in the positive trials suggest that larger studies looking at standardised feverfew extracts would make sense especially with the low level of adverse effects.

Reference:


  1. BK Vogler, MH Pittler, E Ernst. Feverfew as a preventive treatment for migraine: a systematic review. Cephalalgia 1998 18: 704-708.

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