Migraine News for February 1999

Role of Feverfew in Migraine Still Uncertain

NEW YORK, Feb 19 (Reuters Health) -- Feverfew, a popular herbal remedy touted as a migraine reliever, does appear to be more effective than a placebo when it comes to preventing migraine headaches, according to a review of five different studies.

However, "the clinical effectiveness of feverfew in the prevention of migraine has not been established beyond reasonable doubt," according to a report in the medical journal Cephalalgia.

"Collectively, the data imply that dried feverfew preparations might be effective," report Dr. E. Ernst and colleagues at the University of Exeter in the UK. "Yet, the evidence is far from compelling."

The researchers searched published literature for randomized, placebo-controlled, double-blind trials, the "gold standard" for determining if a treatment is indeed effective. They found only five studies that were well-designed.

"In view of the popularity of feverfew, perhaps the most striking finding is the paucity and low average quality of the existing randomized controlled trials on the subject," they report.

Side effects of feverfew -- such as mouth ulceration and gastrointestinal symptoms -- were usually mild, and occurred most often in long-time users. The data indicate that feverfew is safe, but Ernst's group would like to see studies conducted over a longer period of time.

Two of the five trials detected no differences between feverfew and placebo. Although the other three trials detected advantages of feverfew compared with placebo, there were some flaws in the studies.

Based on this review, the investigators conclude that the "data favor feverfew over placebo." But more study is needed to arrive at a definitive answer.

SOURCE: Cephalagia 1998;18:704-708.

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