Atropa belladonna (toxic): cerebral congestion, occipital, dull frontal with malaise, cool skin, mental sluggishness, unpleasant dreams (Ellingwood, pp. 182, 183)
Bryonia alba (toxic): migraine, frontal and orbital neuralgia, right-sided headache, tenderness on pressure, worse from motion (Kuts-Cheraux, p. 75; Ellingwood, p. 89)
Cimicifuga racemosa: congestive, from colds, rheumatic, menstrual (Harper-Shove, p. 36)
Cnicus benedictus: liver botanical
Gelsemium sempervirens (toxic): acute cerebral hyperemia, restlessness, excitability ( Ellingwood, pp. 73, 74, 77)
Lavandula officinalis: depressive headache, depression associated with digestive dysfunction (British Herbal Pharmacopoeia, p. 129)
Melilotus officinalis: certain idiopathic headaches, pain of, coldness, sore and tender to the touch (Felter and Lloyd, p. 1251; Kuts-Cheraux, p. 189)
Nepeta cataria: sedative, nervousness
Passiflora incarnata: nervous, debility, with fullness (Harper-Shove, p. 38)
Piscidia erythrina (toxic): neuralgia (Felter, p. 548)
Rosmarinus officinalis: migraine or hypertensive headache (British Herbal Pharmacopoeia, p. 181)
Salix spp.: anti-inflammatory, anodyne (Weiss, p. 303)
Scutellaria lateriflora: nervine
Sterculia acuminata (cola): migraine, depressive states (British Herbal Pharmacopoeia, p. 71)
Tanacetum parthenium (feverfew): migraine, especially if better for warm applications. Tanacetum inhibits the secretion of serotonin and other platelet granule constituents, decreases smooth muscle response to endogenous substances (norepinephrine, acetylcholine, bradykinin, prostaglandins, histamine, and serotonin), and inhibits the production of inflammatory substances (leukotrienes, thromboxanes). (Murphy JJ, et al. Lancet 1988 Jul 23;2(8604):189-192; JJohnson ES, et al. Br Med J (Clin Res Ed) 1985 Aug 31;291(6495):569-573; Barsby R, et al. Lancet 1991 Oct 19;338(8773):1015; Vogler BK, et al. Cephalalgia 1998 Dec;18(10):704-708.)
Valeriana spp.: sedative, stimulant, nervous excitability
Viscum flavescens, album (toxic): increased flow of blood to the brain, frequent headache and flushing of the face (Ellingwood, p. 153)
complementary herbs
consider: formula containing liver botanicals
can include synergists: Gelsemium sempervirens (toxic), Atropa belladonna (toxic), Bryonia alba (toxic), Hyoscyamus niger (toxic)
footnotes
Barsby R, Salan U, Knight DW, Hoult JR. Irreversible inhibition of vascular reactivity by feverfew. Lancet 1991 Oct 19;338(8773):1015. (Letter)
Abstract: Effects of a crude extract were found to have parthenolide and other a-methylene-lactones which inhibited the contractile response, of aortic muscle rings from rabbits, to serotonin, phenylephedrine, thromboxane A2 agent, and angiotensin ll. Note: These effects were not observed from dried feverfew leaves obtained commercially from a health food store.
Barsby RW, Salan U, Knight DW, Hoult JR. Feverfew and vascular smooth muscle: extracts from fresh and dried plants show opposing pharmacological profiles, dependent upon sesquiterpene lactone content. Planta Med 1993 Feb;59(1):20-25.
Abstract: Preparations of fresh or dried feverfew (Chrysanthemum parthenium) are widely consumed in the U.K. as a remedy for arthritis and migraine, but the pharmacological basis for this has not been established. We have, therefore, compared the properties of extracts of fresh plants with those of dried powdered leaves available commercially from health food shops. The two extracts differed radically in their content of alpha-methylbutyrolactones and in their pharmacological profile when tested in vitro on the rabbit aortic ring and rat anococcygeus preparations. Extracts of fresh leaves caused does- and time-dependent inhibition of the contractile responses of aortic rings to all receptor-acting agonists so far tested; the effects were irreversible and may represent a toxic modification of post-receptor contractile function in the smooth muscle. The presence of potentially -SH reactive parthenolide and other sesquiterpene alphamethylenebutyrolactones in these extracts, and the close parallelism of the actions of pure parthenolide, suggest that the inhibitory effects are due to these compounds. In contrast, chloroform extracts of dried powdered leaves were not inhibitory but themselves elicited potent and
sustained contractions of aortic smooth muscle that were not antagonised by ketanserin (5-HT2 receptor antagonist). These extracts did not contain parthenolide or butyrolactones according to a chemical-HPLC assay, We conclude that there are marked differences in the pharmacological potency and profiles between preparations from fresh and dried feverfew and that this may relate to their lactone content. As the effects of the lactones are potentially toxic, it will be necessary to compare the clinical profiles and side effects of preparations obtained from the two sources.
Groenewegen WA, Heptinstall S. A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro. J Pharm Pharmacol 1990 Aug;42(8):553-557.
Abstract: Extracts of the herb feverfew inhibit human blood platelet aggregation and secretion induced by a number of agents in-vitro and this may relate to the beneficial effects of feverfew in migraine. We previously identified several compounds with antisecretory activity in human blood platelets using adrenaline as the stimulant. In the present study, we have compared the inhibitory activity of one of these compounds, parthenolide, with that of crude feverfew extract. The effects of both on [14C]5-HT secretion from platelets and on platelet aggregation induced by a number of different stimulants were determined. The activating agents studied included the phorbol ester PMA, ADP, arachidonic acid, collagen, the thromboxane mimetic U46619, the calcium ionophore A23187, the diacylglycerol analogue OAG and adrenaline. The results show that there are marked similarities between the effects
of feverfew extract and of parthenolide on both [14C]5-HT secretion and platelet aggregation, which is consistent with the effects of feverfew extract on platelets being brought about by parthenolide or similar compounds in the extract. Only in one case, when A23187 was used as the stimulatory agent, was there any discrepancy, which may have been due to materials in the extract other than parthenolide. Both feverfew extract and parthenolide were more effective as inhibitors of the [14C]5-HT secretion and aggregation induced by some agents and not others, and were most effective as inhibitors of the [14C]5-HT secretion (but not the aggregation) induced by PMA. This suggests that the effects of feverfew/parthenolide on the protein kinase C pathway warrants further study.
Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J (Clin Res Ed) 1985 Aug 31;291(6495):569-573.
Abstract: Seventeen patients who ate fresh leaves of feverfew daily as prophylaxis against migraine participated in a double blind placebo controlled trial of the herb: eight patients received capsules containing freeze dried feverfew powder and nine placebo. Those who received placebo had a significant increase in the frequency and severity of headache, nausea, and vomiting with the emergence of untoward effects during the early months of treatment. The group given capsules of feverfew showed no change in the frequency or severity of symptoms of migraine. This provides evidence that feverfew taken prophylactically prevents attacks of migraine, and confirmatory studies are now indicated, preferably with a formulation controlled for sesquiterpene lactone content, in migraine sufferers who have never treated themselves with this herb.
Notes: An initial survey found that 70% of 270 migraine sufferers who had eaten feverfew daily for prolonged periods of time had both decreased frequency and severity of migraine headaches. In a double blind study, patients who believed they received help from the herb received either the herb or a placebo. Most of the patients who were on the placebo had significant increase in the frequency and severity of headaches along with nausea and vomiting during the 6 months of the study, while patients taking the feverfew showed no change in the frequency or severity of their symptoms. 2 patients in the placebo group, who had been in complete remission during self-treatment with fever few leaves, developed recurrences of incapacitating migraines and had to withdraw from the study. The resumption of the herb in these 2 patients led to renewed remission of symptoms in both patients.
Murphy JJ, Heptinstall S, Mitchell JR. Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet 1988 Jul 23;2(8604):189-192.
Abstract: The use of feverfew (Tanacetum parthenium) for migraine prophylaxis was assessed in a randomised,double-blind, placebo-controlled crossover study. After a one-month single-blind placebo run-in, 72 volunteers were randomly allocated to receive either one capsule of dried feverfew leaves a day or matching placebo for four months and then transferred to the other treatment limb for a further four months. Frequency and severity of attacks were determined from diary cards which were issued every two months; efficacy of each treatment was also assessed by visual analogue scores. 60 patients completed the study and full information was available in 59. Treatment with feverfew was associated with a reduction in the mean number and severity of attacks in each two-month period, and in the degree of vomiting; duration of individual attacks was unaltered. Visual analogue scores also indicated a significant improvement with feverfew. There were no serious side-effects.
Sumner H, Salan U, Knight DW, Hoult JR. Inhibition of 5-lipoxygenase and cyclo-oxygenase in leukocytes by feverfew. Involvement of sesquiterpene lactones and other components. Biochem Pharmacol 1992 Jun 9;43(11):2313-2320.
Abstract: Leaves or infusions of feverfew, Tanacetum parthenium, have long been used as a folk remedy for fever, arthritis and migraine, and derived products are widely available in U.K. health food shops. Previous reports have suggested interactions with arachidonate metabolism. Crude chloroform extracts of fresh feverfew leaves (rich in sesquiterpene lactones) and of commercially available powdered leaves (lactone-free) produced dose-dependent inhibition of the generation of thromboxane B2 (TXB2) and leukotriene B4 (LTB4) by ionophore- and chemoattractant-stimulated rat peritoneal leukocytes and human polymorphonuclear leukocytes. Approximate IC50 values were in the range 5-50 micrograms/mL, and inhibition of TXB2 and LTB4 occurred in parallel. Isolated lactones (parthenolide, epoxyartemorin) treated with cysteine (to neutralize reactive alpha-methylene butyrolactone functions of the sesquiterpenes). Inhibition of eicosanoid generation appeared to be irreversible but not time-dependent. We conclude that feverfew contains a complex mixture of sesquiterpene lactone and non-sesquiterpene lactone inhibitors of eicosanoid synthesis of high potency, and that these biochemical actions may be relevant to the claimed therapeutic actions of the herb.
Vogler BK, Pittler MH, Ernst E. Feverfew as a preventive treatment for migraine: a systematic review. Cephalalgia 1998 Dec;18(10):704-708. (Review)
Abstract: BACKGROUND: Feverfew is a popular herbal remedy advocated for the prevention of migraine. AIM: The aim of this systematic review was to look at the evidence for or against the clinical effectiveness of feverfew in migraine prevention. DATA SOURCES: Literature searches were performed using the following databases: Medline, Embase, Biosis, CISCOM, and the Cochrane Library (all from their inception to April 1998). STUDY SELECTION: Only randomized, placebo-controlled, double-blind trials were included. DATA EXTRACTION: All articles were read by two independent reviewers. Data were extracted in a predefined, standardized fashion. The methodological quality of all trials was evaluated using the Jadad score. MAIN RESULTS: Five trials met the inclusion/exclusion criteria. The majority favor feverfew over placebo. Yet important caveats exist. CONCLUSION: The clinical effectiveness of feverfew in the prevention of migraine has not been established beyond reasonable doubt.
Waller PC, Ramsay LE. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J (Clin Res Ed) 1985 Oct 19;291(6502):1128. (Letter)