FEVERFEW: A HERBAL REMEDY FOR MIGRAINE? "Some of the world's most effective medicines began their careers as herbal remedies: digitalis came from foxglove, aspirin from willow bark, and morphine from poppy blossoms. Potentially the newest plant to cross over from folklore to mainstream treatment is a member of the chyrsanthemum family known as common feverfew or, botanically, Tanacetum parthenium. "The name 'feverfew' indicates the belief, dating from the middle ages, that the herb was a good treatment for fever and certain other ailments, including arthritis, psoriasis, and headaches. In modern England, eating feverfew leaves has become a familiar method for prevention migraine attacks, and there is now some reason to think that the folklore about feverfew has a grain or two of truth to it. Some people for whom the usual migraine treatments have not been very effective have turned to feverfew. The typical users eats 1-4 fresh leaves a day. Food is usually taken at the same time to mask the leaves' bitter taste. Tablets and capsules containing dried feverfew have also begun to appear in...health food store shelves. "To evaluate the remedy, a group of British researchers designed a controlled study. However, they did not feel free to give feverfew to people who had never taken it, because the agent has not gone through animal studies, as is appropriate before a drug is tested in people. But they hit on a human test of feverfew that was both rigorous and ethical. Many of the patients seen in the City of London Migraine Clinic had already been dosing themselves with feverfew for long periods of time as a way to reduce migraine attacks. So, instead of setting up a test in which the drug was GIVEN to subjects, investigators from the clinic set up a test in which feverfew was TAKEN AWAY. "The doctors identified patients who were dosing themselves with feverfew and asked them to participate in a study. During the research period, the subjects would take their medication either as freeze-dried herb or as a placebo (presented in identical-looking capsules). After a period on one preparation, they would switch to the other, and then repeat the two stages again. In this type of "double-blind crossover" test, neither researcher nor subject is told which treatment is being given. However, patients easily guessed when they were receiving placebo because the frequency of headache and nausea virtually tripled, and severity also increased markedly. These results support the claim that a daily dose of something contained in feverfew may be effective in preventing migraine attacks. "The people studied had no serious ill effects while taking feverfew, but that was to be expected, as they had been taking the herb for some time. People who had tried the plaint and then quit because they couldn't tolerate would have been excluded from this study. Feverfew is capable of producing rather marked allergic reactions; some people who try it develop sores in the mouth or, less commonly, a generalized inflammation of the mouth and tongue. This first test of the effectiveness of feverfew must be regarded as preliminary. It will no doubt lead to more thorough testing, as it should. Even if feverfew pans out as preventive medicine for migraine, it probably will not prove to be the 'answer.' But it may join the growing list of effective treatments for a very unpleasant disorder." Quoted from the April 1986 edition of the Harvard Medical School Health Letter, reporting on research appearing in the British Medical Journal, August 31, 1985.