A recent study utilizing air-dried feverfew leaf (Tanacetum parthenium (L.) Schultz-Bip. [Asteraceae]) supports its prophylactic use against migraine (Palevitch et al., 1997). The study, conducted at the Hillel Yaffe Hospital, Hadera, Israel, involved 57 patients (47 female and 10 male), median age 38 (9-65 years), selected at random and treated for two months with daily doses of 100 mg feverfew leaf (two 50 mg capsules a day). Patients were then divided into two groups and examined for an additional two months under a double-blind, placebo-controlled, cross-over regimen utilizing dried parsley leaf capsules as placebo. Significant reductions were observed in pain intensity and the severity of other typical symptoms of migraine headache attacks, such as nausea, vomiting, and sensitivity to noise and light. No mention is made of any effect on the frequency of attacks.

The authors of this report were apparently unaware of the results of the Dutch study using an ethanol extract of feverfew leaves, which yielded no prophylactic effect. (deWeerdt et al., 1996 -- see HerbalGram 41, pp. 16-17.) The authors also incorrectly state in their introduction that feverfew preparations "have long been used as a self-medication in the prevention of migraine . . . ."Actually, such use was only popularized in the 1970s (Johnson, 1984). Palevitch and colleagues also incorrectly assert that "Controlled clinical trials which encompassed feverfew leaves and extracts (author's emphasis) have been conducted in England (Johnson et al., 1985; Murphy et al., 1988). Both British studies employed whole feverfew leaf, freeze-dried and air-dried, respectively. No feverfew extract had been clinically evaluated before the Dutch trial.

In addition, the researchers erroneously claim that their study "is the first to be conducted among patients who had never taken feverfew before." In fact, the Murphy, Heptinstall, and Mitchell study of 1988 reported on 59 patients, only 17 of whom had previously used feverfew -- and only one of the 50 patients involved in the Dutch trial of feverfew extract had ever taken feverfew!

The positive results regarding relief of migraine symptoms are interesting on a number of counts. All the British-grown feverfew used in the earlier British trials was likely quite similar, whereas the feverfew leaf used in the subject study was obtained from plants grown from seeds purchased from the Netherlands and grown in Israel. The moderately high level of the sesquiterpene lactone parthenolide (0.2 percent) in the present study, compared with 0.42 percent, 0.66 percent, and 0.35 percent for the previous trial formulations, suggests that the feverfew was derived from the same chemotype. It also points to the non-sesquiterpene lactone complement of feverfew's chemical profile as the probable source of the therapeutic principle(s) responsible for migraine prophylaxis -- ever mindful of the reported ineffectiveness of the Dutch leaf extract preparation. The 0.2 percent level of parthenolide present in this last preparation is quite coincidentally exactly the level arbitraril y established by Canada's Health Protection Branch in 1992 as an identity criterion for efficacious feverfew leaf.

[deWeerdt, C.J., H.P.R. Bootsma, H. Hendricks. 1996. Randomized double-blind placebo controlled trial of a feverfew preparation. Phytomedicine, Vol. 3, No. 3, 225.

Johnson, S. Feverfew: A traditional herbal remedy for migraine and arthritis. London: Sheldon Press 1984, 19.]

Johnson, E.S., N.P. Kadam, D.M. Hylands, P.J. Hylands. 1985. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J, Vol. 291, 569-573.

Murphy, J.J., S. Heptinstall, J.R.A. Mitchell. 1988. Randomized double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet, Vol. 8601,189-192.

Palevitch, D., G. Earon, R. Carasso. 1997. Feverfew (Tanacetum parthenium) as a prophylactic treatment for migraine: A double-blind placebo-controlled study. Phytotherapy Research, Vol. 11, 508-511.]

Article copyright American Botanical Council.

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By Dennis V.C. Awang