The use of herbal remedies, nutraceuticals, predates modern pharmacology. According to Winslow and Kroll (1998) consumers use nutraceutical because of cultural reasons, religious reasons, and belief that they are healthier than pharmacological interventions. There are fewer reports of negative effects with neutraceuticals. It is therefore not surprising that migraine sufferers turn to neutraceuticals as a popular CAM intervention. Nutraceuticals, considered a food supplement by the Food and Drug Administration are readily available in health food stores, pharmacies, and supermarkets. They are inexpensive and do not require a referral from the specialist or general medical provider. Taylor (2009) conducted a systematic review of neutraceuticals that included Petadolex, magnesium, feverfew and riboflavin. This study is important because it compares the effectiveness of various nutraceuticals. Petadolex, also known as P. hybridus or the butterbur root extract, has been used for migraine relief because of its combined anti-spasmodic, anti-inflammatory and calcium channel blocking effects. Some pharmaceuticals prescribed by medical providers also have these properties. Taylor reviewed the efficacy of magnesium. In a clinical report (as cited by Teitelbaum, 2007) there is circumstantial evidence that some the migraine sufferers have low levels of magnesium. Another nutraceutical that is popular for migraine relief is Feverfew, also called bachelor's button. Feverfew is an anti-inflammatory, which may inhibit chemicals that cause the blood vessels in the brain to spasm (Agosti, Duke, J.E Chrubasik, & S. Chrubasik, 2006). Riboflavin (Vitamin B2) has also been evaluated for its efficacy in migraine relief. The theoretical basis for using riboflavin is its ameliorating effect on the mitochondrial dysfunction that might be involved in the pathophysiology of migraines.
Despite the evidence, the use of nutraceuticals is largely trial and error. Consumers need to be aware of the potential hazards that neutraceutical pose, given the lack of quality control, information and research trials (Winslow & Kroll). The dangers of nutraceutical increase when they are used in conjunction with other prescription and non-prescription medications. In addition to nutraceuticals, consumers also turn to other CAM interventions in order to seek relief.
Agosti, R., Duke, R.K. Chrubasik, J.E. & Chrubasik, S. (2006). Effectiveness of Petasites hybridus preparations in the prophylaxis of migraine: A systematic review. Phytomedicine, 13(9-10), 743-746.
Taylor, F.R. (2009). Lifestyle changes, dietary restrictions, and neutraceuticals in migraine prevention. Techniques in Regional Anesthesia and Pain Management, 13, 28-37. doi:10.1053/j.trap.2009.03.008
Teitelbaum, J. (2007). Natural Rx for migraines. Townsend Letter: The Examiner of Alternative Medicine, 292(4), 121.
Winslow, L. C., & Kroll, D.J. (1998). Herbs as medicine. Archives of Internal Medicine, 158, 2192-2199.