CNS Drugs

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Phytomedicines in the Treatment of Migraine

  • Thilinie Rajapakse
  • William Jeptha Davenport
Leading Article


Migraine is a disabling neurovascular disorder with few targeted, tolerable and effective treatments. Phytomedicines, or plant-based medicinal formulations, hold great promise in the identification of novel therapeutic targets in migraine. Many patients also turn toward herbal and plant-based therapies for the treatment of their migraines as clinical and preclinical evidence of efficacy increases. Patients seek effective and tolerable treatments instead of or in addition to current conventional pharmacologic therapies. We review some phytomedicines potentially useful for migraine treatment—feverfew (Tanacetum parthenium), butterbur (Petasites hybridus), marijuana (Cannabis spp.), Saint John’s Wort (Hypericum perforatum) and the Damask rose (Rosa × damascena)—with respect to their mechanisms of action and evidence for treatment of migraine. The evidence for feverfew is mixed; butterbur is effective with potential risks of hepatotoxicity related to preparation; marijuana has not been shown to be effective in migraine treatment, and data are scant; Saint John’s Wort shows relevant physiological activity but is a hepatic enzyme inducer and lacks clinical studies for this purpose; the Damask rose when used in topical preparations did not show efficacy in one clinical trial. Other plant preparations have been considered for migraine treatment but most without blinded randomized, placebo-controlled trial evidence.


Compliance with Ethical Standards


No sources of funding were used to prepare this manuscript.

Conflict of interest

Thilinie Rajapakse and William Jeptha Davenport have no conflicts of interest that are directly relevant to the content of this study.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Thilinie Rajapakse
    • 1
    • 5
  • William Jeptha Davenport
    • 2
    • 3
    • 4
  1. 1.Division of Neurology, Department of PediatricsFaculty of Medicine and Dentistry, University of AlbertaEdmontonCanada
  2. 2.Department of Clinical NeurosciencesCumming School of Medicine, University of CalgaryCalgaryCanada
  3. 3.Department of Medical GeneticsCumming School of Medicine, University of CalgaryCalgaryCanada
  4. 4.Hotchkiss Brain Institute, University of CalgaryCalgaryCanada
  5. 5.Women and Children’s Research InstituteEdmontonCanada

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