Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Purple butterbur root (Petasites hybridus) has been used traditionally for various ailments, but its use for headache, specifically migraine prevention, is supported by a moderate level of scientific evidence. Several randomized, double-blind, placebo-controlled trials have evaluated standardized butterbur root extracts (notably Petadolex®) for migraine prophylaxis. The largest of these, published in Neurology (2004), found that a 75 mg dose twice daily significantly reduced the frequency of migraine attacks compared to placebo. Meta-analyses and systematic reviews, such as those published in Headache (2012), have concluded that butterbur extract can be effective in reducing headache frequency in migraine sufferers.

The mechanism is thought to involve anti-inflammatory and antispasmodic effects, likely due to active constituents called petasins. These effects may help reduce the triggers of migraine headaches. However, it is important to note that raw butterbur contains pyrrolizidine alkaloids (PAs), which are toxic to the liver; only PA-free extracts are considered safe for use. While evidence is stronger for migraine than for general headache, the moderate quality and consistency of clinical data justify a scientific rating. Nonetheless, authoritative bodies like the American Academy of Neurology have recommended butterbur for migraine prevention, but with caution regarding product purity and safety.

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