butterbur (Petasites hybridus) in prevention of migraine

Last reviewed 01/2018

There is evidence regarding the effectiveness of Petasites hybridus root (butterbur) as a prophylactic treatment for migraine:

• three-arm, parallel-group, randomized trial comparing Petasites extract 75 mg bid, Petasites extract 50 mg bid, or placebo bid in 245 patients with migraine
• patients met International Headache Society criteria for migraine, were ages 18 to 65, and had at least two to six attacks per month over the preceding 3 months
• main outcome measure was the decrease in migraine attack frequency per month calculated as percentage change from baseline over a 4-month treatment period
  • over 4 months of treatment, in the per-protocol analysis
    • migraine attack frequency was reduced by 48% for Petasites extract 75 mg bid (p = 0.0012 vs placebo), 36% for Petasites extract 50 mg bid (p = 0.127 vs placebo), and 26% for the placebo group
  • most frequently reported adverse reactions considered possibly related to treatment were mild gastrointestinal events, predominantly burping
• the study authors concluded that Petasites extract 75 mg bid is more effective than placebo and is well tolerated as a preventive therapy for migraine. Petasites 50 mg PO bid was not significantly more effective than placebo on the primary study endpoints

Reference:

1. Lipton RB et al. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology 2004;63:2240-4