ABSTRACT
Feverfew (Tanacetum parthenium) has been used since antiquity for a variety of medicinal purposes, prominent among them being alleviation of fever, headache, and women’s ailments. Claims of efficacy are almost invariably anecdotal. However, over the past two decades, randomized controlled trials have been conducted in the prophylaxis of migraine and treatment of rheumatoid arthritis. While the quality of these trials is varied, there is good evidence of feverfew’s potential in migraine: statistically significant reduction in frequency and severity of attacks and degree of nausea and vomiting has been observed following administration of feverfew leaf. While it is said that more people in the U.K. currently self-medicate with feverfew for arthritis than for migraine, no clear benefit has been demonstrated in the single clinical trial conducted with rheumatoid arthritic patients. Neither the constituent(s) of feverfew nor the mechanism(s) of action is=are yet known. Parthenolide, the dominant sesquiterpene lactone (STL) constituent of the clinically tested sesquiterpene chemotype, and long considered the active antimigraine principle, is no longer considered to be a significant contributor in that respect. Also, the latest trial, using a supercritical carbon dioxide extract of feverfew leaf, lends promise to the development of a reliably consistent and effective standardized preparation. No serious adverse reactions have been recorded, although the development of mouth ulcers has caused a small percentage of consumers to discontinue treatment. No drug interactions have been observed so far.
