Does Butterbur Prevent Migraine Attacks?

A migraine attack is debilitating head pain in which your head throbs intensely. Other common symptoms include nausea, vomiting, and extreme sensitivity to light and sound. In most cases, these episodes last for a few hours to a few days (2, 3).

Butterbur extract, which is made from the leaves and roots of the butterbur plant, may help reduce the frequency of migraine attacks.

That’s because it contains a family of compounds called petasins, which have anti-inflammatory, anti-spasm, and blood vessel-widening properties (4, 5).

These properties may lower migraine attack frequency by decreasing inflammation, relaxing your muscles, and widening your blood vessels, which may decrease pressure or tension in the head to relieve pain (4, 5).

Keep in mind that studies in butterbur largely haven’t been done since the early 2000s due to concerns over its safety.

Still, in one of these studies, 108 children with migraine were given 50–150 mg of butterbur root extract per day depending on age. After 4 months, 77% reported at least a 50% reduction in the frequency of migraine attacks (6).

In another study, 58 children with migraine were given either butterbur root extract at 50–100 mg per day, music therapy, or a placebo for 12 weeks (7).

Both butterbur and music therapy led to significant reductions in migraine attack frequency up to 6 months after the study, compared with the placebo group (7).

In a randomized, 4-month study of 245 adults with migraine, researchers gave them either butterbur extract (50 or 75 mg per day) or a placebo. Both doses of butterbur extract demonstrated significant reductions — 36% and 48%, respectively — in migraine attacks (8).

Other studies have also found butterbur to be effective at reducing the frequency of migraine attacks (9, 10, 11).

Despite promising results, safety concerns have led most healthcare professionals to discourage butterbur as a treatment for migraine.

Summary

Butterbur extract has been shown to reduce the frequency of migraine attacks. However, due to safety concerns, it’s not widely recommended.

Though butterbur was once given a level A recommendation — indicating strong evidence to support its use — by the American Academy of Neurology and the American Headache Society, that’s no longer the case.

These organizations retracted their recommendation in 2015 due to concerns about severe liver toxicity (12, 13).

Butterbur contains pyrrolizidine alkaloids (PAs), which are toxic to the liver and have been shown to cause cancer. In fact, in the United Kingdom and Germany, butterbur is not authorized for use due to its safety concerns (13, 14, 15).

Further, common side effects of butterbur include indigestion, headache, fatigue, drowsiness, skin irritation or rash, stomach upset, belching, and diarrhea (13).

That said, you can purchase butterbur extract that’s free of PAs in the United States and Canada. Before buying, make sure that the label says “PA-free” or “free of pyrrolizidine alkaloids” and comes from a reputable company (13, 14, 15).

For example, Petadolex is a PA-free butterbur product. Nonetheless, some reports suggest it may cause liver toxicity when taken with other medications (16, 17).

Before trying butterbur, it’s important to monitor your liver function with a healthcare professional and discuss medications and supplements that may interact with butterbur, such as St. John’s wort (13, 16).

Due to lack of research, it’s unknown whether butterbur can cause harm during pregnancy or while breastfeeding. For that reason, it’s advised to avoid butterbur if you’re pregnant or breastfeeding (13, 16).

In addition, some research suggests that there is potential for butterbur to react with anticholinergic medications like atropine. If you’re currently taking these medications, avoid butterbur (18).

If you’re interested in trying butterbur for migraine, it’s best to first talk with your healthcare professional. They can help identify any potential interactions or suggest alternative treatments for you.

Summary

Butterbur contains PAs, which are compounds linked to liver toxicity and cancer. If you choose to take butterbur, talk with your healthcare professional and make sure that the product is PA-free.

Though no cure exists for migraine, many treatments and lifestyle modifications may help manage your symptoms (19, 20, 21, 22).

These can include rest, which requires lying down in a dark, quiet room; and tactile relief, which involves taking a cold compress to your forehead or the back of your neck.

The following treatments may also provide relief:

• Stress management: therapy, yoga, meditation
• Lifestyle modifications: exercise, diet, supplements, stopping smoking, stopping drinking
• Alternative treatments: acupuncture, acupressure, massage therapy, Botox injections, biofeedback, aromatherapy
• Over-the-counter pain medications: aspirin (Bayer), ibuprofen (Motrin), acetaminophen (Tylenol), naproxen (Aleve)
• Prescription medications: ergotamines, triptans, dihydroergotamine (Migranal), anti-nausea drugs, antidepressants, beta-blockers, calcium channel blockers
• Other options: hormonal therapy

There are many types of migraine, such as acute and chronic migraine, optic migraine, vestibular migraine, hormonal migraine, and stress migraine. Each of these may have different causes.

If you’re experiencing recurring migraine attacks, your healthcare professional can help identify the type and cause. This will help you determine the best course of treatment.

Summary

There’s no cure for migraine, but several lifestyle changes may alleviate your symptoms. Migraine may require various treatments, depending on the type.

Butterbur is a traditional medicine used to treat migraine.

Numerous studies demonstrate that butterbur may help reduce the frequency of migraine attacks. However, butterbur comes with serious side effects, so you probably shouldn’t try it.

Safer migraine treatments include over-the-counter and prescription medications, lifestyle modifications, and alternative treatments like acupuncture and meditation.

If you experience recurring migraine attacks, talk with a healthcare professional to determine the best treatment.