Butterbur is an herb native to Europe, south western Asia, and north Africa. The leaf and root extracts of Butterbur contain a compound named petasin which has been used to treat allergies, bronchial asthma, headache, pain, and muscle and urinary tract spasms. Leaf and root extracts of Butterbur have been shown to be effective in clinical trials for migraines and asthma, and showed mixed results in the treatment of allergies. Butterbur is being used as an alternative to feverfew in the botanical treatment of migraines.

Feverfew is considered a remedy for inflammation in herbal supplementation. Modern science speculates that feverfew blocks serotonin, which is the cause for abnormal blood vessel dilation during a migraine. The active ingredient of feverfew is parthenolide – a powerful antioxidant compound which can assist with the prevention of blood clots and arthritis due to its anti-inflammatory properties. Although it was and still is considered to be a viable treatment for migraines, feverfew doesn’t seem to show consistency in its treatment effects. Butterbur has shown to be much more steadily effective in relieving migraine symptoms.

Some speculation exists a to how exactly butterbur works but the general consensus has lead to a belief that petasin in butterbur is responsible for the effects of relief. Petasin, one of the herb’s main compounds, reduces inflammation and may thereby prevent the swelling that leads to migraines. It has been shown to be most effective on chronic, debilitating migraines, not only reducing the instances of episodes but as well increasing the efficacy of regular pain management medication.

If you wish to sample the effects of butterbur you should contact your health provider to assure that it will not interfere with any medications you may be taking or your health. The raw butterbur plants also happen to contain excessive toxic pyrrolizidine alkaloids that can cause liver damage over an extended period of time. During laboratory creation of the butterbur extracts, this toxic compound is removed and the medicine is considered safe for use. Migraine medications which contain butterbur should only use the most reputable labs to avoid any toxin contamination.

Following are the studies conducted which report on the effectiveness of Butterbur in comparison to a placebo. Migraine treatment with a formula which contains butterbur, such as in Migravent, is considered to be more effective.

Grossman W, Schmidramsl H. An extract of Petasites hybridus is effective in the prophylaxis of migraine. Altern Med Rev 2001;6(3):303-10.
Sixty patients with migraine received either butterbur extract or placebo 50 mg twice daily for 12 weeks. Compared to baseline, the frequency of attacks with butterbur decreased by a maximum of 60%. Results were also significant in favor of butterbur extract for the prevention of migraines compared to placebo (p<0.05). Butterbur was well tolerated with no adverse effects.

Danesch UC. Petasites hybridus (Butterbur root) extract in the treatment of asthma–an open trial. Altern Med Rev 2004;9(1):54-62.
In a prospective, non-randomized open trial, 80 patients were treated for two months with butterbur extract followed by two months of optimal intake of extract. Patients had either mild or moderate asthma and were allowed to continue to receive their asthma medication. The number, duration, and severity of asthma attacks decreased, while peak flow, forced ecpiratory volume (FEV1) and all measured symptoms improved during therapy. Forty percent of patients who were receiving asthma medications reduced their intake of the medications during the course of the study. Adverse events were considered not related to the use of butterbur and did not lead to withdrawal of any subjects in the study.

Lee DK, Gray RD, Robb FM, et al. A placebo-controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis. Clin Exp Allergy 2004;34(4):646-9.
In a double-blind crossover placebo-controlled trial, 16 patients were randomized to receive butterbur 50 mg twice a day, fexofenadine 180 mg, or placebo. Peak nasal inspiratory flow (PNIF) was evaluated. There was a significant PNIF fall from baseline with butterbur compared to placebo. There was also a reduction in total nasal symptoms. Authors conclude that butterbur and fexofenadine may be equally effective in improving nasal symptoms in allergic rhinitis.