Complementary and alternative medicine for the prevention and treatment of migraine headache: an overview of systematic reviews

Background Complementary and alternative medicine (CAM) is very popular among migraineurs. Objectives The aim of this article is to summarise and critically evaluate the evidence from systematic reviews (SRs) of CAM for the prevention and treatment of migraine headache. Method Ten electronic databases were searched from 1946 to August 2014. Retrieved papers were also hand‐searched for relevant references. Systematic reviews were eligible for inclusion if they reported the prevention and treatment of migraine headache using any type of CAM. Oxman criteria were used to appraise the methodological quality of the included SRs. Results Thirty‐three SRs, with a total of 45 886 migraine sufferers, were included in the analyses. The majority (64%) of the SRs were of high methodological quality (mean Oxman score=4.87, SD=3.96). Most (60.6%) SRs arrived at positive conclusions (16 of which were of high quality); two (6.0%) SRs arrived at negative conclusions (of which one was of high quality), and 11 (33.3%) arrived at equivocal conclusions (of which four were of high quality). The majority of the high‐quality SRs (Oxman score=6–9) were based on moderate‐quality RCTs. For multiple SRs, unanimously positive conclusions were reached for acupuncture and biofeedback. There was conflicting evidence regarding the effectiveness of homeopathy, herbal medicines such as Petasites hybridus and Tanacetum parthenium L., and spinal manipulative therapy. Conclusion The evidence from SRs evaluating the effectiveness of CAM for the prevention or treatment of migraine headache is mostly positive. However, several caveats should be taken into account, and only for acupuncture and biofeedback are the conclusions unanimously positive.