I suffer from migraines. I am taking medication daily that has helped a great deal but I would like to start taking the herbal treatment feverfew, as I heard that this is effective for migraines. Is it safe to take this with my migraine tablets, Pizotifen?

Feverfew leaves have been used as a remedy for headaches for many years, but have recently been found in a number of trials to be especially effective in treating migraines.

Pizotifen is a good preventative treatment for migraine and is usually taken for several months before it is gradually discontinued, in the hope that the migraine attacks will have stopped. As with most medication taken long-term, it is best to gradually discontinue the Pizotifen rather than to stop taking it suddenly.

My advice would be to reduce the dose slowly, either by taking lower dose tablets daily, or by taking the same dose less frequently over a period of two or three weeks.

It is best to leave a "washout" period of at least three-to-four weeks between stopping the Pizotifen and starting the feverfew. This will help you gauge whether or not the migraines return after the Pizotifen and how effective the feverfew is once you have started it.

Avoid taking feverfew with "blood-thinning"medications, such as aspirin, warfarin and non-steroidal anti-inflammatory drugs such as ibuprofen.

I read that magnesium can help treat migraine. Are there other supplements that you recommend?

Yes, magnesium sulphate supplements look promising. Magnesium is a mineral found naturally in foods such as green leafy vegetables, nuts, seeds and wholegrains. If you decide to take magnesium, supplements should not exceed 600mg a day. Do not take it with medications for osteoporosis, high blood pressure or diuretics.

Co-enzyme Q10 supplements can also help some people. Vitamin B2 (riboflavin) can also help by correcting tiny deficiencies in the brain cells.

I don't sleep very well, could this be why I get migraines?

Lifestyle factors such as a poor sleep pattern, certain foods, and stress are all implicated in bringing on an attack of migraine. Keep a headache diary which will help determine if any of the above are involved.

Of course, it helps to improve the quality of your sleep, which, in turn can help prevent migraines. Massage may help, as will keeping a regular bed-time. Get enough sleep, but don't oversleep. Reduce stress. Try yoga, acupuncture, or bio-feedback -- this encompasses a range of relaxation therapies, designed to control the body's response to stress.

The above treatments offer additional relief and will work better if integrated into your overall care. Always tell your doctor of non-drug treatments you are trying.

- Niamh Houston