Vitamin B2 or Riboflavin is found in dairy products, eggs, meat, green leafy vegetables and whole grain foods. Vitamin B2 is suggested to keep up energy production within brain cells. In a controlled study, 400mg a day of Vitamin B2 was added to the diet of 49 patients for 3 months. The group experienced a 68.2% reduction in the incidence of migraine symptoms. The researchers concluded that high-dose riboflavin is an effective, low cost prophylactic treatment of migraine devoid of short-term side effects. (Schoenen, J., Lenaerts, M., and Bastings, E. High-dose riboflavin as a prophylactic treatment of migraine; results of an open pilot study. Cephalagia, 14: 328-29, 1994.)

White Willow Bark Extract is derived from the white willow tree (Salix alba) The bark has been used for centuries in China to relieve pain and lower fever. The active ingredient in White Willow Bark is salicin, which the body converts to salicylic acid. It works in essentially the same way as aspirin, however, most aspirin is now synthetically manufactured, while White Willow is natural. It is not surprising that White Willow is often referred to as " herbal aspirin."

White Willow Bark has anti-inflammatory properties and helps to relieve headaches. White Willow Bark takes longer to begin acting than aspirin, but its effect may last longer. Moreover, unlike aspirin, it does not cause stomach bleeding nor does it have any other known adverse effects when taken as recommended. Overdoses of willow bark may cause skin rash, stomach inflammation/irritation, nausea, vomiting, kidney inflammation, and tinnitus (ringing in the ears). (Chrubasik S., Eisenburg E., Balan E., Weinberger T., Luzzati R., Conradt C. Treatment of low back pain exacerbations with willow bark extract: a randomized double blind study. Am J Med.; 109:9-14, 2000).

DLPA (DL-Phenylalanine) is a pain reliever. DLPA contains the amino acid, phenylalanine. Phenylalanine comes in two forms. The "L" form is a natural substance found in protein-rich foods, while the "D" form is made synthetically. The combination of the "D" and "L" forms simultaneously help elevate mood, and combat pain. DLPA boosts the body's natural pain-killing response. Avoid taking DLPA with prescription antidepressants or stimulants, unless specifically instructed to do so by your doctor. (Budd K. Use of D-phenylalanine, an enkephalinase inhibitor, in the treatment of intractable pain. Adv Pain Res Ther; 5:305-8, 1983).

Feverfew Standardized Extract (Tanacetum parthenium) has a long history of use for the prevention of migraine headaches. It was described in European herbal literature as early a 1772. Feverfew inhibits both hyperaggregation of platelets and the release of serotonin. (Heptinstall S., White A., et al. Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leukocytes. Lancet, I: 1071-74, 1985). Double blind studies indicate that feverfew taken daily decreases the frequency and severity of migraine headaches. A study conducted at University Hospital in Nottingham, England utilized 72 volunteers. They were given either feverfew or a placebo over a period of eight months. The study concluded that treatment with feverfew was associated with a reduction in the number and severity of attacks. There were no serious side effects. In another double-blind, placebo-controlled study, 57 volunteers were divided into two groups and were given feverfew or a placebo. The results showed that feverfew caused a significant reduction in pain intensity compared to the placebo treatment. (Murphy J.J., and Mitchell J.R. Randomized double-blind placebo controlled trial feverfew in migraine prevention. Lancet, 2 [8604], 189-92, Jul 23,1988, and Palevitch D., Earon G., and Carasso R. Feverfew as a prohylactic treatment for migraine: A double-blind placebo-controlled study. Phytotherapy Research, 11:7,508-11,1997.)

Valerian Root is most often used to treat anxiety, nervous tension, insomnia, and headaches. The sedative action of valerian is partially due to valepotriates, epoxy-iridoid esters, found in the root. Valepotriates have more than just sedative properties, as their primary role appears to be the regulatory effects on the autonomic system. The relief of stress and tension may decrease the number and severity of headaches. Valerian root also contains alkaloids that have blood pressure lowering effects. This may be particularly important in reducing the severity of headaches. (Carvalho, A. P., A. P. Cunha, F. Ferreira, T. Macedo, C. F. Ribeiro, M. S. Santos. Synaptosomal GABA release as influenced by valerian root extract-involvement of the GABA carrier. Arch Int Pharmacodyn Ther 327(2):220-31, 1994).

Skullcap (Scutellaria lateriflora) is a member of the mint family. One of its constituents, scutellarian, has been shown to have mild sedative and antispasmodic actions. (Foster S. Herbs for Your Health. Loveland, CO: Interweave Press, 86-7, 1996). Because of its sedative properties, Skullcap is most commonly used for anxiety, insomnia, pain, and tension headaches.

Passion Flower (Passiflora incarnata) is most often used to treat anxiety. A double- blind study published in 2001 confirmed the effectiveness of Passion Flower as a treatment for anxiety. (Akhondzadeh S, Naghavi HR, Vazirian M, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther; 26:363-7. 2001). Recent studies indicate the primary constituents responsible for the relaxing and anti-anxiety effects of Passion Flower are flavonoids. Passion Flower is often used in combination with Valerian and Skullcap.

References

Akhondzadeh S, Naghavi HR, Vazirian M, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther; 26:363-7, 2001.

Albrecht M. Psychopharmaceuticals and safety in traffic. Z Allg Med; 71:1215-21, 1995.

Andreatini R, Leite JR. Effect of valepotriates on the behavior of rats in the elevated plus-maze during diazepam withdrawal. Eur J Pharmacol; 260: 233-5, 1994.

Andreatini R, Sartori VA, Seabra ML, Leite JR. Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study. Phytother Res; 16:650-4, 2002.

Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. JAMA; 286:208-16, 2001.

Anonymous. Phenylalanine fails to help chronic back pain patients. Fam Pract News; 17:37, 1987.

Balderer G, Borbely AA. Effect of valerian on human sleep. Psychopharmacology; 87:406-9, 1985.

Bisset NG. Herbal Drugs and Phytopharmaceuticals. Stuttgart, Germany: Medpharm Scientific Publishers; 437-439, 1994. v Blaschek W, von Bruchhausen F, Ebel S, et al. Hagers Handbuch der Pharmazeutischen Praxis [in German]. Berlin, Germany: Springer; 469-477, 1998.

Blumenthal M. German Federal Institute for Drugs and Medical Devices. Commission E. The Complete German Commission E monographs: therapeutic guide to herbal medicines. Austin, Tex: American Botanical Council: 227, 1998.

Blumenthal M. The Complete German Commission E Monographs. Austin, Tex: American Botanical Council. Boston: Integrative Medicine Communications; 1998.

Bradley PR. British Herbal Compendium. Volume 1. London: British Herbal Medicine Association; 1997.

Budd K. Use of D-phenylalanine, an enkephalinase inhibitor, in the treatment of intractable pain. Adv Pain Res Ther 1983; 5:305-8.

Burkhart CG, Burkhart CN. Phenylalanine with UVA for the treatment of vitiligo needs more testing for possible side effects. J Am Acad Dermatol; 40:1015 [letter], 1999.

Chrubasik S, Eisenburg E, Balan E, Weinberger T, Luzzati R, Conradt C. Treatment of low back pain exacerbations with willow bark extract: a randomized double blind study. Am J Med.; 109:9-14, 2000.

Chrubasik S. Pain therapy using herbal medicines [abstract]. Gynakologe; 33(1): 59-64, 2000.

Cropley M, Cave Z, Ellis J, Middleton RW. Effect of kava and valerian on human physiological and psychological responses to mental stress assessed under laboratory conditions. Phytother Res ;16:23-7, 2002.

Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots I. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry; 33:47-53, 2000.

Duke J. Dr. Duke's Phytochemical and Ethnobotanical Database. Beltsville, Md: USDA; 2000. U.S. Department of Agriculture website: http://www.ars-grin.gov/duke. Accessed on April 26, 2001.

Ernst E, Chrubasik S. Phyto-anti-inflammatories. A systematic review of randomized, placebo-controlled, double-blind trials. Rheum Dis Clin North Am. 26(1):13-27, 2000.

Fischer E, Heller B, Nachon M, Spatz H. Therapy of depression by phenylalanine. Arzneimittelforschung 25:132. 1975.

Fisher AA, Purcell P, Le Couteur DG. Toxicity of Passiflora incarnata L. J Toxicol Clin Toxicol; 38:63-6, 2000.

Foster S, Duke JA. A Field Guide to Medicinal Plants and Herbs of the Eastern and Central US. Boston, Mass: Houghton Mifflin: 321-323, 2000.

Gao Z, Huang K, Xu H. Protective effects of flavonoids in the roots of Scutellaria baicalensis Georgi against hydrogen peroxide-induced oxidative stress in HS-SY5Y cells. Pharmacol Res.; 43(2): 173-178, 2001.

Garges HP, Varia I, Doraiswamy PM. Cardiac complications and delirium associated with valerian root withdrawal. JAMA; 280:1566-7, 1998.

Gessner B, Klasser M. Studies on the effect of Harmonicum Much on sleep using polygraphic EEG recordings [in German]. EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb; 15: 45-51, 1984.

Gruenwald J, Brendler BA, Christof J, et al. PDR for Herbal Medicines. Montvale, NJ: Medical Economics; 1111-1112 1999. Gruenwald J, Brendler T, Christof J. PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical Economics Company: 678-679, 2000.

Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm.; 57(13): 1221-1227, 2000.

Hoffman D. The Complete Illustrated Holistic Herbal. A Safe and Practical Guide to Making and Using Herbal Remedies. Brisbane, Australia: Element Books Limited; 1996.

Hoffmann D. Therapeutic Herbalism. Santa Cruz, Calif: Therapeutic Herbalism Press; 2000.

Houghton PJ. The scientific basis for the reputed activity of Valerian. J Pharm Pharmacol 1999;51:505-12, 1999.

Hsu Hong-Yen, Chen Yuh-Pan. Oriental Materia Medica: A Concise Guide. Long Beach Calif: Oriental Healing Arts Institute; 1986.

Huang RL, Chen CC, Huang HL, Chang CG, Chen CF, Chang C, Hsieh MT. Anti-hepatitis B virus effects of wogonin isolated from Scutellaria baicalensis. Planta Med; 66(8): 694-698, 2000.

Ikemoto S, Sugimura K, Yoshida N, et al. Antitumor effects of Scutellariae radix and its components baicalein, baicalin, and wogonin on bladder cancer cell lines. Urology; 55(6): 951-955, 2000.

Kamm-Kohl AV, Janson W, Brockmann P. Moderne baldriantherapie gegen vervose storungen im senium. Med Welt; 35:1450-4, 1984.

Kohnen R, Oswald WD. The effects of valerian, propranolol, and their combination on activation, performance, and mood of healthy volunteers under social stress conditions. Pharmacopsychiatry; 21:447-8, 1988.

Kuhlmann J, Berger W, Podzuweit H, Schmidt U. The influence of valerian treatment on "reaction time, alertness and concentration" in volunteers. Pharmacopsychiatry; 32:235-41, 1999.

Kuhn MA, Winston D. Herbal Therapy and Supplements. Philadelphia, Pa: Lippincott; 2001.

Lad V, Frawley D. The Yoga of Herbs. Santa Fe, NM: Lotus Press; 1986.

Larrey D, Vial T, Pauwels A, et al. Hepatitis after germander (Teucrium chamaedrys) administration: another instance of herbal medicine toxicity. Ann Coll Physicians. ; 117: 129-132, 1992.

Leathwood PD, Chauffard F, Heck E, Munoz-Box R. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol Biochem Behav; 17:65-71, 1982.

Leathwood PD, Chauffard F. Aqueous extract of valerian reduces latency to fall asleep in man. Planta Med ;(2): 144-8, 1985.

Leathwood PD, Chauffard F. Quantifying the effects of mild sedatives. J Psychiatr Res; 17:115-22, 1982-83.

McGuffin M, Hobbs C, Upton R, Goldberg A. eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, Fla: CRC Press;: 101, 1997.

Meier B. Passiflora incarnata L.-Passion flower: Portrait of a medicinal plant. Zeitschrift Phytother;16:115-26, 1995.

Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician's Guide. New York, NY: Pharmaceutical Products Press; 1998.

Mills S. The Dictionary of Modern Herbalism. Rochester, Vt: Healing Arts Press; 1988.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 206-7, 1996.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London, England: The Pharmaceutical Press: 268-270. 1996.

Newmark TM, Schulick P. Beyond Aspirin: Nature's Answer to Arthritis, Cancer & Alzheimer's Disease. Prescott, Ariz: Hohm Press; 2000.

Ortiz JG, Nieves-Natal J, Chavez P. Effects of Valeriana officinalis extracts on [3H] flunitrazepam binding, synaptosomal [3H] GABA uptake, and hippocampal [3H] GABA release. Neurochem Res; 24:1373-8, 1999.

Poyares AR, Guilleminault C, Ohayon MM, Tufik S. Can valerian improve the sleep of insomniacs after benzodiazepine withdrawal? Prog Neuropsychopharmacol Biol Psychiatry; 26:539-45, 2002.

Sabelli HC. Clinical studies on the phenylethylamine hypothesis of affective disorder: urine and blood phenylacetic acid and phenylalanine dietary supplements. J Clin Psychiatry ;47:66-70, 1986.

Schilcher H. Phytotherapy in Paediatrics: Handbook for Physicians and Pharmacists. Stuttgart, Germany: Medpharm; 1997.

Schulz H, Stolz C, Muller J. The effect of valerian extract on sleep polygraphy in poor sleepers: a pilot study. Pharmacopsychiatry; 27:147-51, 1994.

Schulz V, Hänsel R, Tyler VE. Rational phytotherapy: a physician's guide to herbal medicine. Berlin: Springer: 81, 1998.

Stevinson C, Ernst E. Valerian for insomnia: a systematic review of randomized clinical trials. Sleep Med; 1:91-9, 2000.

Vorbach EU, Gortelmeyer R, Bruning J. Therapy of insomnia. The efficacy and tolerability of valerian [in German]. Psychopharmakotherapie; 3: 109-15, 1996.

Weiss RF; Meuss AR, trans. Herbal Medicine. Beaconsfield, England: Beaconsfield Publishers;: 302-303, 1994.

Wichtl M. Herbal Drugs and Phytopharmaceuticals. Boca Raton, FL: CRC Press, 363-5, 1994.

Ziegler G, Ploch M, Miettinen-Baumann A, Collet W. Efficacy and tolerability of valerian extract LI 156 compared with oxazepam in the treatment of non-organic insomnia: a randomized, double-blind, comparative clinical study. Eur J Med Res; 25:480-6, 2002.