a
Department of Phytopharmaceuticals (Traditional Pharmacy), School
of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
b Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
c Center for Nanotechnology in Drug Delivery, Shiraz University of Medical Sciences, Shiraz, Iran
b Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
c Center for Nanotechnology in Drug Delivery, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Ethnopharmacological relevance In Persian ethnomedicine
several herbal remedies and functional foods have been used to treat
migraine headache which are mostly summarized in Qarabadin-e-kabir
(Aghili-Shirazi MH, 1773). One of them is Citron syrup
(Sharbat-e-Balang) containing edible Citrus medica L. fruit juice and
sugar. The present study was designed to assess the efficacy and safety
of Citron syrup on patients with migraine headache. Materials and
methods Citron syrup was prepared as described in Qarabadin-e-kabir. In
this double blind randomized placebo-controlled clinical trial, ninety
patients with migraine headache were allocated to three parallel groups
(Citron syrup, propranolol or placebo). Patients received 15 ml of
Citron syrup, placebo syrup or 20 mg of propranolol tablet three times
daily after a meal for 4 weeks. Primary outcomes were obtained from
three measures: the frequency (per month), mean duration (hour) and mean
intensity (visual analogue scale "VAS" 0-10 score) of headache attacks
evaluated prior to and following 4 weeks of the intervention. Results
Citron syrup was superior to placebo in reduction of headache attacks
intensity (P<0.01) and duration (p<0.0001) and as effective as
propranolol in patients with migraine headache (P>0.05). However,
unlike propranolol, Citron syrup could not significantly reduce the
frequency of attacks compared to placebo. No indication of any serious
side effects from Citron syrup was observed. Conclusion According to
obtained results, Citron syrup as a traditional Persian remedy can be
suggested as an effective treatment for decreasing pain intensity and
duration of attacks in migraine headache and the effectiveness is
comparable to propranolol. However, the syrup did not show significant
effect on frequency of attacks. © 2015 Elsevier Ireland Ltd. All rights
reserved.
Author keywords
Citron; Citrus medica; Clinical trial; Juice syrup; Migraine headache; Persian Traditional Medicine
Indexed keywords
EMTREE drug terms: antimigraine agent; citrus medica extract; placebo; plant extract; propranolol; unclassified drug
EMTREE medical terms: adult; Article; citron;
comparative study; controlled study; demography; disease duration;
dizziness; double blind procedure; drug design; drug effect; drug
efficacy; drug safety; female; fruit juice; human; major clinical study;
male; migraine; nausea; outcome assessment; randomized controlled
trial; syrup; tablet; traditional medicine; visual analog scale
Chemicals and CAS Registry Numbers: propranolol, 13013-17-7, 318-98-9, 3506-09-0, 4199-09-1, 525-66-6
