Fullscript Protocols

Headaches

Woman ordering supplements on her laptop

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

As a result, the Fullscript Integrative Medical Advisory team advises using an evidence-informed approach to protocol development. To simplify this process for practitioners, we have assembled a sampling of evidence-based standardized protocols that practitioners can use as a foundation when developing individualized protocols.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence. These are categorized as follows:

Class Qualifying studies Minimum requirements
A Systematic review or meta-analysis of human trials
B Human RDBPC ≥ 2 studies and/or 1 study with ≥ 50
subjects
C Human RDBPC or RCT 1 study < 50 subjects
D Human trials or In-vivo animal trials

RDBPC = Randomized Double-Blind Placebo Controlled
RCT = Randomized Controlled Trials

Please refer to the complete Rating Scale for further information.

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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Headaches

Butterbur (Petasites hybridus) 

100-150 mg, total per day, minimum 12 weeks1,2

  • Petasites hybridus is well-tolerated and is recommended as an alternative for prophylactic treatment in migraine patients1,2,3,4
  • A 50% to 68% decrease in frequency of migraine attacks was observed1,2,3,4
Petasites hybridus in the Fullscript catalog.

Feverfew (Tanacetum parthenium) 

50-100 mg, total per day, minimum 8 weeks6

  • Feverfew has been shown to be beneficial in the prevention of migraines5,7
  • Migraine frequency, severity, and degree of vomiting was shown to be reduced8,9,10
  • Although shown to be safe, Tanacetum parthenium possesses cyclooxygenase-2 (COX-2) inhibition activity; long-term use could be of concern5,7,8,9,10
Feverfew (Tanacetum parthenium) in the Fullscript catalog.

Magnesium

600 mg, total per day of magnesium citrate, minimum 12 weeks11,14,15

  • A reduction in the intensity and number of migraine attacks was observed when a high level of magnesium is administered (600 mg qd)11,14
  • An increase in cortical blood flow in the insular regions, inferolateral frontal and inferolateral temporal was observed after magnesium treatment15
  • Intravenous magnesium has been shown to decrease acute migraine attacks within 15 minutes to 24 hours after the initial administration12,13
  • High dose of magnesium is well-tolerated, however, adverse events including diarrhea and gastric irritation have been noted11,14
Magnesium in the Fullscript catalog.

References

3
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/16987643
5
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/22435410
6
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/14973986
7
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/11276299
11
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/29131326
12
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/26752497