Ayurveda for management of migraine: A narrative review of clinical evidence.

Migraine is a primary headache disorder characterized by recurrent attacks. The economic and societal burden of migraine is substantial, affecting patients' quality of life in terms of work, social activities, and family life. This article attempts to review the available literature for clinical evidence of Ayurveda in the management of migraines. We performed a literature search from January 2000 to July 2020 on popular search engines such as Pub Med, Google Scholar, and AYUSH Research Portal using the keywords "Complementary and Alternative Medicine (CAM) and Migraine", "Ayurveda and Migraine" and "Panchakarma and Migraine". The selection criteria involved published clinical trials, including pilot studies, whereas review articles, concept papers, letters to the editor, and studies published in languages other than English were excluded. Out of 77 studies that were screened, 12 articles that satisfied the selection criteria consisted of six Randomized controlled Trials (RCTs), five non-RCTs, and one pilot study. Among them, ten studies used polyherbal and Herbo mineral formulations, two studies contained no oral medications, three trials utilized external therapies, and ten studies used panchakarma procedures. Eleven studies found Ayurveda to be clinically beneficial as monotherapy, while one study demonstrated the usefulness of Ayurveda as an add-on to conventional management. This review reveals the beneficial role of Ayurveda in the management of migraines without many side effects. Yet several limitations exist, like small sample size, short follow up, and lack of better outcome measures for pre and post-assessments. Future research should overcome these limitations and follow a robust methodology so that definitive conclusions can be drawn.