'Placebo Effect' treatment of migraines

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'Placebo Effect' May Be Common in Headache Treatment

Study Shows Many Patients Feel Better Even When Their Medicine Is Just a 'Dummy

Pill'

May 23, 2011 -- There is a substantial " placebo effect " in the treatment of

migraines and tension headaches, a new research analysis shows.

Placebo treatments or no treatment appeared to work just as well as drugs in a

large percentage of headache patients participating in more than 100 studies.

Researchers from Erasmus University in The Netherlands analyzed the studies in

an effort to determine the magnitude of the placebo effect on headache recovery.

A placebo effect occurs when a treatment with no known effectiveness, such as a

dummy pill, is given to a patient and the patient nevertheless has subsequent

improvement in symptoms.

Just over one in three patients in the placebo or no treatment portions of the

studies (36%) reported improvement in headache symptoms.

The placebo effect was much greater in studies where a dummy pill was compared

to drugs than in studies examining lifestyle interventions and other non-drug

treatments.

Slideshow: A Visual Guide to Migraine Headaches

Role of Patients' Expectations

Almost 40% of placebo-treated patients participating in the drug trials got

better after receiving dummy pills, compared to 15% of patients in the

sham-therapy portions of the non-pharmaceutical trials.

Since drugs used to treat migraines and other recurring headaches can have side

effects, study co-author Bart W. Koes, PhD, says the findings suggest that many

patients might benefit from non-pharmaceutical interventions.

Koes is a professor of general practice medicine at Erasmus Medical Center in

Rotterdam.

" Patient expectations appear to have a lot to do with outcomes, " Koes tells

WebMD. " If we understood more about why this placebo effect occurs it could

impact both clinical practice and future research. "

Placebo Effect in Migraine Patients

More than nine out of 10 people experience occasional or frequent headaches, and

various drug treatments, lifestyle interventions, and alternative approaches are

used to treat and prevent head pain.

Tension headaches, which account for about 90% of all headaches, typically

originate in the neck, upper back, or other muscle groups, while migraines most

often involve pulsating pain on one side of the head and may also include

nausea, vomiting, and sensitivity to light or sound.

The newly reported analysis included data on more than 7,000 patients with

migraines or tension headaches participating in 119 clinical trials of

pharmaceutical and non-pharmaceutical headache treatments.

The placebo effect was highest for trials involving drug treatments given to

children. Almost half (45%) of children in the placebo arms of these trials got

better after taking the dummy pills, compared to 36% of adults.

The placebo effect was also greater in trials involving migraine patients, with

almost 41% of these patients who got the sham treatments or no treatment

recovering, compared to 34% of tension headache patients.

While the research suggests that patients who unknowingly take placebo pills

have better outcomes than those who get no treatment at all, the researchers

acknowledge that " a placebo cannot easily be prescribed in daily practice. "

The research analysis appears in the June issue of the Journal of Manipulative

and Physiological Therapeutics.

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Carruthers

Wakefield, UK