A new study suggests that what you are told when your doctor prescribes medication for your migraine may be influenced by your body’s response to it.
Researchers from Harvard Medical School and Beth Israel Deaconess Medical Center in Boston looked at the effects of the common migraine drug Maxalt, and an inactive placebo in 66 people who get migraine headaches.

The results showed that taking the pills along with hearing positive information increased the effectiveness of the treatment, whether or not the patient had taken Maxalt or a pill labeled “placebo.”

Headache specialist Dr. Andrew Charles, professor and director of the headache and research and treatment program at University of California School of Medicine, Los Angeles, said,”when migraine patients were told by their doctor that a pill would help ease their headaches, this advice seemed to produce results whether or not the pill was a real migraine medication or a dummy placebo. Relief was still higher with the actual medicine, so drugs do work beyond the placebo effect, but the researchers say that the placebo effect may still account for half of the therapeutic value of a drug.” Charles was not involved in the study.

To establish a baseline, each person was asked to report their pain and symptoms 30 minutes after the onset of an unmedicated migraine episode, and again 2.5 hours after its onset.

Each participant in the study then received 6 treatment envelopes. The envelopes were labeled in one of three ways: “Maxalt”, “placebo”, or “Maxalt or placebo.” The 3 situations were labeled as positive (meaning a drug that could help was provided), negative (meaning no drug, only a placebo pill was provided), or neutral (meaning it was unknown if the drug or placebo pill was inside the envelope). However, for two situations, one of the “Maxalt” envelopes held a placebo and one of the “placebo” envelopes contained Maxalt.

Dr. Ted Kaptchuk, a senior author of the study said that while Maxalt was superior to the placebo in terms of decreasing pain, “we found that under each of the three messages, the placebo effect accounted for at least 50% of the subjects’ overall pain relief.”

The authors were surprised to find that even when patients were given a placebo labeled as “placebo” they reported pain relief, compared with no treatment. Said Kaptchuk, “we don’t know what that’s about. It’s a novel finding.”

Kaptchuk was asked if these results can have an effect in other medical conditions. “Obviously we don’t know, we only looked at migraine. But I think that in many categories of illness and drugs, this would be proof of concept.”     Healthday     1/8/14



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