Drug Effectiveness & Power of Suggestion: Migraine Study

Role of Self Suggestions In Migraine

Doctor’s Words Affect Migraineurs’ Response To Drug (1)

A recent study conducted by researchers from Harvard Medical School and Beth Israel Deaconess Medical Center in Boston on migraineurs has shown that the type of labeling on the drug affects the body’s response to pain, nausea, photo-sensitivity, sound-sensitivity as well as vomiting (symptoms associated with a typical migraine attack).

According to Dr. Andrew Charles professor and director of the headache research and treatment program in the department of neurology at University of California School of Medicine, Los Angeles, who was not involved in the research, “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.” (2)

The research studied over 450 migraine attacks in total of 66 migraineurs over a period of their seven attacks.

  • The first attack was to go untreated but the migraineurs were expected to self-rate their pain and migraine-associated symptoms on a scale.
  • From the second attack up to the seventh attack the migraineurs were given medication (pills) in packets that were labelled.
  • The packets were labelled ‘Maxalt’ (Rizatriptan) – positive suggestion ( a drug that will help); ‘Placebo’ – a negative suggestion (drug with no effect on pain); ‘Maxalt or placebo’ – neutral suggestion (unknown if the drug will help or not).
  • But for two situations, one of the “Maxalt” envelopes actually held a placebo and one of the “placebo” envelopes contained Maxalt.
  • The migraineurs were to record the level of pain and discomfort 30 minutes from the onset of the migraine attack (for each of episode 2 through 7th episode)
  • Then they were to take the pills in the labelled packets.
  • Then they were to record their pain and discomfort two our thence ( A total of 2.5 hours after the commencement of a migraine attack)
  • In addition, they were also given a rescue medication in the event that the study medicines did not provide them with any relief. This rescue medication consisted of 1 Maxalt and 2 Naproxen tablets.
  • But for two situations, one of the “Maxalt” envelopes actually held a placebo and one of the “placebo” envelopes contained Maxalt.

Here is a chart depiction of the study methodology: (3)

Migraine Placebo Effect

As per Dr. Ted Kaptchuk, a senior author of the study, director of the Program in Placebo Studies, Beth Israel Deaconess Medical Center, and a professor of medicine at the Harvard Medical School, “We found that under each of the three messages, the placebo effect accounted for at least 50 percent of the subjects’ overall pain relief. When Maxalt was labelled “Maxalt,” the patients’ reports of pain relief more than doubled compared to when Maxalt was labeled “placebo.This tells us that the effectiveness of a good pharmaceutical may be doubled by enhancing the placebo effect.”

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. They had no idea why this occurred.

However, the findings of the study are best used for indicative purposes only and more research will be needed to be done to find out these results could be applied to clinical care and how placebos might help boost drug treatment care. As per Kaptchuk it is possible that simply hearing the words of medicine can have a healing effect, he noted.

SOURCES:

  1. Image Credit: Help Yourself Key Shows Self Improvement Online; Image by Stuart Miles; Freedigitalphotos.net; Web January 2014; http://www.freedigitalphotos.net/images/help-yourself-key-shows-self-improvement-online-photo-p211446
  2. Power of Suggestion Shown in Study of Migraine Drug; WebMD.com; January 2014; http://www.webmd.com/migraines-headaches/news/20140108/power-of-suggestion-revealed-in-study-of-migraine-drug
  3. Table Credit: Placebo effects are not the “power of positive thinking”; Science-Based Medicine; Web January 2014; http://www.sciencebasedmedicine.org/ted-kaptchuk-versus-placebo-effects-again/

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