Placebo Effect & Migraine: What Does the Research Mean?
Research examining the relationship between the placebo effect and a Migraine treatment medication in a novel way, which was published in January, received a lot of attention. Unfortunately it required much sifting through articles about this study to find a few gems that accurately captured the importance of the findings.
While we generally can't jump on breaking news here at Migraine.com, I take pride in providing our readers with accurate information that puts hot topics in context.
These researchers set out to learn more about the placebo effect by pitting a placebo (a treatment with no active ingredient of any kind) against Maxalt, a Migraine treatment medication that's been shown more effective than placebo in past studies. The difference between this study and traditional placebo-controlled trials? Two things. (1) The pills study subjects received had three different labels on the packages: "placebo", "Maxalt or placebo" and "Maxalt"; and (2) The accuracy of the labeling.
The findings broke down as follows:
- No treatment: 15 percent increase in pain.
- Known placebo: 26 percent decrease.
- Known Maxalt: 40 percent decrease.
- Placebo labeled Maxalt: 25 percent decrease (not statistically significant).
- Maxalt labeled as placebo: 36 percent decrease (not statistically significant).
- Unknown pill (labeled "Maxalt or placebo"): 40 percent decrease.
Much, though certainly not all, of the reporting on this important research mischaracterized the results in an important way. Rather than demonstrating you can think your way out of experiencing the symptoms of a Migraine attack, the results support the idea that how we talk about a treatment can increase the effectiveness of that treatment by 50 percent or more. Regardless of the label on the packet, when study participants took the placebo, they experienced at least half (50% or more) the effectiveness they did when they'd taken Maxalt.
The placebo effect is not about the power of positive thinking, as so many blithely assert. This is a vast oversimplification of a complex phenomenon we're only beginning to understand. Rather, it's about the power of suggestion associated with what we know about a treatment and the expectations we develop based on that knowledge.
If we know a particular medication is likely to be effective for a Migraine patient and couple that knowledge with a physician/patient discussion that empowers the patient with the same knowledge, this can only benefit patients. A prescribing physician may know a lot about the effectiveness of a given medication for Migraine. But do patients know any of that information?
As much as I wanted to put my fist through my laptop every time I saw a terrible article about this research, a select few did a fantastic job reporting on this research. It's an important reminder to be careful in choosing where you get your information. The more you learn about Migraine Disease, the better your chances of being able to critically evaluate any information you come across.
Can you tell when a migraine attack is coming?