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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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Slavenka Kam-Hansen, et al. "Altered Placebo and Drug Labeling Changes the Outcome of Episodic Migraine Attacks." Sci Transl Med. 2014;6, 218ra5. DOI: 10.1126/scitranslmed.3006175.
  2. Kendra Cherry. "What Is the Placebo Effect?" About.com Psychology. Viewed January 29, 2014. http://psychology.about.com/od/pindex/f/placebo-effect.htm.
  3. Richard Knox. "Half Of A Drug's Power Comes From Thinking It Will Work." NPR.org. January 10, 2014. http://www.npr.org/blogs/health/2014/01/10/261406721/half-a-drugs-power-comes-from-thinking-it-will-work.

Comments

  • bluebird
    5 years ago

    Thank you for the responsible and clear presentation of information on this subject. The mysteries of the Placebo effect often come close to the best pharmacological drugs can do …at least for a few weeks….!
    When we had trusting relationships with our care givers…physicians,nurses, shamans…the trusting relationship went a long way to support the healing effect of remedies.
    May I suggest doing a similar article about the power of “positive thinking” which also has some benefits but clearly is not the solution many well meaning friends and family wish it were. Then we could send out the link to all those Folks who wish us well.

  • Diana-Lee author
    5 years ago

    That’s a great idea! Thank you for reading and thank you for the suggestion.

  • Hennie Duits
    5 years ago

    Regarding placebo and classical homeopathy, watch https://www.youtube.com/watch?v=CcA6HJffWro , start at 6’15”. Some people believe or say, homeopathy is just placebo. Forget it, those who get the (*their*) correct remedy will know beyond any doubt it is a working and effective remedy – there is nothing placebo about that.

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