The way that a doctor presents information about migraine treatments to a migraine patient can dramatically affect treatment outcomes, notes research conducted at Boston’s Beth Israel Deaconess Medical Center (BIDMC).

Doctors and researchers have long believed in a correlation between a doctor’s message and how well a patient responds to therapy, but this research was the 1st to evaluate the phenomenon.

During the study, doctors evaluated 66 patients who were taking the migraine drug Maxalt. When doctors described the drug as an “effective drug for the treatment of acute migraine,” patients were more likely to report pain-relieving benefits–even when that medication was a placebo.

Patients report reduced levels of migraine pain when doctors describe the medicine they take as powerful. 

“One of the many implications of our findings is that when doctors set patients’ expectations high, Maxalt (or potentially other migraine drugs) becomes more effective,” says Dr. Rami Burstein, director of pain research in the Department of Anesthesia, Critical Care, and Pain Medicine at BIDMC.

Patients who participated in the study collectively experienced 450 migraine attacks during the course of research. Headaches were characterized by throbbing pain, nausea, and vomiting. Patients also demonstrated sensitivity to light and sound.

To control patients’ expectations during their 6 migraine treatments, the pills they took were separated into labeled envelopes. Two envelopes had “Maxalt” labels to create a positive expectation, although only 1 of the envelopes contained a Maxalt pill. The other envelope contained a placebo.

2 envelopes were marked “placebo,” to create a negative expectation. However, only one of the pills was a placebo. The other was Maxalt. The last 2 envelopes read “Maxalt or placebo,” to create a neutral expectation. 1 envelope contained Maxalt and the 2nd a placebo.

Patients took their 6 treatments, documenting their pain levels. Doctors found that envelopes labeled Maxalt led patients to report less pain–even when the pill was a placebo.

The placebo effect is very real, researchers say. Believing a medicine is powerful can make it so.

Patients who thought they were taking a placebo, but were actually taking Maxalt, experienced half the pain relief as patients who knew they were taking Maxalt.

“The placebo effect accounted for at least 50% of the subjects’ overall pain relief,” says Ted Kaptchuk, director of the Program in Placebo Studies and Therapeutic Encounter at BIDMC.“The effectiveness of a good pharmaceutical may be doubled by enhancing the placebo effect.”

What do you think of the idea that messaging influences how well migraine treatments works? 

Image by HealthGauge via Flickr


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