We have all read about how placebos can work as well as taking real medication. A recent study in the treatment of migraines has also shown evidence supporting the placebo effect. Only this study has an added twist of people reporting pain relief even when they knew they were taking a placebo.
The study tested 66 people who regularly suffered migraines. Each person had an initial migraine that was not treated, which served as his or her own control. Then for the next six migraine attacks, the participants took either the drug Maxalt or a placebo to treat their migraine.
Here is where the testing got creative. The participants were given six envelopes. Three of the envelopes contained Maxalt and three contained a placebo.
However, the pill in the envelope did not always match what was marked on the outside.
The three Maxalt envelopes were labeled differently. The first one was marked "Maxalt". The second one was marked "placebo" even though it contained Maxalt. And the last one was labeled as "placebo or Maxalt" even though it too contained Maxalt.
The same system was used for the placebo. Those envelopes were marked "Maxalt", "placebo" and "placebo or Maxalt" even though they all contained placebo.
So in essence, the researchers set up three different expectations by the participants. A positive expectation was associated with the Maxalt envelopes regardless of what was inside. A negative expectation was created by the envelopes marked "placebo" and a neutral expectation was stirred by the "placebo or Maxalt" envelopes.
The results were interesting.
When the participants took a placebo that was accurately marked, they had 26 percent less pain. When they took Maxalt that was accurately marked they had 40 percent less pain. But when they took a mystery pill that could have been placebo or Maxalt they still had a 40 percent improvement in pain.
That means that subjects had pain relief even when they knew they were taking a placebo.
“When subjects took Maxalt that was labeled as placebo, their decrease in pain was statistically no different than when they took a placebo labeled as Maxalt,” reported NPR.
"We were surprised that the efficacy of Maxalt mislabeled as placebo was not significantly better than the efficacy of placebo mislabeled as Maxalt," the researchers wrote.
The researchers attribute the differences to the expectations the participant had of what they were taking.
The results showed that giving the pills from an envelope with a positive expectation incrementally boosted the pain relief reported from both the active migraine medication and the inert placebo.
Taking pills from a neutral expectation envelope showed that pain relief was influenced by a 50 percent chance/belief that the pill was the real drug.
"Contrary to conventional wisdom that patients respond to a placebo because they think they're getting an active drug, our findings reinforce the idea that open label placebo treatment may have a therapeutic benefit," the authors said in a EurekAlert! press release.
The researchers suggested that further research will be needed to explore how placebos may be used to boost the effect of drug treatments.
This study was funded by a grant from Merck & Co., by grant support from the National Institutes of Health (NIH), and by support from the National Center for Complementary and Alternative Medicine (NCCAM).
Sources:
Migraines and the mystery of the ‘placebo effect’. WebMD.com. Retrieved Feb. 9, 2014.
http://www.webmd.boots.com/migraines-headaches/news/20140110/migraines-p...
Half Of A Drug's Power Comes From Thinking It Will Work by Richard Knox. NPR.org. Retrieved Feb. 9, 2014.
http://www.npr.org/blogs/health/2014/01/10/261406721/half-a-drugs-power-...
S. Kam-Hansen et. al. Altered Placebo and Drug Labeling Changes the Outcome of Episodic Migraine Attacks. Sci Transl Med 8 January 2014: Vol. 6, Issue 218, p. 218ra5. Sci. Transl. Med. DOI: 10.1126/scitranslmed.3006175. Abstract:
http://stm.sciencemag.org/content/6/218/218ra5
Study finds that information is as important as medication in reducing migraine pain Findings also show that patients report pain relief even when they know they are receiving a placebo. EurekaAlert.com. Retrieved Feb. 9, 2014.
http://www.eurekalert.org/pub_releases/2014-01/bidm-sft010214.php
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles
Edited by Jody Smith