Is this proof that a placebo can cure migraines? Tablets found to perform better when a patient is told they are effective

Being told a pill will help makes it work better. A study found that migraine tablets are better at easing pain if patients believe they are effective.

Even dummy drugs provide more benefit if expectations are raised.  

The researchers behind the Harvard Medical School study of Maxalt pills said that information is as important as medication in reducing migraine pain.

Placebo: The researchers said the patient receiving information is as important as the medication itself

They said: ‘One of the many implications for our findings is that when doctors set patient’s’ expectations high, Maxalt – or potentially other migraine drugs – becomes more effective.

‘Increased effectiveness means shorter migraine attacks and shorter migraine attacks mean that less medication is needed.’ 

The research team looked at how much headache pain 66 migraine patients suffered during an attack. 

They then gave them envelopes with pills to be taken during each of their next six attacks.  

Three of the envelopes contained Maxalt, a migraine drug used in the UK as well as the US.  

These were either labelled correctly, in an attempt to raise expectations, wrongly labelled as placebo, to avoid raising hope,  or marked neutrally as ‘Maxalt or placebo’.  

The same labelling system was used on a second three envelopes which contained placebo pills.  

Overall, Maxalt was better at easing pain than the placebo.  However, the placebo did have an effect. 

Experiment: The patients in the survey were given six envelopes, some containing medication and other containing a placebo

This effect was especially strong if the patients thought they were taking proper pills – but even those knowingly taking a dummy pill felt better than when they took nothing.  

And, to the researchers’ surprise, when Maxalt was labelled as a placebo it worked no better than a dummy drug marked as being the real thing

The findings, published in the journal Science Translational Medicine (MUST CREDIT), add to evidence that the placebo effect –the idea that having faith in a medication increases the chances of it working - is real.  

Researcher Professor Ted Kaptchuk said: ‘Our discovery showing that patients’ reports of pain were nearly identical when they were told that an active drug was a placebo as when they were told that a placebo was an active drug demonstrates that the placebo effect is an unacknowledged partner for powerful pain expectations.’   

With the Maxalt working less well if the patients believed it was a dummy drug, the researchers said that doctors might want to avoid stressing the possibility of side effects and other negatives to patients.

However, they acknowledged that withholding information is fraught with ethical issues.  

It could lead to an erosion of trust between patient and doctor.  

The research team expect similar results would be obtained for other migraine treatments.

However, the pattern may be different for conditions that appear symptomless to the patient, such as high cholesterol.