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Migraines respond to great expectations

Meds and placebos both fight pain better when patients anticipate getting active drug

2:15pm, January 8, 2014

In a new study, migraine patients experienced the greatest decline in pain when placebo pills (blue) and Maxalt pills (brown) were labeled as “Maxalt” (M) or “Maxalt or placebo” (U). Pills labeled “placebo” (P) were the weakest painkillers in each treatment condition. Between 30 minutes and 2.5 hours after an attack started, migraine pain increased among patients who got no treatment at all (black). 

When it comes to pain, what migraine-headache sufferers think about their pills’ identities matters nearly as much as whether or not those pills contain active medication, a new study suggests.

Migraine meds labeled as placebos dull headache pain less effectively than the same pills identified either as the real deal or as possibly a genuine drug, say neuroscientist Rami Burstein of Harvard Medical School and his colleagues. Placebo pills given to migraine patients worked the same way, easing headache pain better when labeled as definitely or possibly containing active medication, the researchers report in the Jan. 8 Science Translational Medicine.

Placebo pills mislabeled as the migraine drug Maxalt provided close to as much pain relief as Maxalt mislabeled as a placebo. Overall, though, Maxalt eased migraine pain better than placebos did.

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