Substantial recovery rate with placebo effect in headache treatment

May 23, 2011

Headache is a very common complaint, with over 90% of all persons experiencing a headache at some time in their lives. Headaches commonly are tension-type (TTH) or migraine. They have high socioeconomic impact and can disturb most daily activities. Treatments range from pharmacologic to behavioral interventions. In a study published online today in the Journal of Manipulative and Physiological Therapeutics, a group of Dutch researchers analyzed 119 randomized controlled clinical trials (RCTs) and determined the magnitude of placebo effect and no treatment effect on headache recovery rate.

"Although the intention of control and placebo interventions in research studies is to be relatively ineffective, the question rises as to what factors might cause improvement seen in these groups," commented corresponding investigator Arianne P. Verhagen, PhD, Assistant Professor, Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands. "The aim of this study was to analyze the observed effects in the 'no treatment' and placebo control groups in with TTH and migraine patients."

In the headache clinical trials studied, the "no treatment" and placebo groups had a high overall recovery rate of 36%. Control groups in pharmacological trials showed a higher response rate than the behavioral (non-pharmacological) trials (38.5% vs. 15.0%). Patients had higher recovery rates in the acute treatments compared with the prophylactic treatments (39.6% vs. 32.8%). Knowing that a substantial portion of patients improve without treatment is important when considering the benefits and risks of daily headache treatment.

Pharmacological treatment typically starts when non-pharmacological treatments like , relaxation therapy, cognitive therapy, and reassurance do not work. Many of the prescribed or over-the-counter medications, such as (NSAIDs), may lead to adverse events and medication overuse headache. Considering the risks of adverse events, the authors recommend that "the prescription of medication needs to be carefully considered and evaluated with each individual patient. Because of the recovery results in 'no treatment' control groups in pharmacological trials, the question rises whether or not this way of prescription is always preferable over no treatment (wait and see) especially in the TTH population."

More information: The article is "Headache: The Placebo Effects in the Control Groups in Randomized Clinical Trials; An Analysis of Systematic Reviews" by Femke M. de Groot, BSc, Annieke Voogt-Bode, BSc, Jan Passchier, PhD, Marjolein Y. Berger, MD, Bart W. Koes, PhD, and Arianne P. Verhagen, PhD. It will appear in the Journal of Manipulative and Physiological Therapeutics, Volume 34, Issue 5 (June 2011), DOI 10.1016/j.jmpt.2011.04.007

Related Stories

Recommended for you

Google searches can be used to track dengue in underdeveloped countries

July 20, 2017
An analytical tool that combines Google search data with government-provided clinical data can quickly and accurately track dengue fever in less-developed countries, according to new research published in PLOS Computational ...

MRSA emerged years before methicillin was even discovered

July 19, 2017
Methicillin resistant Staphylococcus aureus (MRSA) emerged long before the introduction of the antibiotic methicillin into clinical practice, according to a study published in the open access journal Genome Biology. It was ...

New test distinguishes Zika from similar viral infections

July 18, 2017
A new test is the best-to-date in differentiating Zika virus infections from infections caused by similar viruses. The antibody-based assay, developed by researchers at UC Berkeley and Humabs BioMed, a private biotechnology ...

'Superbugs' study reveals complex picture of E. coli bloodstream infections

July 18, 2017
The first large-scale genetic study of Escherichia coli (E. coli) cultured from patients with bloodstream infections in England showed that drug resistant 'superbugs' are not always out-competing other strains. Research by ...

Ebola virus can persist in monkeys that survived disease, even after symptoms disappear

July 17, 2017
Ebola virus infection can be detected in rhesus monkeys that survive the disease and no longer show symptoms, according to research published by Army scientists in today's online edition of the journal Nature Microbiology. ...

Mountain gorillas have herpes virus similar to that found in humans

July 13, 2017
Scientists from the University of California, Davis, have detected a herpes virus in wild mountain gorillas that is very similar to the Epstein-Barr virus in humans, according to a study published today in the journal Scientific ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.