It’s called the placebo effect — the surprising power of the brain to affect the body when we take a pill we think is medication, even though it isn’t.
It’s been found to influence a number of conditions, including depression and irritable bowel syndrome, as Smithsonian magazine noted, but the most recent research concerns the pain of chronic migraines — those severe pounding headaches often accompanied by nausea, vomiting and sensitivity to light.
In the study, published in Science Translational Medicine, researchers with Harvard medical school found that a dummy pill labeled as a drug provided nearly as much relief for migraine sufferers as did the real drug. In other words, patients reported their pain had been reduced about equally for both kinds of pills, as long as they didn’t know the pill was a sham.
There was one significant difference, however: When it came to an objective measurement — whether the pain was actually gone 2 1/2 hours after taking the pill — the real drug was four times more effective than the placebo.
The 66 subjects were given six envelopes containing a pill to take after their next six migraine attacks. Two of the envelopes were labeled with the name of a migraine drug (Maxalt, the brand name for the generic rizatriptan) even though only one of the envelopes had the real drug; two had no label so subjects didn’t know which was a placebo and which was the drug; and two were labeled “placebo,” even though only one really was.
The subjects were asked to rate their pain relief two hours after taking a pill. When they took the pill labeled a placebo, they reported 26 percent less pain. When they took a Maxalt-labeled pill, they reported 40 percent less pain. And when they took a mystery pill that could have been either a placebo or Maxalt, they also reported a 40 percent decrease in pain.
This means that people who took a placebo pill labeled Maxalt got just as much pain relief as those who took a real Maxalt pill labeled as a placebo. It also means that those who thought they were taking placebo, even though it was really a drug, reported half as much relief as those who took a real placebo labeled as a drug.
Obviously, this shows the power that expectation can have if you think a pill is going to help you. But the findings also show that asking patients for their subjective feelings — like how much their pain has been reduced — is very different from asking for an objective measurement. There was no question which type of pill was more effective when patients were asked whether the pain was completely gone. The real drug won, hands down.
That’s because pain relief is “a judgment call,” study author Ted Kaptchuk, an associate professor of medicine at Harvard medical school, explained to NPR’s health blog. “Being pain-free is not a judgment call.”
So what’s the lesson here? The words a doctor uses when prescribing a drug for a patient matter, researchers said in a press statement. Setting patients’ expectations high that a drug will work may help the drug be more effective. And for drug companies testing new medication, it may be more useful to measure an objective outcome rather than rely on patients’ subjective feedback.
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