Placebo vs. Migraine Medication

The placebo effect is the nemesis of the pharmaceutical industry because, simply put, their drugs are often no more effective than a fake pill labeled as a “magic substance”.  This is truly remarkable, because it means that a patient’s condition can greatly improve with positive thinking. It is the patient’s expectation that turns distilled water, salt or sugar into a “magic cure”.

The scientific study of the placebo effect was pioneered in 1955 by the anesthesiologist Henry K. Beecher (1904-1976). Beecher analyzed 26 studies and concluded that an average of 32% of patients responded to placebo

Placebo accounts for more than 50% of the drug effect

A recent study conducted the Department of Neurology of Harvard Medical School, proved once again, not only that the placebo effect is powerful and real, but that it increased substantially based on increased patient expectation. The scientists followed 60 migraineurs and randomly gave them 10mg of rizatriptan (brand name: maxalt) or a fake pill for each of their migraine attacks. The scientists played around with the labeling to find out which positive responses could be attributed to the drug itself and which responses were caused by the patient’s belief.

Relative to no treatment, the placebo, under each information condition, accounted for more than 50% of the drug effect. Increasing “positive” information incrementally boosted the efficacy of both placebo and medication during migraine attacks. The benefits of placebo persisted even if placebo was honestly described. Whether treatment involves medication or placebo, the information provided to patients and the ritual of pill taking are important components of care.

I agree wholeheartedly with the study’s authors that “information provided to patients” is an important component of care, but I disagree that “the ritual of pill taking” is a necessary one.  More often than not, it is the patient’s positive thinking that initiates the healing. Both healing and positive thinking were around prior to the invention of pills, so I cannot concede that the pill is required for healing in all cases. While some drugs are life-saving under the right (rare) circumstances, it seems to me that it would be wise for doctors to exploit the placebo effect to its fullest potential prior to even attempting a (real) drug that has harmful side effects.

Real drugs have real side effects

The main difference between taking a real drug as compared to a fake drug is with regard to the harmful unwanted side effects. One of the most common side effects of triptans (the most commonly-prescribed drugs for migraines) is that they actually cause migraines to increase in frequency and severity. In fact, the term M.O.H. (Medication Overuse Headaches) was coined to deal with this issue. Using a fake pill, or even a glass of water with some (non-existent) magic powder dissolved in it as a placebo, can never produce the terrible condition called M.O.H.

The best natural cure

The best natural cures for nearly any medical condition will involve positive thinking as part of a healthy lifestyle. For information on healing migraines without any pills (real or fake), please see my articles: The Lotus Lifestyle and Help for Migraines and Headaches. Hint: you need only natural things like sunshine, clean food, and the right kind of exercise for getting and staying wiggly.


  1. Altered placebo and drug labeling changes the outcome of episodic migraine attacks. Kam-Hansen S, et al. Science Translational Medicine. 2014 Jan 8.
  2. The Powerful Placebo, Beecher, 1955.