Placebo, chronic daily headache, and pain: Ten points to ponder

Lake, Alvin E.

doi:10.1007/s11916-006-0002-6

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…In a meta‐analysis of 22 placebo‐controlled trials, the percentage of placebo responders (>50% improvement) was 23.5% ± 8.0% . The response has been reported to be more pronounced in invasive placebo treatment . The analysis of pooled data of 2 randomized placebo‐controlled trial on onabotulinum toxin A revealed placebo effect in 35.1% at 24 weeks .…”

Section: Discussionmentioning

confidence: 99%

Amitriptyline vs divalproate in migraine prophylaxis: a randomized controlled trial

2013

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Objective -This study compares efficacy and safety of divalproate extended release (DVA-ER) and amitriptyline (AMT) in migraine. Materials and methods -Three hundred migraineurs having >4 attacks monthly were randomized into DVA-ER or AMT. The primary end points were >50% reduction in frequency, ! 1 grade improvement in the severity, and >50% improvement in a visual analogue scale (VAS). Secondary end points were functional disability, rescue medication, and adverse events. Results -The median age was 32 years, and 241 were women. 150 patients each received DVA-ER and AMT. At 3 months, 74.7% in DVA-ER and 62% patients in AMT group improved in headache frequency (P = 0.02) and at 6 months, 65.3% and 54%, respectively (P = 0.90). At 3 months, the VAS score improved by >50% in 80.7% in DVA-ER and 64% in AMT (P = 0.005). At 6 months, there was no significant difference between the two groups in VAS score (69.3% vs 56%; P = 0.47) and other outcome parameters. The composite side effects were also not different between the two groups (68% vs 81%); however, hair fall, menstrual irregularity, polycystic ovary, and weight gain were commoner in DVA-ER group. Conclusion -Divalproate extended release is more effective at 3 months than AMT; however, at 6 months, both are equally effective in migraine prophylaxis.

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Section: Discussionmentioning

confidence: 99%

Amitriptyline vs divalproate in migraine prophylaxis: a randomized controlled trial

2013

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“…Psychological factors may play a major role in the natural history of medication‐overuse headache 26,32 . Comorbid substance abuse or psychiatric disorders may be less frequent in those who overuse triptans 33,34 . By contrast, patients whose overuse involves opioid‐ and butalbital‐containing combination analgesic medications tend to have comorbid psychopathology with or without an associated drug or alcohol use disorder 18,33,35 .…”

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confidence: 99%

Evidence‐Based Understanding of Medication‐Overuse Headache: Clinical Implications

Dodick¹,

Freitag²

2006

Headache

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This article discusses the problem of medication-overuse headache from a variety of perspectives, based on the best available evidence. This presentation clarifies the definition of the disorder, distinguishing it from alternative terminology, and describes its epidemiology, natural history, and clinical course. Antimigraine medications are believed to differ in their relative liability to contribute to the development of medication-overuse headache. Patients most at risk of developing medication-overuse headache need to be identified so that appropriate preventive measures can be initiated.

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“…Contextual and placebo effects might also play a curative role that is underestimated. Both have a strong influence on headache, [34] as they elicit symptoms in controlled studies [35]. For acupuncture, the placebo control (sham acupuncture at non-acupuncture locations) was found to have nearly the same effects as the verum acupuncture [36,37] which is unlikely to be due solely to the physiological effects of tiny skin penetrations.…”

Section: Discussionmentioning

confidence: 99%

Homeopathic Treatment of Chronic Headache (ICD-9: 784.0) – a Prospective Observational Study with 2-Year Follow-Up

Witt

Lüdtke²,

Willich

2009

Forsch Komplementmed

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Background: Details and effects of individualised homeopathic treatment of headache (ICD-9: 784.0) in usual care have not yet been investigated. Methods: Prospective multi-centre observational study. Consecutive primary-care patients beginning homeopathic treatment were followed for 2 years, keeping regular records of complaint severity, health-related quality of life (QoL), and medication use. Results: 230 adults (77.0% women), age 38.2 ± 11.3 years, and 74 children (10.4 ± 3.2 years, 55.4% girls) treated by 73 physicians were included. Patients suffered from headaches (average duration: adults 9.3 ± 9.5 years, children 2.7 ± 2.6 years) and other chronic diseases. Most patients (adults 90.0%, children 70.8%) had been pre-treated (usually with conventional treatment). Severity of diagnoses and complaints showed marked improvements in the first 3 months, continuing on until the end of the study. For headache, standardised effects (mean change divided by standard deviation at baseline) in adults reached 1.63 (95% CI 1.78–1.49), 2.27 (2.45–2.09), and 2.44 (2.63–2.25) at 3, 12, and 24 months, respectively. In children, the standardised effects at these time points were 1.67 (1.91–1.44), 2.55 (2.82–2.28), and 2.74 (3.03–2.46), respectively. Whilst the QoL among adults improved over time, this trend was not observed in children. Use of conventional treatment and health services decreased markedly. Conclusion: This observational study of patients seeking homeopathic treatment because of headache showed consistent improvements over the 24-month period. The observational and uncontrolled character of the study design does not allow conclusions on a specific relationship between treatment and the observed effects.

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Placebo, chronic daily headache, and pain: Ten points to ponder

Cited by 5 publications

References 15 publications

Amitriptyline vs divalproate in migraine prophylaxis: a randomized controlled trial

Amitriptyline vs divalproate in migraine prophylaxis: a randomized controlled trial

Evidence‐Based Understanding of Medication‐Overuse Headache: Clinical Implications

Homeopathic Treatment of Chronic Headache (ICD-9: 784.0) – a Prospective Observational Study with 2-Year Follow-Up

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Placebo, chronic daily headache, and pain: Ten points to ponder

Cited by 5 publications

References 15 publications

Amitriptyline vs divalproate in migraine prophylaxis: a randomized controlled trial

Amitriptyline vs divalproate in migraine prophylaxis: a randomized controlled trial

Evidence‐Based Understanding of Medication‐Overuse Headache: Clinical Implications

Homeopathic Treatment of Chronic Headache (ICD-9: 784.0) &ndash; a Prospective Observational Study with 2-Year Follow-Up

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Product

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Homeopathic Treatment of Chronic Headache (ICD-9: 784.0) – a Prospective Observational Study with 2-Year Follow-Up