You have heard of the placebo response and have a general idea of how it works. The reality is that few of us know just how powerful it is.
This wouldn’t be a problem except that most drugs, when studied in clinical trials, are compared to placebo. This means that patient beliefs during treatment may have much stronger effects than the drug itself. Many drugs are studied under double-blind placebo controlled studies in the attempt to control for the placebo response. In these studies, neither the reviewer (many times this is the treating physician) nor the patient knows who is taking the placebo and who is taking the active drug. But if the patient even thinks he or she is on the active drug, it can completely throw off the results of the study.
Efficacy and Safety of Topiramate for the Treatment of Chronic Migraine
Talk about a difference in perception!!! The authors conclude that “Topiramate is safe and generally well tolerated in this group of subjects with chronic migraine, a burdensome condition with important unmet treatment needs. Safety and tolerability of topiramate were consistent with experience in previous clinical trials involving the drug.”
Look at the data and tell me is “generally” means 10% of the study population stopped due to side effects. And all of this for a whopping 1.5/91 days decrease in headache over placebo. So, we’re going to spend, what, say $600 for 3 months Topamax to have 1.5 days less HA? But let’s cut chiro Rx to save money.