Placebo as good as most drugs for kids’ migraines

A drug-free placebo pill prevents migraines in kids and teens just as well as most headache medicines, according to a new review of past evidence.

Researchers found only two drugs known to help migraine-plagued adults reduced the frequency of kids’ headaches better than a placebo. And even in those cases, the effect was small - a difference of less than one headache per month compared to the dummy pills.

“Parents should be aware that our medication choices aren’t as good as they should be,” said Dr. Jennifer Bickel, a neurologist and headache specialist at Children’s Mercy Hospitals and Clinics in Kansas City, Missouri.

Bickel, who wasn’t involved in the new research, said no drugs have been rigorously tested and approved for preventing migraines in kids, so doctors have to rely on headache drugs made for adults.

Those medicines, she added, are “not a miracle cure.”

For cases when medication may not be enough, Bickel told Reuters Health, parents may want to look into relaxation techniques - such as meditation - for kids with chronic headaches.

According to data from the Cleveland Clinic, about 2 percent of young children and 7 to 10 percent of older kids and teenagers up to age 15 get migraines.

Placebo Effect: Fake Pill, Real Power
To understand how a person can be so desperate for pain relief that they can trick themselves into thinking they’ve been given an agony-abating medication, it helps to step back in history: In 1772, when smallpox and typhoid fever left thousands of patients in misery (and today’s narcotics were a mere fantasy), Scottish physician William Cullen had two seemingly bizarre ideas. The first was that sympathy could cure disease. The second was that an inert substance, like mint water, could relieve pain. Turns out, he was onto something, and his notes mark the birth of the placebo effect, or what happens when an inactive treatment convinces your brain that it’s a powerful cure.

Centuries later, the phenomenon was hinted at in pop culture in the 1939 movie The Wizard of Oz (although the guy was a faker, his mind tricks still helped the movie’s characters feel better), but it really hit the big time in 1955, when war surgeon Henry Beecher published an article that claimed more than one-third of all patients could be cured by placebos alone. His paper caused a bigger stir then than a Kardashian wedding does today and solidified the placebo effect as scientific fact.

Yet placebo is still sometimes considered a dirty word. Pharma companies go to expensive lengths to show that their meds outperform inert pills, and drug trials are often dismissed for having “just a placebo effect.” For a consumer, though, the most fascinating thing about faux treatments (yes, including stuff like Cullen’s mint water) is what they reveal about the healing power of the mind.

In their review, Dr. Jeffrey Jackson from the Medical College of Wisconsin in Milwaukee and his colleagues looked at 21 trials comparing headache drugs to each other or to placebos. They found only topiramate (marketed as Topamax) and trazodone (Oleptro and Desyrel) significantly reduced the frequency of headaches in kids and teens who got regular migraines.

Other adult headache prevention medicines, including flunarizine, propranolol and valproate, were of no help.

“All the drugs in our analysis have been found effective in adults with migraine headaches, but few were beneficial among children,” Jackson’s team wrote.

“This suggests there may be something different about pediatric migraines or that the response to treatment differs between children and adults.”

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