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Topamax Exceeds Placebo as CDH Preventive

A 16-week clinical trial of 59 people who have CDH from transformed migraine (not chronic tension-type headaches) found that about 29% experienced at least 50% headache relief while taking Topamax. On average, participants in this group had 3.5 fewer bad days a month. Those who received a placebo had a 0.2 day increase in headache days. The amount of headache relief was determined by headahce and quality of life questionnaires, including MIDAS and HIT.

It often takes three months for a patient to determined if a particular drug is an effective preventive for them. Because Topamax has to be started at a small dose and slowly increased to a higher dose, it takes about a month to reach the full dose. In this study, researchers only included the level of patient response in their last four weeks of treatment.

The side effect data gathered from the trial is initially shocking. Of those who took Topamax, 75% had side effects. But, 52% people on the placebo also had side effects. The researchers concluded that there was no statistically significant difference between the two groups in the incidence of side effects.

Speaking of side effects, if you visit a headache forum, you’ll see a large number of posts on the evils of Topamax. Dubbed Dopamax by patients and medical practitioners alike, the mental fogginess, trouble concentration and a bad memory are the frequently side effects. Waiting out the initial three months of taking the drug leads to a decrease in the severity and/or amount of side effects.

As with the aspirin study results, this study was presented at the European Headache Federation‘s annual meeting.

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Even More on the Placebo Effect

Here’s another report on a study indicating that the placebo effect is more than participants wanting to please researchers. This isn’t the first study to blow that high school biology theory out of the water, just the most recent. All three articles I’ve blogged about are on the same study, which was published in the August 24 issue of the Journal of Neuroscience. I’m writing about it again because this article makes the most sense out of all of them.

Basically the article says that brain chemical receptors, called mu-opioid receptors, appear to be activated to produce the placebo effect. So the effect is more than reporting bias, as it shows “brain mechanisms involved in the resiliency of the organism to respond to environmental events (e.g., injury, etc.). . . .”

Placebos and Pain Relief and Placebo Pain Relief Revisited are my previous posts on the subject.

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Placebo Pain Relief Revisited

Brain’s Painkillers may Cause ‘Placebo Effect’, Study provides a more thorough account of how painkillers in the brain can be influenced by the placebo effect, which I posted on yesterday in Placebos & Pain Relief. Even if you read the previous one, the newest article takes a different angle and is worth looking at.