IngentaConnect Placebo response in a patient with chronic migraine and ergotic o...

Authors: Pascual-Lozano, AM¹; Chamarro-Lazáro, R¹; Láinez, MJA

Source: Cephalalgia, Volume 25, Number 5, May 2005 , pp. 391-394(4)

Abstract:

Pascual-Lozano AM, Chamarro-Lazáro R & Láinez MJA. Placebo response in a patient with chronic migraine and ergotic overuse. Cephalalgia 2005; 25:391–394. London. ISSN 0333-1024

Facilitation of nociceptive systems has been implicated in Chronic-Migraine pathogenesis. Daily consumption of medication may be a contributing factor. The patient was male, aged 76 years, with history of migraine without aura. Six years ago, he presented with a mild-moderate daily pulsating headache. He was overusing analgesics and ergotamine. After withdrawing, the patient started a nonpulsating headache, diffuse and constant. During follow up, he was refractive to several symptomatic and prophylactic treatments. When we treated him with placebo capsules, the headache responded very well. At first, pain-relief occurred for 6 h and progressively, extended. Two years later, when our patient started to use transdermal patches of fentanyl for treatment of a complex regional pain syndrome type 1, his headache did not improve. Patient has maintained prolonged response to placebo. Actually, he is pain-free for 2–3 days with 1 placebo capsule. We discuss mechanisms of chronic-migraine, drug-overuse, drug-induced headache and placebo addiction. Powerful psychological mechanisms could determine response to placebo in this patient.

Keywords: Chronic-migraine; drug-overuse; drug-induced headache; placebo analgesia; placebo addiction

Document Type: Research article

DOI: 10.1111/j.1468-2982.2005.00806.x

Affiliations: 1: Department of Neurology, University Clinic Hospital, Valencia University, Valencia, Spain

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