Homeopathy National Knowledge Week, 11-15 June 2007
Robert T Mathie, PhD
British Homeopathic Association
The entire research evidence for homeopathic treatment of headache (tension-type, cervicogenic or migraine) was systematically reviewed by Owen & Green (2004).1 No new studies in this area have been published since that review. Six original research papers were identified: 4 randomised controlled trials (RCT) and 2 prospective observational (non-randomised non-controlled) studies (POS). The 4 RCTs were all placebo-controlled. All 6 studies investigated individualised (classical) homeopathy, though one of the RCTs limited prescription to a selection of just 8 medicines.
The key research data are summarised in the table below (adapted from Table 2 of the review by Owen & Green):
|
First author, date of publication |
Headache type |
Study design |
Sample size |
Study duration (months) |
Outcome |
|
Brigo, 19912 |
Migraine |
RCT |
60 |
4 |
+ |
|
Walach, 19973 |
Chronic |
RCT |
98 |
3 |
+/- |
|
Whitmarsh, 19974 |
Migraine |
RCT |
60 |
4 |
+/- |
|
Straumsheim, 20005 |
Migraine |
RCT |
73 |
4 |
+/- |
|
Muscari-Tomaioli, 20016 |
All |
POS |
53 |
4-6 |
+ |
|
Walach, 20017 |
Chronic |
POS |
18 |
12 |
+ |
+ Positive findings (homeopathy superior to placebo [RCT]; clear proportion of patients with symptom improvement [POS]).
+/- Non-statistically significant differences between homeopathy and placebo.
Improvement in headache symptoms was observed in all 6 studies. However, 3 of the RCTs found no significant difference between homeopathy and placebo – symptoms improved in both groups of patients. The fourth RCT, where homeopathic prescribing was limited to one of just 8 options, found homeopathy was superior to placebo. In common with most such research in homeopathy, both studies of POS design found clear improvement in symptoms. Thus, the overall evidence suggests that the homeopathy might benefit headache patients, but it does not convincingly indicate it is more effective than placebo. In no study was homeopathy found to be less effective than placebo, or harmful.
The review led the authors to conclude there is insufficient evidence to support or refute the use of homeopathy for managing headache. However, they also noted several flaws in the design of studies published to date, and recommended further investigation, highlighting the challenges that exist in finding a rigorous research model that is also relevant to homeopathic practice.
References
1. Owen JM, Green BN. Homeopathic treatment of headaches: A systematic review of the literature. Journal of Chiropractic Medicine 2004; 3: 45–52. [Abstract]
2. Brigo B, Serpelloni G. Homoeopathic treatment of migraines – A randomized double-blind controlled study of sixty cases - (homoeopathic remedy versus placebo). Berlin Journal of Research in Homeopathy 1991; 1: 98–106.
3. Walach H, Häusler W, Lowes T, Mussbach D, Schamell U, Springer W, Stritzl G, Gaus W, Haag G. Classical homeopathic treatment of chronic headaches. Cephalalgia 1997; 17: 119–126. [Abstract]
4. Whitmarsh TE, Coleston-Shields DM, Steiner TJ. Double-blind randomised placebo-controlled study of homoeopathic prophylaxis of migraine. Cephalalgia 1997; 17: 600–604. [Abstract]
5. Straumsheim P, Borchgrevink C, Mowinckel P, Kierulf H, Hafslund O. Homeopathic treatment of migraine: A double blind, placebo controlled trial of 68 patients. British Homeopathic Journal 2000; 89: 4–7. [PubMed abstract]
6. Muscari-Tomaioli G, Allegri F, Miali E, Pomposelli R, Tubia P, Targhetta A, Castellini M, Bellavite P. Observational study of quality of life in patients with headache, receiving homeopathic treatment. British Homeopathic Journal 2001; 90: 189–197. [PubMed abstract]
7. Walach H, Lowes T, Mussbach D, Schamell U, Springer W, Stritzl G, Haag G. The long term effects of homeopathic treatment of chronic headaches: one year follow-up and single case time series analysis. British Homeopathic Journal 2001; 90: 63–72. [PubMed abstract]
