Homeopathic treatment of headaches & migraine: a meta-analysis of the randomized controlled trials.

BACKGROUND:Homeopathy seems scientifically implausible and is the most controversial forms of CAM therapies. This review aims to summarize treatment effects of individualized homeopathy in headaches and migraine. METHODS:Relevant studies were identified by a comprehensive literature search in electronic databases, reference list of relevant papers, and contacts with experts. Randomized controlled trials comparing individualized homeopathic treatment strategy with placebo were eligible. Information on patients, methods, interventions, outcomes, and results was extracted in a standardized manner and quality was assessed using a checklist and scoring system. Trials providing sufficient data were pooled in a quantitative meta-analysis. Risk ratio above 1 indicated benefit. Bias effects were examined in funnel plot model. RESULTS:A total of four randomized placebo-controlled trials involving 390 patients were considered for the analysis. Methodological quality of the trials was variable. The combined risk ratio for the four studies entered into the meta-analysis was 1.58 (95% CI 0.8 to 3.1) [when corrected for publication bias it becomes 0.98 (0.5, 1.9), i.e. negative], showing positive trend, but no statistically significant difference in favor of homeopathy. CONCLUSIONS:The results of our meta-analysis are not compatible with the notion that homeopathy has significant effect beyond placebo. However, the evidences are not convincing because of methodological inconsistencies and are too insufficient to arrive at a definite conclusion. Further replications are warranted provided the trials are rigorous and systematic.