The placebo effect is real and it’s here to stay. In the latest study to prove that fake pills help patients feel better just as much as “real” drugs, researchers at the Program in Placebo Studies and the Therapeutic Encounter at Harvard have found that sugar pills can reduce migraine pain.
When patients with migraines were given a fake pill under the expectation that they were receiving a drug intended to relieve headache pain, the researchers found that the patients experienced significant pain relief. In comparison, when these same patients received an active headache drug that was labelled incorrectly as “placebo,” pain relief was not as effective.
The Harvard researchers took the study one step further when they decided to tell the patients that they were swallowing nothing more potent than a sugar pill. The pain-relieving effects of the placebo remained undiminished despite having revealed the deception.
This poses interesting possibilities for doctors, who heretofore may have had qualms about prescribing fake pills to patients without their consent. Giving a patient a sugar pill without telling him or her has been seen as unethical behavior on the part of a doctor. The patient is being deceived and while the placebo effect works sometimes, it doesn’t work every time. The argument goes that a drug will perform as expected every time—i.e. a pain-relieving drug will reduce pain symptoms no matter what interaction happens between patient and doctor.
The Harvard study, however, has suggested that doctors could now tell their patients that they are getting a sugar pill and that the sugar pill still has a very good chance of making a patient feel better. Many doctors are already prescribing fake pills in the form of vitamins or sedatives (which ought to be considered drugs in their own right). Now, a doctor could explain how the placebo effect is real and could help reduce symptoms. No more need to prescribe fake pills behind a patient’s back.
Why does the placebo effect work? There are a number of different theories. Part of the reason a fake pill may work as well as an active drug is that all patients respond to the attention and caring of a doctor. Research has shown that patients who see a doctor they perceive as warm and compassionate tend to recover quicker from health complaints. And, in fact, many patients turn to alternative therapists because these practitioners are often invested in the emotional health and healing of a patient.
Another reason why the placebo effect works is that real physiological processes are triggered in the body. If a patient believes a fake pill will help, physiological processes that trigger healing can be activated. Then too, the body may remember feeling better after taking a drug and releasing the same neurotransmitters that trigger the healing process when taking nothing more than a sugar pill.
One final suggestion for the potency of the placebo effect is that the patient believes in the ritual of taking “medicine” to get better and they improve their motivation to do whatever they can to heal themselves whether it’s resting, eating healthy, or staying mentally positive.
Kam-Hansen, S., et al., “Altered placebo and drug labeling changes the outcome of episodic migraine attacks,” Sci Transl Med. January 2014; 6(218): 218ra5.
Barton, A., “The placebo effect: A new study underscores its remarkable power,” The Globe and Mail web site, Jan. 12, 2014; http://www.theglobeandmail.com/life/health-and-fitness/health/the-placebo-effect-a-new-study-underscores-its-remarkable-power/article16281897/, last accessed Jan. 15, 2013.