Patients were told their pills were sugar pills with no medicine in them, and their symptoms still improved more than in people given nothing
Placebos are usually thought to work only when patients believe they are getting real medicine. In 2010, a team at Harvard Medical School tested what happens when doctors are completely honest about it.
In the trial led by Ted Kaptchuk, 80 patients with irritable bowel syndrome, a common gut condition that causes pain and bloating, were randomly assigned to one of two groups. One group received no treatment. The other received a bottle of pills clearly labeled as placebo pills, along with an explanation that they contained no active ingredient, like sugar pills, but that placebo pills had been shown in studies to produce improvement through mind-body processes.
Patients were asked to take two pills twice a day for three weeks. After that time, those taking the honest placebo reported significantly greater improvement in their symptoms than those who received no treatment. About 59% of the placebo group said they had adequate relief, compared with about 35% of the no-treatment group.
The researchers were careful about what this does and does not show. Both groups had the same amount of time and attention from the study team, so the difference was not simply about more care. But the trial could not separate the effect of the pill itself from the ritual of taking it, or from patients’ hope that it might work.
Since then, open-label placebo studies have been run for chronic back pain, cancer-related fatigue, allergies and other conditions. Many have found modest benefits, especially for symptoms that people experience and report themselves, such as pain and fatigue.
One explanation is that placebo effects do not depend only on deception. Taking a pill as part of a routine, with a clear explanation and an expectation of possible benefit, may activate the brain’s own systems for managing pain and discomfort, even when people know there is no drug involved.
This does not mean placebos can treat infections, cancer or other diseases, or replace effective medicine. The benefits are mostly in how symptoms feel, not in the underlying disease. But the research suggests that the context of care, how treatments are explained and the relationship between patient and clinician, can matter more than people usually assume.
The original trial was small and lasted only three weeks, and patients could not be blinded to whether they received pills. Larger and longer studies are still needed to understand how far these effects reach.
Source
Kaptchuk TJ, Friedlander E, Kelley JM, et al. “Placebos without deception: A randomized controlled trial in irritable bowel syndrome.” PLOS ONE, 2010.
DOI: 10.1371/journal.pone.0015591
