Rethinking Healthcare

Placebos work. Should doctors prescribe fake pills?

Placebos work. Should doctors prescribe fake pills?

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Patients with irritable bowel syndrome were given placebos to ease their discomfort. They were even told that the pills were placebos containing inert substances... yet their symptoms improved.

You’ve heard it before in commercials: "...compared to patients taking sugar pill." But as it turns out, sugar pill works.

In clinical trials, placebos like that are meant to make sure that patients taking [insert drug name with registered trademark symbol here] aren’t just imagining that they’re getting better. People who got the treatment showed effects of the drug, people who got placebos aren’t really supposed to as much.

But a new study shows that a placebo provided relief for people with irritable bowel syndrome (IBS), even though they knew perfectly well that they weren’t given any active ingredients.

To be fair, people taking placebos have sometimes been known to feel better. That sort of power-of-positive-thinking is called the ‘placebo effect’ and it’s presumably because they thought they were taking a treatment drug.

In any case, the secret is to not tell the placebo-takers that they got fakes. Or at least that’s what researchers have long believed.

“People just assumed it was that belief was important, and that was never tested, and I don’t know why,” says Harvard’s Ted Kaptchuk.

His team gave 80 people with IBS either (1) no treatment or (2) blue and maroon gelatin capsules that were labeled: “placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes.”

There's no doubt whatsoever that patients realized they were inactive, Kaptchuk says: "They were told so many times, they had it coming out of their ears."

Turns out, people given the placebos showed improved IBS symptoms. In fact, the placebo was almost twice as effective.

So should doctors prescribe placebos?

If placebos require the patient to believe that they are getting a real treatment, the doctor must lie to a patient to prescribe one, violating the ethical mandate that a patient must give informed consent to treatment, Kaptchuk says. The new research, if confirmed, may show lying to a patient to reap a placebo’s benefits may not be necessary [Bloomberg].

He adds, "Let's see if placebos can work when they're applied in an honest way."

As for harnessing the healing powers of placebos for other ailments? "It wouldn't work on a tumor or kill microbes, but it's likely to affect illnesses where self-appraisal is important, such as depression" says Kaptchuk.

The study was published in PLoS ONE last week, and it was done on a shoe-string, Kaptchuk says. “No one would fund a study that was going to tell patients that they were going to get placebo.” In the end, funding came from the National Center for Complementary and Alternative Medicine.

Image: National Institutes of Health

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Janet Fang

Contributing Editor

Janet Fang has written for Nature, Discover and the Point Reyes Light. She is currently a lab technician at Lamont-Doherty Earth Observatory. She holds degrees from the University of California, Berkeley and Columbia University. She is based in New York. Follow her on Twitter. Disclosure