Why Placebos Really Work: The Latest Science

Scientists are finding a growing number of ways placebos appear to bring about real health benefits in patients. The research could someday lead to increased use of placebos—substances that have no apparent pharmaceutical effect—in treatments for common diseases.

Studies have shown that administering placebos reduces pain and symptoms in patients with irritable bowel syndrome and migraines, even when patients know they are taking a placebo. Scientists are exploring if they can get the same result in chronic back pain and cancer-related fatigue. Parkinson’s-disease researchers discovered that stopping patients’ real medication and substituting a placebo continues to ease their symptoms, likely because the body is preconditioned to trigger the same response.

Numerous studies have documented neurobiological effects that placebos have in the brain, resulting in the release of neuromodulators that can help reduce pain and symptoms of illness. New evidence suggests the fake drugs may also affect the body, in particular the immune system, according to an animal study published online in July in the journal Nature Medicine.

“This is not just making it up in your mind. The placebo effect has a biology,” says Ted J. Kaptchuk, director of the Program in Placebo Studies and Therapeutic Encounter at Beth Israel Deaconess Medical Center in Boston and a professor at Harvard Medical School. “The pathways that we know the placebo effects use are the pathways many significant drugs use.”

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The placebos doctors most often prescribe are active drugs but in such low doses that there is no apparent therapeutic benefit, says Walter Brown, a clinical professor of psychiatry at Brown University who wrote “The Placebo Effect in Clinical Practice,” a book published in 2013. Physicians also prescribe vitamins, antibiotics or over-the-counter analgesics, like aspirin. Doctors rarely will prescribe an outright sugar pill.


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What We Know

Placebos cause neurobiological effects in the brain. A new animal study suggests they may also affect the body, especially the immune system.

Patients taken off a real drug and put on a placebo continue to have fewer symptoms, perhaps because the body is preconditioned to continue the same response.

Even when patients know they are getting placebos, the fake drugs reduce migraine pain and symptoms of irritable bowel syndrome. Researchers are testing if they can get the same result in chronic back pain.

Genetic differences appear to make some people more likely to respond to a placebo.

More than half of doctors already prescribe placebos, studies show, especially when there isn’t a suitable remedy on the market.

Placebos usually are vitamin pills, over-the-counter pain relievers or doses of existing medications that are too low to have therapeutic value.