Placebos Don’t Work If You Know It’s a Placebo

By Crystal Lindell

Migraine patients who knew they were getting a placebo did not get any pain relief from it.

That’s a short summary of an actual study that was published in JAMA Network Open.

And to be honest, as a pain patient and a former migraine sufferer myself, I’m annoyed that they even wasted their time and resources on this research.

So how did they reach this very obvious conclusion? They recruited 120 chronic or episodic migraine patients for a three-month trial at two headache centers in Germany. About half the participants were given an “open-label placebo” twice a day — fake pills that the patients knew were fake — along with their usual treatments. The other patients just received treatment as usual and served as a control group..

Not surprisingly, they found that the open label placebos did not reduce monthly headache days, pain intensity, or days needing rescue medication compared to the control group.

In other words, the fake pills did not work. A conclusion I could have told them before a single participant was even registered for the study.

The frustration doesn’t stop there though. The researchers then tried to salvage these results by claiming that some of the patients did have slight improvements in what they call "secondary outcomes." That includes things like quality of life, pain-related disability, and “Global Impression of Change.” The latter is a fancy way of saying they felt better.

Even though they literally got no pain relief from the placebo pills and no reduction in migraine days, the authors insist that open-label placebos (OLPs) "might have a supportive role in migraine care.”

“Although more research is needed, OLPs… could potentially be a safe and suitable complementary option for patients with migraine, especially those who prefer nonpharmacologic approaches,” said lead author Julian Kleine-Borgmann, MD, a resident in the Department of Neurology at the University Medical Center Essen.

In other words, they want to explore this ineffective line of treatment even further!

This whole study was a waste of time, and the only saving grace would have been if they saw the results and concluded that further research into fake treatments should end – so that real treatment options can be further developed.

But no, the researchers looked at these very clear results and concluded that since some patients felt slightly better, further studies are needed. 

No. Stop it.

We get it, the medical community has had little success treating migraines or developing new pain treatments. But resorting to fake pills that patients know are fake won’t help anyone – except maybe the researchers who build their careers studying it. 

In fact, it only serves to reinforce the stigma that many pain patients are just looking for attention from doctors. 

It’s not difficult to imagine doctors thinking that if fake pills work on patients who know they are fake, then clearly their pain is probably fake too.

The results of this study should prove that is not the case, but I fear that the researchers don’t seem to have fully absorbed that lesson, given the fact that they want to explore placebo treatment further.

Migraines are a very real and debilitating medical condition that can greatly impact people’s lives. Patients who suffer from them deserve very real treatments in response.