Psychopharmacology

, Volume 211, Issue 1, pp 113–122 | Cite as

Are the colors and shapes of current psychotropics designed to maximize the placebo response?

  • Arif Khan
  • Eswara Prasad Bomminayuni
  • Amritha Bhat
  • James Faucett
  • Walter A. Brown
Original Investigation

Abstract

Rationale

Patient expectations are an important aspect of the placebo response. Color and shape of a medication lead to perceptions that an agent is stimulating or calming, strong or weak.

Objectives

We assessed the degree to which central nervous system medications match the perceived drug action and thereby harness the placebo response.

Methods

We consulted the 2009 Physicians’ Desk Reference and recorded the formulation and color of each referenced dose of central nervous system therapeutics approved for sale in the USA. On the basis of the expectations they engender, orange, yellow, and red pills were categorized stimulating; green, blue, and purple pills calming. White and gray pills were considered neutral.

Results

The majority of the 176 unique doses that were included in the study were in tablet (55%) and capsule (33%) form. Stimulants (75%) were the only drug category primarily formulated as capsules. Of the 176 unique doses included, 43% were stimulating, 23% calming, 23% neutral, and 12% were a formulation other than pill or capsule. There were no instances in which over 50% of the pills of an indication were stimulating or calming in color.

Discussion

Our study did not confirm the hypothesis that pharmaceutical companies color and formulate the shape of drugs to enhance the treatment response. In several instances, each approved dose of a given medication was a different color, and the majority of doses were in tablet form. Further research into the effect of different colors and formulations of medications on perceptions and efficacy evaluations should be considered.

Keywords

Drug Antipsychotic Antidepressant Anxiolytic-placebo-response Color(s) 

References

  1. Adams FM, Osgood CE (1973) A cross-cultural study of the affective meanings of color. J Cross Cult Psychol 4:135–156CrossRefGoogle Scholar
  2. Blackwell B, Bloomfield SS, Buncher CR (1972) Demonstration to medical students of placebo responses and non-drug factors. Lancet 1:1279–1282CrossRefPubMedGoogle Scholar
  3. Buckalew LW, Coffield KE (1982a) An investigation of drug expectancy as a function of capsule color and size and preparation form. J Clin Psychopharmacol 2:245–248CrossRefPubMedGoogle Scholar
  4. Buckalew LW, Coffield KE (1982b) Drug expectation associated with perceptual characteristics: ethnic factors. Percept Mot Skills 55:915–918PubMedGoogle Scholar
  5. de Craen AJM, Roos PJ, de Vries AL, Kleijnen J (1996) Effect of colour of drugs: systematic review of perceived effect of drugs and their effectiveness. BMJ 313:1624–1626PubMedGoogle Scholar
  6. Duric VM, Fallowfield LJ, Saunders C, Houghton J, Coates AS, Stockler MR (2005) Patients’ preferences for adjuvant endocrine therapy in early breast cancer: what makes it worthwhile? Br J Cancer 93:1319–1323CrossRefPubMedGoogle Scholar
  7. Fallowfield F, Atkins L, Catt S et al (2005) Patients’ preference for administration of endocrine treatments by injection or tablets: results from a study of women with breast cancer. Ann Oncol 17:205–210CrossRefPubMedGoogle Scholar
  8. Frank JD, Frank JB (1991) Persuasion and healing: a comparative study of psychotherapy. The Johns Hopkins University Press, BaltimoreGoogle Scholar
  9. Hussain MZ (1972) Effect of shape of medication in treatment of anxiety states. Br J Psychiatry 120:507–509CrossRefPubMedGoogle Scholar
  10. Jacobs KW, Nordan FM (1979) Classification of placebo drugs: effect of color. Percept Mot Skills 49:367–372PubMedGoogle Scholar
  11. Khan A, Kolts RL, Thase ME, Krishnan KRR, Brown W (2004) Research design features associated with the outcome of antidepressant clinical trials. Am J Psychiatry 161:2045–2049CrossRefPubMedGoogle Scholar
  12. Khan A, Kolts RL, Rapaport MH, Krishnan KRR, Brodhead AE, Brown W (2005) Magnitude of placebo response and drug-placebo differences across psychiatric disorders. Psychol Med 35:743–749CrossRefPubMedGoogle Scholar
  13. Leuchter AF, Cook IA, Witte EA, Morgan M, Abrams M (2002) Changes in brain function of depressed subjects during treatment with placebo. Am J Psychiatry 159:122–129CrossRefPubMedGoogle Scholar
  14. Oken BS (2008) Placebo effects: clinical aspects and neurobiology. Brain 131:2812–2823CrossRefPubMedGoogle Scholar
  15. Thomson Reuters (2009) Physicians’ Desk Reference, 63rd edn. Thomson Reuters, MontvaleGoogle Scholar
  16. Ridgway D, Khan A, Cierpial MA, Lineberry CG (2007) Subject numbers and placebo outcome variability in clinical trials of new CNS medications. Drug Inf J 41:701–708Google Scholar
  17. Rutherford BR, Sneed JR, Roose SP (2009) Does study design influence outcome? The effects of placebo control and treatment duration in antidepressant trials. Psychother Psychosom 78:172–181CrossRefPubMedGoogle Scholar
  18. Sallis RE, Buckalew LW (1984) Relation of capsule color and perceived potency. Percept Mot Skills 58:897–898PubMedGoogle Scholar
  19. Schapira K, McClelland HA, Griffiths NR, Newells DJ (1970) Study on the effects of tablet colour in the treatment of anxiety states. BMJ 2:446–449CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Arif Khan
    • 1
    • 2
  • Eswara Prasad Bomminayuni
    • 1
  • Amritha Bhat
    • 1
  • James Faucett
    • 1
  • Walter A. Brown
    • 3
    • 4
  1. 1.Northwest Clinical Research CenterBellevueUSA
  2. 2.Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamUSA
  3. 3.Department of Psychiatry and Human BehaviorBrown UniversityProvidenceUSA
  4. 4.Tufts University School of MedicineBostonUSA

Personalised recommendations