German students who knowingly took inactive placebo pills tended to report lower levels of test anxiety two weeks later, according to a new pilot study published in Scientific Reports.

“Open-label placebos are very interesting because they offer a new way to treat, for example, allergic rhinitis or pain,” said study author Michael Schaefer, a professor of neuropsychology at Medical School Berlin.

In the study, the researchers explained the potentially powerful effect of placebos to 58 students. “They were told that the body may automatically respond to taking placebo pills, like Pavlov’s dogs that salivated when they heard the bell. A positive attitude may be helpful for the placebo effect, but is not necessary,” the authors of the study explained.

The students then completed assessments of test anxiety, quality of life, and self-management abilities, before being randomly assigned to either take placebo pills for 14 days or not take the pills.

After the 14 days, which was the day before taking their final exam, the participants again completed assessments of test anxiety, quality of life, and self-management abilities.

The students who took the placebo pills showed reductions in test anxiety and improvements in self-management skills.

“Here we showed that open-label placebos also have an effect on healthy subjects. Our study demonstrated that taking open-label placebos reduces test-anxiety and improves self-management abilities before an exam,” Schaefer told PsyPost.

“This is remarkable, because open-label placebo means that you swallow a pill and you know there is nothing in it — it is just a sugar pill. But still it seems to work.”

“Given that test anxiety is a big problem for many students, these results might be very important for many individuals. Placebos are essentially sugar pills. They are cheap and have no side-effects. Therefore, placebos may be a way to treat students with low risks and costs,” Schaefer explained.

Previous research has found that taking open-label placebo pills can lead to reductions in pain and disability in patients with chronic low back pain. But the evidence supporting the use of open-label placebos is still very much preliminary.

“Future studies with bigger samples are needed to replicate our results. In addition, the exact way how open-label placebos work is still not known,” Schaefer said.

“Open-label placebos are a fascinating new way to treat patients and, as our study showed, even healthy individuals. Future studies will give us more information how this works and might offer new ways to treat symptoms without side-effects and in an ethical way.”

The study, “Open-label placebos reduce test anxiety and improve self-management skills: A randomized-controlled trial“, was authored by Michael Schaefer, Claudia Denke, Rebecca Harke, Nina Olk, Merve Erkovan, and Sören Enge.