One Pill, Two Pill, Red Pill, Blue Pill: Putting Color of Healing in Context


Meaning and context are essential elements of healing. Sometimes called the placebo effect, meaning and context refer to how a treatment is delivered rather than the efficacy of the treatment itself. For healing to be optimized for any treatment, you need the expectation of an effect and you need its social meaning delivered in the right context. 

Meaningfulness is not just about what you’re thinking in your head. It’s about your deep, core beliefs and that of the social group in which you live. It’s what the cultural belief is – what your physician believes, what you believe, and what your family and society believes is real.

If context didn’t matter then pill color wouldn’t matter. But it does.

Pill Color Matters

The studies on perceived action of colored drugs showed that red, yellow and orange pills are associated with a stimulant effect, while blue, purple and green pills have a tranquillizing effect.

Drug companies market most of their sedatives and antidepressants in blue or purple or similar, subdued colors and most of their stimulants are in white, red, yellow or orange – bright colors. In Italy, however, a blue pill does not have this effect because of context.

 pill colors

For many Italians (especially men), blue is stimulating and exciting because blue is the color of the national soccer team.  For others, (especially women) the same color is associated with the Virgin Mary, a soothing, calming image. These perceptions cancel each other out when the impact of blue pills is studied in Italy. This cultural context and the meaning it produces leads to a change in the effect of the pills.

Cultural Beliefs Affect Treatments, Sell Pills 

This shows the power of context. The meaning behind the treatment is can be more effective than the treatment itself. This meaning is one of the main mechanism whereby healing happens. The expectancies, not just of me, not just of my neighborhood, but of my culture, of my family, are embedded in not only my head but are expressed in my body; baked into us from childhood.

Pharmaceutical companies have already taken note of this and use it to determine the name, color, shape, dosage, timing and taste of medication.(1) They attempt to enhance the chemical effect of their pills with these meanings. This sells more pills.

But we need the rest of the health care system to pay attention to this also. 

For example, researchers at Brigham and Women’s Hospital found that if the color or shape of a pill changes, the patient will be 50% less likely to take it routinely. (2) This type of information is essential to providing care that works for the patient. Most doctors don’t know or pay attention to this information.

Enhance the Positive Response 

There are multiple opportunities to enhance the positive response from the meaning and context of any treatment. You can learn more about the meaning and context effect by watching the video below. It will give you a flavor (or should I say color) of how healing happens.


(1) Inderscience Publishers. “Color and shape of pills affects how patients feel about their medication.” ScienceDaily. ScienceDaily, 19 January 2011. Link

(2) “Variations in Pill Appearance of Antiepileptic Drugs and the Risk of Nonadherence” Aaron S. Kesselheim, MD, JD, MPH; Alexander S. Misono, MD, MBA; William H. Shrank, MD, MSHS; Jeremy A. Greene, MD, PhD; Michael Doherty; Jerry Avorn, MD; Niteesh K. Choudhry, MD, PhD. Archives of Internal Medicine, January 2013, doi:10.1001/2013.jamainternmed.997 Link