Do OTC Pain Relievers Have Psychological Effects?

A new review of the scientific literature suggests there’s ample evidence over-the-counter painkillers have psychological effects.

Kyle Ratner, PhD

Over-the-counter (OTC) pain medications might be doing more than taking away headaches—they might also be affecting our moods and emotions.

That’s the finding of a new scientific review, which noted that there is mounting evidence that acetaminophen, and possibly ibuprofen, affect cognitive and affective processes.

“There had been several studies in the psychology/neuroscience literature that had reported psychological effects of these OTC drugs (mostly acetaminophen) but they had not been put together in one place in an academic review,” study author Kyle Ratner, PhD, an assistant professor of social psychology at the University of California, in Santa Barbara, told MD Magazine. “I felt that given how widely these drugs are taken and the possibility of these studies for changing our understanding of these drugs it was time to write a review on the topic.”

Ratner said he specifically chose to publish in a policy-oriented journal, Policy Insights from the Behavioral and Brain Sciences (PIBBS), in part because he wanted to reach both research scientists and policymakers.

In the study, Ratner noted that OTC pain medications can affect “social pain,” in addition to physical pain. The research also indicates that the 2 pain types might have overlapping biological mechanisms.

Included in the paper was data from a 2010 study that found patients who took acetaminophen before bed reported fewer hurt feelings than their counterparts taking a placebo. Other studies found acetaminophen reduced personal stress and suggested that people have less empathy for others after taking a dose of an OTC painkiller.

Ratner wrote that the findings are “in many ways alarming,” but he told MD Magazine that his goal is not so much to raise alarm as it is to prompt additional research. “Something that I want to strongly emphasize is that there are really only a handful of studies that have looked at the psychological effects of these drugs,” he said.

Ratner said a number of questions still need to be answered. For one, there is not enough evidence out there to know to what extent these psychological effects are merely the result of people being in better moods once their pain is gone.

“A reason I did the review was to bring attention to the topic and suggest that more research is necessary to carefully answer these question,” Ratner said. “That said, some of the papers I reviewed argue that what they were reporting were not simply mood effects.”

Ratner also noted that the participants in the studies were not taking the medications because of physical pain, and so the psychological effects might be a difference in cases where the person experienced physical pain and then relief.

For now, Ratner is urging caution and nuanced interpretation of the data. He said stoking fears of these drugs could have negative consequences, as could a full embrace of the pills as mood-altering therapies.

It is too soon to draw such conclusions, Ratner said. The important thing is that the questions get asked. “[B]efore the public, policymakers, and researchers change their view on these drugs we need careful replication studies of existing work to confirm reported results and also studies that probe the nuances suggested by the studies already in the literature,” he said.

The study, “Can Over-the-Counter Pain Medications Influence Our Thoughts and Emotions?,” was published in PIBBS.

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