A new study has discovered the bizarre and important problem that acetaminophen (Tylenol) blunts emotions. . . .

This study should change the way we look at a painkiller that many people pop like candy without concern. The study was double-blind. It gave either 1,000mg of acetaminophen or a placebo and then waited one hour for the Tylenol to enter the brain. The researchers then showed pictures of positive and negative events to the people in the study.

People who took the Tylenol evaluated unpleasant events less negatively and pleasant events less positively than did people who really just took a placebo. The Tylenol takers also rated positive and negative events as less emotionally arousing than did the people who got the placebo.

The researchers of this incredible study concluded that acetaminophen has a general blunting effect on people. That means that Tylenol has psychological as well as physical side effects.

What makes the new picture worse for Tylenol is that it has considerable physical side effects and doesn't even work that well.

As we reported recently, double-blind research has shown that acetaminophen (Tylenol), despite being the most recommended drug for back pain, is no more effective than a placebo for treating back pain (Lancet 2014;doi:10.1016/S0140-6736(14)60805-9). This disappointing result has now been confirmed in a meta-analysis.


Researchers conducted a systematic review and meta-analysis of thirteen controlled studies that compared acetaminophen to placebo for back pain or osteoarthritis.They found that, despite the fact that Tylenol is the first line painkiller recommended by doctors for back pain, there is, in fact, "high quality" evidence that it is ineffective for reducing pain, for reducing disability or for improving quality of life. For osteoarthritis, though there is"high quality" evidence that there is a statistically significant effect on pain and disability, that effect is not clinically important, meaning that the benefit is real, but not with enough real world significance to help you. What's worse than Tylenol not helping back pain or osteoarthritis is that it does harm. The meta-analysis found "high quality" evidence that people taking acetaminophen are more than four times more likely to have abnormal results on liver function tests.

These studies combined should change the way we see and use Tylenol.

BMJ 2015;350:h1225

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