Mixed Emotions About Acetaminophen


Over my past 3 decades of pharmacy practice, acetaminophen has been one of my most recommended OTC treatments.

A pain reliever taken on a daily basis by nearly 25% of the US adult population has some newfound side effects.

Acetaminophen was first marketed in the United States in 1955 as an analgesic and antipyretic medication known as Tylenol. Over the past 70 years, it has grown to become the most popular and best-selling pain medication on the market.

Interestingly, acetaminophen's mechanism of action has never been strictly understood, other than it being a weak inhibitor of prostaglandin synthesis, which may be responsible for its potent analgesic and antipyretic effects. Unlike non-steroidal anti-inflammatory medications, acetaminophen has very little effect on inflammatory response.

Recently, researchers became interested in isolating how acetaminophen works to decrease emotional response. Their results suggest acetaminophen may decrease strong emotions, given that “people who took acetaminophen didn’t feel the same highs or lows as did the people who took placebos."

This emotional blunting effect has not been identified in other OTC pain relievers, such aspirin, though the research team plans on studying this category in the future. Furthermore, the researchers are unsure whether acetaminophen's little effect on the inflammatory process plays any role in its emotional blunting activity.

Nevertheless, these findings may help health care professionals better understand how patients respond to both positive and negative events in their lives.

As a practicing community pharmacist, I am left with mixed emotions (that are not currently blunted by acetaminophen). Over my past 3 decades of pharmacy practice, acetaminophen has been one of my most recommended OTC treatments.

My concern is, has acetaminophen grown in popularity because of its known pain- and fever-reducing properties, or has its unknown ability to decrease emotional response been a major contributing factor in its widespread use?

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