Study Links Tylenol Consumption with Risk Taking

The psychological side effects of acetaminophen, aka Tylenol, continue to mount, with research showing users are more likely to make risky decisions. When coupled with past research linking this supposedly safe pain reliever to blunted empathy and emotions, the widespread social effects on society could be immense.

Acetaminophen, commonly known by its brand name Tylenol, is one of the most commonly used medications worldwide — and research suggests it could be causing users to engage in more risky behaviors.^[1] In the U.S. alone, acetaminophen can be found in more than 600 prescription and over-the-counter drugs and is taken by 23% of — or 52 million — Americans each week.^[2]

Many don’t think twice about popping a Tylenol or two to relieve a headache, reduce a fever or ease minor aches and pains or cold and allergy symptoms, but research continues to reveal that this supposedly “safe” pain reliever has more risks than many people realize. Among them are surprising effects on psychological processes such as behavior and perception, including altering willingness to take risks.

Considering that so many people take acetaminophen on a daily basis, even slight changes in risk-taking behaviors “could have important effects on society,” study co-author Baldwin Way, an associate professor of psychology at The Ohio State University, noted in a press release.^[3]

Acetaminophen Makes People More Likely to Take Risks

The study involved 189 college students, who took a standard recommended adult dosage of 1,000 milligrams (mg) of acetaminophen or a placebo. They were then asked to rate the riskiness of activities such as bungee jumping, taking a skydiving class, walking home alone at night in an unsafe area and starting a new career in your mid-30s.

Those under the influence of acetaminophen rated these activities as less risky than those who took a placebo. “Acetaminophen seems to make people feel less negative emotion when they consider risky activities — they just don’t feel as scared,” Way said.^[4]

In a second part of the study, 545 college students took part in a computer task intended to measure risk-taking behavior. The students had to click a button to inflate a balloon in order to earn money. The bigger the balloon, the more money they would receive, but if the balloon got too big and burst, they would lose their money.

As in the first study, those who took acetaminophen took more risk, pumping the balloons more times and earning more burst balloons, than those who took a placebo. “If you’re risk-averse, you may pump a few times and then decide to cash out because you don’t want the balloon to burst and lose your money,” Way said. “But for those who are on acetaminophen, as the balloon gets bigger, we believe they have less anxiety and less negative emotion about how big the balloon is getting and the possibility of it bursting.”^[5]

It’s previously been suggested that those with increased risk-taking on these types of computer-simulated tasks may be more likely to engage in risky behaviors in real-life as well, including using drugs and alcohol, stealing and driving without a seatbelt.^[6]

Acetaminophen Blunts Empathy, Positive and Negative Emotions

While potentially increasing risky behaviors, acetaminophen has also been found to blunt both positive and negative emotions. In this way, Way and colleagues revealed in 2015 that over-the-counter acetaminophen provides relief from “pain and pleasures alike,” essentially dampening users’ ability to experience emotionally pleasurable sensations.^[7]

The next year, in 2016, Way and colleagues found acetaminophen to be an “empathy killer,”^[8] as it reduced users’ empathy in response to others’ pain. Because empathy plays an important role in prosocial and antisocial behaviors, acetaminophen-induced alterations in empathy could be having broad social side effects.^[9]

In a 2019 study, Way and colleagues again compared acetaminophen to a “social analgesic,” stating that it blunts “social pain” by reducing the activity of the anterior insula and anterior cingulate brain regions, which are associated with emotional awareness and motivation.^[10] Even positive empathy was blunted by the drug.

When people were given 1,000 mg of acetaminophen, then read scenarios about uplifting experiences of other people, the acetaminophen reduced personal pleasure and empathic feelings directed toward others, once again suggesting that the widespread use of acetaminophen could be having a negative effect on prosocial behavior on a societal level.^[11]

Acetaminophen has also been found to cause an “inhibition of evaluative processing,”^[12] meaning it could alter your ability to make decisions and cause you to react slower or miss errors that you would spot otherwise.^[13]

Acetaminophen Is ‘Not Particularly Effective’ or Safe

Acetaminophen’s reputation as a “safe and effective” painkiller is increasingly being called into question, and anyone who uses it should be aware that in addition to psychological effects, acetaminophen is linked to serious physical adverse effects.

GreenMedInfo.com has compiled 236 studies related to acetaminophen’s toxicity, and a European Journal of Hospital Pharmacy editorial concluded, “We have considerable evidence that as well as not being particularly effective, neither is it particularly safe.”^[14] Some of the health risks linked to acetaminophen use include:^[15]

• Increased mortality
• Cardiovascular adverse events, including heart attack, stroke and fatal coronary artery disease
• Gastrointestinal adverse events, including gastroduodenal ulcers and upper gastrointestinal hemorrhage
• Acute liver failure necessitating transplantation
• Abnormal liver function

What’s more, acetaminophen has been shown to be ineffective for treating back pain, “practically ineffective” for arthritis and “in the least effective quartile of drugs” for treating postoperative pain. It’s also only modestly effective for migraines and tension-type headaches, while no evidence shows that it works to relieve pain related to cancer, menstrual cramps, rheumatoid arthritis or the neck.^[16]

Considering its significant risks — including psychological risks that are only beginning to be understood and explored–and questionable effectiveness, it makes sense to try nontoxic, natural pain relief options first, of which there are hundreds to choose from.

References

[1] Social Cognitive and Affective Neuroscience, nsaa108, https://doi.org/10.1093/scan/nsaa108, https://academic.oup.com/scan/advance-article/doi/10.1093/scan/nsaa108/5897711

[2] Consumer Healthcare Products Association, Acetaminophen https://www.chpa.org/Acetaminophen.aspx

[3] Ohio State News September 8, 2020 https://news.osu.edu/a-pain-reliever-that-alters-perceptions-of-risk/

[4] Ohio State News September 8, 2020 https://news.osu.edu/a-pain-reliever-that-alters-perceptions-of-risk/

[5] Ohio State News September 8, 2020 https://news.osu.edu/a-pain-reliever-that-alters-perceptions-of-risk/

[6] Ohio State News September 8, 2020 https://news.osu.edu/a-pain-reliever-that-alters-perceptions-of-risk/

[7] Psychological Science April 10, 2015 https://journals.sagepub.com/doi/abs/10.1177/0956797615570366

[8] Soc Cogn Affect Neurosci. 2016 Sep; 11(9): 1345-1353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015806/

[9] Soc Cogn Affect Neurosci. 2016 Sep; 11(9): 1345-1353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015806/

[10] Front Psychol. 2019; 10: 538. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455058/

[11] Front Psychol. 2019; 10: 538. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455058/

[12] Social Cognitive and Affective Neuroscience, Volume 11, Issue 6, June 2016, Pages 899-906, https://doi.org/10.1093/scan/nsw023, https://academic.oup.com/scan/article/11/6/899/2224073

[13] Science Alert April 12, 2016 https://www.sciencealert.com/tylenol-may-make-it-harder-for-users-to-spot-errors-says-study

[14] European Journal of Hospital Pharmacy Volume 23, Issue 4 https://ejhp.bmj.com/content/23/4/187

[15] European Journal of Hospital Pharmacy Volume 23, Issue 4 https://ejhp.bmj.com/content/23/4/187

[16] European Journal of Hospital Pharmacy Volume 23, Issue 4 https://ejhp.bmj.com/content/23/4/187