Pain medication

Our rating
For celecoxib 1 smiley: This treatment is promising and may be useful. It has some evidence to support it, but more evidence is needed to be sure it works.
For minocycline Question mark: This treatment has not been properly researched. It is not possible to say whether they are useful or not.
For other pain medication No smiley: On the available evidence, these treatments do not seem to be effective.

 

The rating system

  • 3 smiliesThese treatments are very useful. They are strongly supported as effective by scientific evidence.
  • 2 smiliesThese treatments are useful. They are supported by scientific evidence as effective, but the evidence is not as strong.
  • 1 smileyThese treatments are promising and may be useful. They have some evidence to support them, but more evidence is needed to be sure they work.
  • No smiley On the available evidence, these treatments do not seem to be effective.
  • Question markThese treatments have not been properly researched. It is not possible to say whether they are useful or not.
  • Exclamation MarkSafety or other concerns have been raised for the use of these treatments.

What is it?

Pain medications, or painkillers, refer to drugs like paracetamol, aspirin, and codeine, as well as other drugs which are available with a prescription. They come mostly in tablet form and are usually taken with water, or dissolved in water. Their main uses are for headaches, colds, muscular pains and other pain from injuries.

How does it work?

Research has suggested that inflammatory processes may have a role in depression. Pain medication which reduces inflammation may therefore be of use in treating depression.

Is it effective?

There is no evidence that common pain medication such as aspirin or paracetamol have any effect on people's mood.

There is some evidence on the use of a specific anti-inflammatory pain medication, celecoxib, in the treatment of depression. An analysis of data from 8 studies have found that people who were prescribed celecoxib in addition to standard antidepressant medication experienced a greater reduction in their depression symptoms than those who were prescribed only the antidepressant medication.

There is also a small number of studies about the treatment of depression using another specific anti-inflammatory medication which is sometime used for pain, minocycline. However, more higher quality studies are needed.

Are there any disadvantages?

Pain medications can cause side effects in some people and are toxic in high doses. If you take pain medication, ask your doctor or pharmacist it if might interfere with other medications or supplements you are taking, and make sure to always follow the recommended dose instructions on the packaging. You should also talk with your doctor if your symptoms worsen or new ones develop.

Where do you get it?

Common pain medications are available from pharmacists without a prescription and are sold in most supermarkets.

Celecoxib and minocycline are only available with a prescription from your doctor. 

Recommendation

Common pain medications are unlikely to be helpful for depression, but can help with headaches or other pains that may accompany depression. If severe pain or serious physical illness is causing depression, discuss this with your doctor.

Celecoxib appears to be a promising treatment for depression when combined with regular antidepressant medication.

There is not enough good evidence to recommend minocycline as a treatment for depression.

Key references

  • Baune BT, Sampson E, Louise J, Hori H, Schubert KO, Clark SR, et al. No evidence for clinical efficacy of adjunctive celecoxib with vortioxetine in the treatment of depression: A 6-week double-blind placebo controlled randomized trial. European Neuropsychopharmacology. 2021; 53:34-46.
  • Faridhosseini F, Sadeghi R, Farid L, Pourgholami M. Celecoxib: a new augmentation strategy for depressive mood episodes. A systematic review and meta-analysis of randomized placebo-controlled trials. Hum Psychopharmacol. 2014 May; 29(3): 216-23.
  • Gędek A, Szular Z, Antosik AZ, Mierzejewski P, Dominiak M. Celecoxib for Mood Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Medicine. 2023; 12(10):3497.
  • Jones BDM, Daskalakis ZJ, Carvalho AF, Strawbridge R, Young AH, Mulsant BH, et al. Inflammation as a treatment target in mood disorders: Review. BJPsych Open. 2020; 6(4):e60-e.
  • Kohler O, Benros ME, Nordentoft M, Farkouh ME, Iyengar RL, Mors O, et al. Effect of anti-inflammatory treatment on depression, depressive symptoms, and adverse effects: a systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry. 2014; 71(12): 1381-91.
  • Simon MS, Arteaga-Henríquez G, Algendy AF, Siepmann T, Illigens BMW. Anti-Inflammatory Treatment Efficacy in Major Depressive Disorder: A Systematic Review of Meta-Analyses. Neuropsychiatric Disease and Treatment. 2023; 19:1-25.
  • Wang Z, Wang Q. Effect of celecoxib on improving depression: A systematic review and meta-analysis. World journal of clinical cases. 2022; 10(22):7872-82.

Last reviewed and updated: 22 December 2023

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