Mindpath Health’s Julian Lagoy, M.D. helps discuss if Minocycline can cause depression or help treat it, based on recent research.
If you’ve ever had pneumonia or a urinary tract infection, you may have received a prescription for minocycline — a tetracycline antibiotic that also goes by the brand names Minocin, Minolira, Solodyn, and Ximino.
This short-term medication is used to treat a wide range of bacterial infections, including:
- infections of the eyes, respiratory tract, intestines, and skin
- certain sexually transmitted infections
- severe acne
- infections transmitted by ticks, mites, and other animals
Minocycline is typically prescribed for a period of 10 to 15 days for most common infections, but it may be prescribed for 3 or more months for skin treatment, according to Chanel Johnson, MA, a licensed professional counselor, and owner of Altus Home Counseling.
As with other antibiotics, you may experience side effects while on minocycline. Some people taking this medication report increased symptoms of depression — but others report reduced symptoms of depression. Here’s what to know about minocycline’s potential impact on depression.
Does minocycline cause or worsen depression?
Some evidence does suggest certain antibiotics may increase your risk of depression or worsen existing depression symptoms. A large 2015 study of patients with existing depression, anxiety, and psychosis linked a single antibiotic course to increased depression risk. The risk of depression and anxiety increased further with additional antibiotic treatments.
Here’s why this might happen: Antibiotics kill bacteria — both harmful bacteria and the “good bacteria” your body needs.
“This results in a change in the microbiome,” says Johnson. “Your gut is directly connected to brain function, and alterations can affect the release of certain brain chemicals and neurotransmitters that play a role in your feelings and mood.”
In fact, 2019 research links disruption of the gut microbiome to major depressive disorder (MDD).
Individual case studies also point to a possible link between minocycline and negative mental health effects.
In one 2019 case report, a 37-year-old woman taking minocycline for a skin condition began experiencing symptoms of depersonalization 2 days after starting the medication. She also reported a loss of interest in things she’d usually consider important, another symptom of depression.
She had no personal or family history of any psychiatric condition — and her symptoms improved within just a few days of stopping minocycline.
Depersonalization, which some evidence links to depression, refers to a sense of being detached from your body, mind, and surroundings. People who experience depersonalization often say they feel like an outside observer of their own life.
Existing evidence isn’t conclusive
Experts continue to study the potential link between minocycline and depression. Future research may help clarify why it contributes to depression symptoms, along with how frequently this happens.
“There’s not enough evidence for it to be avoided in patients who have depression,” says Laura Purdy, MD, a board-certified family medicine physician in virtual private practice and chief medical officer of Open Loop. “Much of the evidence is anecdotal, and depression is not listed as a potential side effect.”
Julian Lagoy, MD, a psychiatrist with Mindpath Health, says you might be experiencing minocycline-related depression if you only start experiencing symptoms right after starting the medication, or if your symptoms get noticeably worse right after starting it.
If your symptoms follow a different pattern, minocycline likely isn’t the cause.
Can it help treat depression?
On the flip side, minocycline seems to have antidepressant properties.
In one small 2012 study of adults receiving inpatient care for psychotic depression, a daily dose of minocycline and an antidepressant significantly reduced both depression and psychotic symptoms after 6 weeks of treatment.
Experts believe this effect stems from minocycline’s anti-inflammatory and neuroprotective effects.
Research has found people with depression tend to have higher levels of inflammation in their brains — and minocycline appears to stop immune cells from releasing inflammatory proteins into the brain. In short, minocycline may reduce brain inflammation, which could help relieve depression, in turn.
Lagoy says the antidepressant effects may stop when you stop taking minocycline, but they’re more likely to last if you use other treatments, like therapy, to help manage your symptoms.
It may have benefit when other treatments don’t work
Purdy notes that minocycline is typically only prescribed as a last resort, if other medications haven’t helped.
Research from 2018 suggests it may help address depression that occurs with bipolar disorder and treatment-resistant depression. About 12-20% of all people with depression have treatment-resistant depression, which means they haven’t responded to two or more types of treatment.
Evidence also suggests minocycline may help improve depression symptoms for people with health conditions that affect the immune system, like HIV. According to a 2016 study of people living with both HIV and mild to moderate depression, minocycline appeared to help improve depressive symptoms.
As a 2021 review notes, though, these few existing studies have smaller sample sizes, so future research may offer more insight into minocycline’s effectiveness in depression treatment.
What about anxiety?
A 2015 study found that repeated exposure to antibiotics may increase your chances of developing anxiety. But not much evidence supports this link.
Regardless, this side effect should go away shortly after you stop taking minocycline, Lagoy says.
To contrast, some people find minocycline has a positive impact on anxiety symptoms. Immune dysregulation plays a key role in anxiety disorders, and since minocycline can treat the underlying immune system issues, it has the potential to ease anxiety.
Johnson notes minocycline may also help reduce inflammation in the brain, which is associated with anxiety as well as depression. A 2018 study of male rats found that minocycline treatment helped reduce behavior related to post-traumatic stress disorder (PTSD), which many experts consider an anxiety disorder.
“It’s possible that minocycline may be added to an anxiety treatment plan as an adjunctive treatment when other medications have failed,” says Purdy.
Other minocycline side effects
Most people tolerate minocycline well, and side effects are usually mild and short-lived. The most common side effects include lightheadedness and dizziness, nausea, and vertigo.
Other minor side effects include:
- dry mouth
- ringing in your ears
- loss of appetite
- hair loss
- tingling or prickling sensation on the skin
- sore throat
- muscle pain
- tooth discoloration
Severe side effects are rare, but you should get medical attention right away if you experience:
- changes in vision, including seeing double
- hives or rash
- shortness of breath
- difficulty breathing or swallowing
- bloody urine or stool
- chest or joint pain
- swelling anywhere on your throat, tongue, or face
- signs of infection, like fever or swollen lymph nodes
- dark yellow or brown urine, trouble urinating, or less frequent urination
Many of these more serious side effects may suggest an allergic reaction, says Purdy, which requires medical attention right away.
Allergic reactions to tetracycline antibiotics happen more commonly in women, and, while very rare, they can be life threatening.
How to handle side effects
Symptoms of depression will typically go away once you stop taking minocycline, according to Johnson, but it may take up to a week for symptoms to improve.
If you experience unwanted side effects, Lagoy strongly recommends reaching out to the prescribing clinician rather than quitting the medication on your own.
A healthcare professional can work with you to determine the safest course of action, whether that means reducing your dose of minocycline, gradually tapering off the dose, or stopping it altogether.
Therapy can help
Working with a therapist can also go a long way toward helping you navigate increased or severe symptoms of depression — especially if they don’t improve after you adjust to minocycline or stop taking it.
A therapist can offer more support with pinpointing the source of the depression and determining whether it relates to medication or underlying psychosocial stressors, Lagoy explains.
Additionally, a therapist can help you create a routine that incorporates coping and emotion regulation skills that can help reduce the effects of depression, Johnson emphasizes.
The bottom line
Minocycline, a type of antibiotic used to treat bacterial infections, can have varying effects on depression and anxiety. Some people say it worsens their symptoms, while others find this antibiotic offers some relief.
Anecdotal evidence suggests minocycline could potentially trigger mental health symptoms like depression and anxiety, even if you didn’t have them before beginning the medication.
If you develop symptoms of depression while taking minocycline, Purdy recommends connecting with your doctor right away to find an alternate treatment and get support and treatment for depression.
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