Can Minocycline Cause Depression or Help Treat It?

Research is inconclusive on how the antibiotic used to treat pneumonia or urinary tract infections affects depression. In this Healthline article, Mindpath Health’s Julian Lagoy, MD, explains about side effects to watch for and when to get help.

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.

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, LPC.

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.”

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. “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

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.

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.

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 by pinpointing the source of depression and determining whether it relates to medication or underlying psychosocial stressors, Lagoy explains.

Read the full Healthline article with sources.