Medications That May Cause Anxiety as a Side Effect

For everyone, including the most calm people, occasional anxiety is a normal response to life stressors. For example, it’s not unusual for young adults to feel anxious before an exam or job interview along with tackling financial obligation or relocation. Facing with a completely different set of obstacles, on the other hand we have elderly patients who are trying to cope with health problems while coming to terms with the natural aging process, anxiety is inevitable for them. With that being said, besides the “normal” anxiety due to life stressors, anxiety can also be caused by medication side effects. Please continue reading to learn more about some medications that can cause anxiety disorders as side effects.

What is generalized anxiety disorder?

Generalized anxiety disorder (GAD) is a mental health condition where the affected person frequently feels uneasy, worried, nervous, or fearful. This can be in response to stressful life events or even in the absence of any such event. Therefore, GAD is characterized by a persistent feeling of worry or dread that interferes with quality of life. Generalized anxiety disorder can cause both psychological and physical symptoms. Physical symptoms of anxiety disorders can include chest pain, muscle tension, sleep problems, fatigue, and sweating.

GAD is not the same as occasional anxiety which is due to stressful life events. People with GAD may experience anxiety symptoms for several months or even years. Generalized anxiety disorder develops gradually and is more common in women than men. It can be treated with psychotherapy, anti-anxiety medication, the combination of both, and other treatment approaches.

There are other types of anxiety disorders such as panic disorder (panic attacks), social anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).

Can medication side effects cause anxiety?

Yes, medication side effects can cause anxiety. This is called a medication-induced anxiety disorder. You can also develop anxiety symptoms when you stop taking certain medications. In the following paragraphs, we will list some of the common medications that can worsen or contribute to anxiety symptoms.

What blood pressure medications cause anxiety?

Like all medications, medications used to treat high blood pressure can cause side effects. However, there is no concrete evidence proving that blood pressure medications directly cause anxiety as a side effect.

Historically, blood pressure medicines, especially those that pass the blood brain barrier, are believed to cause mood changes and depression. A meta-analysis (a research that combines and analyzes the results of other scientific studies) has found data to support the view that calcium channel blockers, beta blockers, and angiotensin antagonists may increase the risk of depression. However, there are several limitations of this analysis due to the types of the studies.

More recently, contrary to this idea of blood pressure medications being the culprit for high blood pressure, a study has found that certain medications can even lower the risk of depression.

It is important that you talk to your doctor if you notice any changes in mood while taking blood pressrure medication. Blood pressure medications are proven to lower the risk of stroke, heart attack, and other heart diseases, so it is crucial that you take it as prescribed. However, on the other hand, you shouldn’t have to live with untreated depression. Your doctor can help you identify the cause of your mood problems and, possibly, choose a different blood pressure medication for you. The good news is that there are several anti-hypertensive to choose from.

What medications cause anxiety disorders as side effects?

Here are some medications that can potentially cause anxiety as a side effect.

Stimulants Used to Treat ADHD

Stimulants like dextroamphetamine amphetamine (Adderall), dextroamphetamine (Dexedrine), and methylphenidate (Ritalin, Concerta) are commonly used to treat attention deficit hyperactivity disorder (ADHD). These medications can cause or worsen anxiety because they increase activity in the nerve cells of the sympathetic nervous system.

Medications Containing Caffeine

Some multi-ingredient medications used to treat headaches and cold symptoms contain caffeine, for example, Excedrin Migraine and Fioricet. Caffeine is a stimulant and can worsen anxiety and sleep problems.

Asthma Inhalers

Short-acting beta-agonists (SABAs) are commonly used as rescue medications for asthma. The active ingredient in these asthma inhalers, albuterol, works by relaxing the air passages. However, it can also elicit responses in the rest of the body and cause side effects such as tremors, nervousness, and sleep difficulties. These side effects can make anxiety disorders and panic disorders worse.

Antidepressants

Prescription medications used to treat depression work by increasing the levels of certain chemicals in the brain thereby regulating mood and reducing mood swings and anxiety. The following groups of antidepressants are frequently used for psychiatric treatment of anxiety symptoms:

Selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), and fluvoxamine (Luvox)
Serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor XR), desvenlafaxine (Pristiq), and duloxetine (Cymbalta)
Tricyclic antidepressants (TCAs)
Monoamine oxidase inhibitors (MAOIs)

While these medications reduce anxiety, there is a small number of people that experience increased irritability, agitation, and anxiety.

Corticosteroids

Steroid medications, such as hydrocortisone, prednisolone, prednisone, methylprednisolone, and dexamethasone, are used to treat a wide range of conditions such as life-threatening allergic reactions, autoimmune disorders, inflammatory bowel disease, contact dermatitis, and many more. Side effects of corticosteroids, especially at high dosages or when used for a long time, can include psychological symptoms like irritability, sleep difficulties, mood changes, and anxiety.

Thyroid Medications

Some medications used to treat hypothyroidism (underactive thyroid gland), such as levothyroxine (Synthroid), may cause anxiety and anxiety-related side effects like restlessness, rapid heartbeat, tremors, and sweating if given in excess.

Decongestant Medications

Nasal decongestants used to treat upper respiratory conditions like rhinitis, sinusitis, seasonal allergies, and headaches may contain active ingredients that can contribute to anxiety. For instance, the active ingredient pseudoephedrine in Sudafed, a common medication for head colds and sinus congestion, can cause blood vessel constriction and reduce blood flow. It can also lead to physical symptoms of anxiety like restlessness, nervousness, and difficulty sleeping.

Antihistamines

Antihistamines are commonly used to get relief from seasonal allergies, flu and common cold, skin allergies, and certain digestive conditions. Some people can develop physical anxiety symptoms like a pounding heartbeat while taking antihistamines like diphenhydramine.

Psychoactive Substance

Other substances that are illegal , such as crack/cocaine, LSD, methamphetamine, and cannabis at high doses, are risk factors for anxiety.

Can taking anxiety medication cause anxiety?

Some anti-anxiety medications, such as benzodiazepines, are associated with a risk of psychological and physical dependence. These treatment options for anxiety should be navigated by a healthcare professional licensed to prescribe this medication risk of dependence and benefit for treatment. There is also the possibility of withdrawal and re-emergence of anxiety if someone has been treated with benzodiazepines and has not been able to refill their medication.

For instance, antidepressants and sedative hypnotics can cause withdrawal symptoms, including an anxiety attack or panic attack, if they are stopped abruptly. Also, corticosteroids, beta-blockers, opiates, and certain other medications used to treat hypertension can cause withdrawal symptoms resulting in anxiety.

Drug interactions between other medications can cause unexpected side effects and worsening anxiety as well, but your pharmacist or provider should be aware after they review your medication list.

Which side effect is most common to all anti-anxiety drugs?

The four major classes of prescription drugs used to treat anxiety can cause the following side effects:

Selective Serotonin Reuptake Inhibitors (SSRIs)

Blurred vision, dizziness, drowsiness, fatigue, dry mouth, agitation, restlessness, headaches, nausea, sexual dysfunction, sleep difficulties, and weight gain.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Dizziness, drowsiness, constipation, dry mouth, headaches, increased blood pressure, nausea, loss of appetite, sexual dysfunction, sleep problems, sweating, and weight gain.

Tricyclic Antidepressants (TCAs)

Blurred vision, drowsiness, dizziness, constipation, urination problems, dry mouth, increased appetite, orthostatic hypotension (low blood pressure on standing up), sexual dysfunction, tremors, and weight changes.