Certain drugs can cause anxiety or aggravate anxiety symptoms. Learn about these medications and find out what you can do to counter their side effects.
Medications that receive approval by the US Food and Drug Administration (FDA) are assumed to be safe. (1)
What that really means is that FDA-approved drugs are thought to be more beneficial to a person’s health than not.
But all prescription and over-the-counter (OTC) drugs carry risks in the form of side effects or adverse reactions.
Between 2011 and 2017, the FDA received more than 5.4 million reports of adverse events from prescription drugs.
These reports included more than 1 million deaths. (2)
Many different factors can influence an individual’s risk for side effects.
These factors include age, gender, allergies, other medications you’re taking, how the body absorbs the drug, and even preexisting conditions like anxiety.
Some drugs can cause anxiety or exacerbate the condition in people who already have it or are prone to its debilitating effects.
These drugs can even include medications used to treat anxiety and depression.
What Is Anxiety?
Anxiety is a normal part of life.
Everyone feels anxious at times, especially when faced with certain life events that can be overwhelming.
Anxiety is an emotion, according to the American Psychological Association (APA). (3)
The emotion of anxiety involves feelings of tension, worrying, and physical changes to the body, both internally and externally.
Physical changes related to anxiety might include increased blood pressure and heart rate or sweaty palms, trembling, and rapid breathing.
Some people might also experience gastrointestinal (GI) problems or have difficulty sleeping despite feeling weaker and more tired than usual.
Normal Anxiety: Fight-or-Flight
Anxiety is not only normal, but it’s also necessary.
Anxious thoughts and feelings can be triggered by potentially dangerous events or worry about possible harm.
Anxiety is the result of fear.
The purpose of fear is to help us survive. (4)
Fear helps us to know when to avoid or appropriately confront danger.
Our response to fear is called the “acute stress response,” more commonly known as “fight-or-flight.”
In the 1920s, physiologist, professor, and chairman of the Department of Physiology at Harvard Medical School, Walter Cannon, was the first to describe this response. (5)
Cannon developed the phrase fight-or-flight to explain an animal’s reaction to threats.
The sympathetic nervous system is activated, and the hormone adrenaline is released during stressful conditions to boost this response.
The general idea is that the body is preparing you to seek safety by either physically fighting or fleeing the situation altogether.
While this response likely made more sense for our prehistoric ancestors, it can still be a valuable reaction today.
That nervous feeling we get in response to crucial life demands like work, health, or family can help us effectively deal with issues requiring our attention.
This response is also still useful in helping us to avoid walking into the street without looking both ways or jumping into rough waters without a life vest, etc.
Anxiety is normal, but some people have anxiety that does not go away or worsens over time.
Anxious behavior might also cause other problems for the person with anxiety, such as a decline in one’s job or school performance.
Severe persistent anxiety can also interfere with personal relationships or influence where one goes or what one does.
These people have an anxiety disorder.
Anxiety disorders are the most common type of mental disorders, according to the American Psychiatric Association.
The psychiatry organization suggests that nearly 30 percent of adults are affected by the condition at some point during their lives. (6)
Generally, in anyone diagnosed with an anxiety disorder, the fear or anxiety is disproportionate to the actual situation.
Also, the anxiety must impair a person’s ability to function normally. (7)
There are different types of anxiety disorders.
Someone who suffers from recurrent panic attacks, for example, has a panic disorder.
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These attacks can be overwhelming, with symptoms so severe that a person may feel as though they are having a heart attack or suffering from a life-threatening illness.
The attacks can occur in response to a specific fear or, seemingly, for no reason at all.
Some anxiety disorders, like panic disorder, may occur along with other mental disorders, like depression, post-traumatic stress disorder (PTSD) or obsessive-compulsive disorder (OCD).
Types of anxiety disorders include:
- Generalized anxiety disorder: persistent and excessive worry that interferes with daily activities
- Phobias / Specific phobia: excessive and persistent fear of a specific object, situation, or activity that is generally not harmful
- Agoraphobia: fear of being in situations where escape may be difficult or embarrassing, or help might not be available if you panic
- Social anxiety disorder: significant anxiety and discomfort about being embarrassed, humiliated, rejected, or looked down on in social interactions
- Separation anxiety disorder: excessive fear or anxiety about separation from those with whom a person is attached; not age-appropriate
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Medications That Cause Anxiety
Anxiety disorders are typically caused by a combination of factors, including environmental stress and genetics.
Changes in the brain can also contribute to the development of anxiety disorders.
Some medications that are catalysts for these changes are thereby likely culprits.
Medications that trigger anxiety disorders usually target parts of the body and physiological reactions that result in symptoms of anxiety. (8)
This is sometimes referred to as substance-induced anxiety disorder, which is described as anxiety that directly results from taking medications or even withdrawing from some medications.
This reaction can also be caused by the misuse of drugs or exposure to substances that are otherwise toxic to our bodies.
Headache / Migraine Medications with Caffeine
Pain relievers containing caffeine can quickly treat a headache while also stimulating the nervous system.
Caffeine can lead to jitters or feelings of nervousness and anxiety, especially for those already prone to anxiety.
According to Roland Griffiths, a professor of psychiatry and neuroscience at the Johns Hopkins University School of Medicine, caffeine is a “mood-altering drug.” (9)
Learn more —
15 Links Between Caffeine and Anxiety
Headache remedies that contain caffeine, such as Excedrin Migraine, Anacin, and ergots (for migraines), or even just a normal cup of coffee, can aggravate anxiety and panic disorders. (10)
In some, caffeine leads to a pleasurable response by blocking the depressant function of a naturally occurring chemical in the body called adenosine.
This results in an increased sense of alertness and focus and can even enhance or improve memory.
But in others, caffeine leads to anxiety-related symptoms and sensations, like sweating or a racing heart.
This can, in turn, lead to an impending sense of doom and panic.
Alternative pain relievers for individuals sensitive to the effects of caffeine include acetaminophen (Tylenol) or NSAIDs (nonsteroidal anti-inflammatory drugs).
Aspirin, naproxen, and ibuprofen (Advil, Motrin) are all examples of NSAIDs.
Asthma Medications and Corticosteroids
Asthma medications have been found to worsen mood disorders like depression and anxiety.
Some of these medicines can also cause anxiety in people who have never had a problem with it before.
Asthma itself can cause anxiety when a person struggles to breathe.
And anxiety can, in turn, exacerbate asthma.
Inflammation may be the primary reason for this association.
A 2006 paper published by Harvard University called Inflammation: A Unifying Theory of Disease established that inflammation can lead to numerous mental and physical illnesses. (13)
But despite the evidence of a link just between the conditions themselves, medications used to treat asthma also often pose a risk of anxiety as a side effect.
Medications like albuterol (Ventolin, Proventil, ProAir), salmeterol (Serevent), epinephrine (EpiPen), and theophylline can cause tremors, nervousness, sweating, and fast heartbeats.
Corticosteroids, sometimes used to treat asthma as well as allergies, arthritis, and bronchitis, can be linked to anxiety and irritability too.
ADHD or Stimulant Medications
Another condition that often occurs alongside anxiety is attention deficit hyperactivity disorder (ADHD).
About 30 to 40 percent of people with ADHD have an anxiety disorder, as told to Psych Central by Roberto Olivardia, a clinical psychologist and instructor at Harvard Medical School. (14)
That figure might be even closer to 50 percent, according to the Anxiety Disorders Association of America.
This makes treating ADHD difficult since medications called stimulants that are often used to treat the disorder can worsen anxiety symptoms.
Learn more —
Natural Remedies for ADHD: An In-Depth Review
Medications within this drug class include amphetamine / dextroamphetamine (Adderall), dexmethylphenidate (Focalin) and methylphenidate (Concerta, Ritalin).
Stimulants do exactly what their name implies.
They stimulate the brain and change the way the nerve cells transmit messages.
They are also thought to increase levels of a feel-good neurotransmitter called dopamine.
Dopamine is associated with motivation, attention, and movement, leading to greater concentration and focus and less hyperactive and impulsive behaviors.
But some people cannot tolerate stimulants.
In these individuals, the physiological changes brought on by stimulants can also result in restlessness and anxiety.
In such cases, doctors may choose to prescribe other mood-altering drugs, including selective serotonin reuptake inhibitors (SSRIs).
Other antidepressant medications can also treat ADHD.
These include tricyclic antidepressants (Aventyl, Tofranil), Wellbutrin, Effexor, and Effexor XR, and monoamine oxidase (MAO) inhibitors (Nardil).
Non-stimulants are another option that can sometimes be paired with an SSRI or other antidepressant.
Strattera is a popular non-stimulant used to treat ADHD.
Several other medications are also linked to a risk for anxiety and anxiety symptoms.
These medications can cause shakiness, restlessness, nervousness, panic attacks, agitation, dizziness, erratic heartbeat, and phobias. (15)
A list of medications associated with anxiety include:
- Thyroid medications: Armour Thyroid, Nature-Throid, NP Thyroid
- Parkinson’s disease medications: Sinemet (levodopa / carbidopa) in extended-release (ER) form (Rytary), antidyskinetics
- Seizure medications: phenytoin (Dilantin, Phenytek)
- Antibiotics: cycloserine (Seromycin)
- High blood pressure medications: reserpine (Demi-Regroton), methyldopa (Aldomet)
- Over-the-counter (OTC) decongestants, cough medicines, and diet medications
Depression Medications Can Worsen Anxiety
More than 100 million people worldwide, including one in 10 people in the US, take depression and anxiety medications called selective serotonin reuptake inhibitors, or SSRIs. (16)
SSRIs include medications like Prozac, Zoloft, and Paxil.
But these drugs can also worsen a person’s anxiety in the first few weeks following the start of treatment.
SSRIs are believed to improve a person’s mood by promoting only “good feelings” via an increase of serotonin in the brain.
Abnormally low levels of serotonin are linked to depression in some studies.
However, serotonin may have both good and bad effects on a person’s mood.
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Whether good or bad feelings prevail may depend largely on where the drug acts in the brain, according to scientists at University of North Carolina Health Care who studied the phenomenon.
According to the researchers, the ability of SSRIs to artificially and inadvertently silence certain serotonin-activated pathways in the brain can actually promote anxious behavior.
The team tested their theory on mice and found that certain serotonin-activated neurons allowed a rise in anxiety levels.
They determined that concurrently altering the activity of these neurons on the brain’s neural pathways with a compound to block the stress-signaling molecule corticotropin-releasing factor (CRF) may help to fix the problem.
The results, though, were strictly limited to mice.
The hypothesis has yet to be tested on humans, meaning anxiety may still pose a risk for people just starting out on SSRIs.
The good news is that the effect is thought to be short-term.
Tips for Controlling Anxiety
There are some ways to take control of your anxiety.
First, if it is medication-related, your doctor may be able to change medications or dosing.
If you are prone to anxiety, you may also consider psychotherapy or talk therapy.
This type of therapy includes cognitive behavioral therapy (CBT), which teaches people different ways to think, behave, and react to situations that cause anxiety.
It also helps for people with anxiety to be aware of how the anxiety is physically manifesting in their bodies.
Learn more —
25 Proven Natural Remedies for Anxiety Relief
For instance, when they are anxious, do they feel tension in their neck or shoulders, is their stomach upset, are they shaking or sweating?
Taking control of physical symptoms can help regulate mental and emotional reactions.
Other ways to reduce anxiety and anxiety-related symptoms include:
- staying busy
- healthy sleep habits
- healthy diet
- social interaction
- meditation and positive thinking
- joining a support group
Drugs That Cause Anxiety: The Bottom Line
Prescription medications are sometimes necessary but are not without risks.
Certain drugs, especially those that treat asthma, headaches, and attention disorders, can cause or aggravate anxiety symptoms.
If you suspect that any medications you take are causing anxiety, you don’t have to resign yourself to living with these side effects.
Talk to your doctor about changing your prescription or dosage.
You’ll find a step-by-step plan for having a productive discussion with your doctor about your medications in this expert-recommended plan.
About the author
Kristin Compton is a writer for Drugwatch.com, a website dedicated to providing consumers with informational resources about pharmaceutical drugs and medical devices, procedures, and conditions. As a mother and longtime patient herself, Kristin has firsthand experience with prescription drug side effects and the harm they can present to women and children.