Medications That Cause Anxiety

Anxiety is a common feeling of fear, uneasiness and worry. It’s something we all deal with from time to time. However, for some people, anxiety can be a persistent, recurring issue that gets in the way of living a fulfilling, happy life.

If you have anxiety that’s severe or doesn’t get better over time, it could be a sign that you have an anxiety disorder.

Several different factors can cause or contribute to anxiety, including your exposure to stressful events, your history of mental illness and your physical health.

One potential cause of anxiety that many people aren’t aware of is medication. From common over-the-counter treatments to prescription drugs, several widely-used medications have been linked with anxiety symptoms and even clinically significant anxiety disorders. Below, we’ve discussed the link between medication and anxiety in detail and listed the drugs, supplements and other substances that are known to cause or aggravate anxiety.

We’ve also talked about what you can do if you’re prone to anxiety symptoms and think that medication or other substances could be to blame.

Before we get into the specifics of medications that can cause anxiety, let’s briefly go over what anxiety is and how it can become problematic.

Anxiety is a feeling of fear, uneasiness and worry. It’s a natural feeling that we all experience at certain points in life, usually during stressful situations such as prior to taking a test, performing in front of others or making a major decision.

Anxiety can involve psychological and physical symptoms. Common psychological symptoms of anxiety include:

• Feeling on-edge, restless or full of energy

• Finding it difficult to concentrate or remember things

• Irritability and a “short fuse” with other people

• Excessive, irrational feelings of worry or concern

• Difficulty falling asleep, staying asleep or feeling rested

• Feeling out of control of yourself, or that something bad is about to occur

Common physical symptoms of anxiety include:

• Muscle tension, stiffness and pain

• Feeling physically tired and fatigued

• Difficulty breathing and a sense that you’re smothering or choking

• Sweating, trembling and/or shaking

• A fast, pounding heartbeat and heart palpitations

It’s normal to experience some of these symptoms at certain times. However, if you’ve noticed severe anxiety symptoms — or symptoms that occur on a regular basis — it could indicate that you have an anxiety disorder.

Our guide to the types of anxiety disorders goes into more detail about these symptoms, as well as common anxiety disorders such as generalized anxiety disorder (GAD), social anxiety, panic disorder and others. 

Sometimes, anxiety can develop as a side effect of certain medications or substances. This type of anxiety is typically referred to as a substance-induced anxiety disorder, or medication-induced anxiety disorder.

Anxiety can develop as a side effect of certain medications or as a withdrawal symptom when a medication or other substance is stopped abruptly.

Many common medications can cause, worsen or contribute to anxiety. We’ve listed some of the most common causes of medication-induced anxiety below.

ADHD Medications

Attention deficit hyperactivity disorder, or ADHD, is a neurodevelopmental disorder that typically involves difficulty paying attention and/or controlling impulsive behaviors.

Some medications used to treat ADHD can cause or contribute to anxiety. This is because most ADHD medications are stimulants — medications that work by increasing activity in your central nervous system.

Common stimulants used to treat ADHD include dextroamphetamine/amphetamine (Adderall®), methylphenidate (Ritalin® and Concerta®) and dextroamphetamine (Dexedrine®).

Anxiety is one of the most frequently reported side effects of adults who use Adderall XR®, one of the most widely-prescribed ADHD medications.

Because of their effects on your central nervous system, these medications can cause a faster heart rate, increased blood pressure and increased breathing. When misused, they may cause paranoia, anger and psychosis.

Products and Medications That Contain Caffeine

Caffeine is an extremely popular stimulant. In fact, research suggests that caffeine is the most widely used psychoactive substance in the world, with 80 percent of the adult population in the Western world contributing enough caffeine to have a noticeable effect on the brain. 

As a type of stimulant, caffeine affects your cardiovascular system, your respiratory system and your brain. It increases blood flow and promotes a faster heartbeat.

While small doses of caffeine (for example, the amount in a few cups of coffee) generally aren’t considered harmful, some research has found that caffeine may exacerbate anxiety and certain sleep issues.

In people with existing psychiatric issues, caffeine consumption may also increase hostility and anxiety.

In addition to coffee, caffeine is found in lots of energy drinks, health and fitness supplements, cold and flu treatments, headache medications and other products, including medications sold over the counter.

Asthma Inhalers

Asthma inhalers, or short-acting beta-agonists (SABAs), are “rescue” medications that are used to provide rapid relief from the symptoms of asthma.

Many asthma inhalers contain the medication albuterol, a bronchodilator that works by relaxing the air passages and allowing air to more easily flow to the lungs. Albuterol can help to prevent shortness of breath, chest tightness, wheezing, coughing and other asthma symptoms.

Albuterol, which is also called salbutamol, can activate motor nerve terminals found throughout the body and cause anxiety-related side effects such as nervousness, tremors, difficulty falling asleep or staying asleep and increased blood pressure.

These side effects may make the physical symptoms of generalized anxiety disorder and panic disorder more severe. 

Antidepressants

Antidepressants are prescription medications that are primarily used to treat depression. They work by increasing the levels of certain naturally-occurring chemicals, called neurotransmitters, that control your moods and stress levels.

In certain cases, antidepressants may also be used to treat the symptoms of anxiety disorders, including generalized anxiety disorder.

Common types of antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Tricyclic antidepressants (TCAs)

• Monoamine oxidase inhibitors (MAOIs)

Most people who use antidepressants are prescribed SSRIs or SNRIs. Common SSRIs include sertraline (Zoloft®), escitalopram (Lexapro®), fluvoxamine (Luvox®), citalopram (Celexa®) and fluoxetine (Prozac®).

Common SNRIs include venlafaxine (Effexor XR®), duloxetine (Cymbalta®) and desvenlafaxine (Pristiq®).

Despite helping many people to deal with anxiety disorders, some antidepressants may make anxiety, agitation and irritability worse after starting treatment. This is sometimes referred to as jitteriness/anxiety syndrome.

Although human research is limited, some experts believe that this increase in anxiety may be linked to the effects of the neurotransmitter serotonin on certain brain circuits.

Many people develop side effects from antidepressants, and it’s normal to try several different medications before finding one that works well for you without causing significant issues.

Corticosteroids

Corticosteroids are medications that work by controlling inflammation and inhibiting the immune system. They’re used to treat allergic reactions, contact dermatitis, inflammatory bowel disease, autoimmune disorders, arthritis and many other conditions.

Widely-used corticosteroids include prednisone, prednisolone, hydrocortisone, dexamethasone, methylprednisolone and others. These medications may be available as tablets, topical creams, inhalers, eye drops, ear drops and in other forms. 

Corticosteroids can cause significant side effects, especially when they’re used at a high dosage or for a long period of time. These side effects may include anxiety, irritation, difficulty sleeping, mood changes and even psychosis.

Research also suggests that use of corticosteroids may affect certain mental skills referred to as executive cognitive function, such as memory, flexible thinking and self-control.

Thyroid Medications

The thyroid is a small, butterfly-shaped gland located inside your neck that produces hormones responsible for controlling your body’s metabolism. Most thyroid medications are used to treat an underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism). 

Treatment for hypothyroidism involves using medication to bring your thyroid hormone levels up to the normal range.

Some medications used to treat hypothyroidism, such as levothyroxine (Synthroid®) can cause anxiety as a side effect. They can also cause heart palpitations, restlessness, tremors, sweating and increased, rapid weight loss.

If you develop anxiety from a thyroid medication, your healthcare provider will use a blood test to check that your thyroid hormone levels aren’t overly high. If necessary, they may adjust your dosage to reduce your risk of feeling anxious or experiencing other side effects. 

Nasal Decongestants

Nasal decongestants are medications that are used to treat upper respiratory illnesses, such as rhinitis (inflammation and swelling of the inside of your nose), common allergies and headaches caused by sinus infections.

Certain decongestant medications contain active ingredients that may cause or contribute to the symptoms of anxiety.

For example, the head cold and sinus congestion medication Sudafed® contains the ingredient pseudoephedrine, which can narrow blood vessels and cause physical anxiety symptoms such as restlessness, nervousness, elevated blood pressure and difficulty sleeping.

Antihistamines

Like nasal decongestants, antihistamines are commonly used to provide relief from the nose and/or eye symptoms linked to seasonal allergies, the common cold and flu. They’re also widely used to treat allergy-related skin conditions, peptic ulcers and certain digestive issues.

Many antihistamines are associated with feelings of calmness and drowsiness. However, some people who take antihistamines report developing physical symptoms that are commonly linked to anxiety. 

For example, palpitations, rapid heartbeat and central nervous system stimulation are all known side effects of diphenhydramine, a first-generation antihistamine.

Research suggests that the risk of anxiety may differ between antihistamine medications, with a study published in the International Journal of Psychiatry in Clinical Practice finding that certain antihistamines scored higher on patient depression and anxiety assessments than others.

While most medications that cause anxiety do so as an unwanted side effect, others can cause anxiety as a withdrawal effect.

For example, many common antidepressants can cause withdrawal symptoms when treatment is stopped abruptly. This is often referred to as “antidepressant discontinuation syndrome,” and it tends to occur when treatment is stopped abruptly after at least one month of use.

Symptoms of antidepressant discontinuation syndrome include anxiety, irritability, agitation and mania (abnormally high levels of activity or energy), as well as lethargy, fatigue, nausea, vertigo, dizziness and other physical symptoms.

Other medications that may cause withdrawal symptoms include sedative-hypnotics (drugs that are used to treat anxiety and insomnia), opiates, beta-blockers, corticosteroids and certain high blood pressure medications.

If you’ve recently stopped using any type of medication and notice persistent or severe anxiety symptoms, it’s important to let your healthcare provider know. 

Many recreational drugs, both legal and illegal, can either cause or contribute to the symptoms of anxiety. If you have an existing anxiety disorder, using recreational drugs and/or alcohol may make your anxiety disorder symptoms worse. 

Some recreational drugs might provide short-term relief from anxiety. However, in the long term, many illicit substances can make anxiety more severe and extreme.

Recreational drugs associated with anxiety include:

• Cocaine and crack cocaine

• Lysergic acid diethylamide (LSD)

• Phencyclidine (PCP)

• Methamphetamine

Although cannabis is often viewed as a drug that promotes relaxation and calmness, research findings are mixed, with some studies suggesting that tetrahydrocannabinol (THC), one active compound in cannabis, may cause anxiety when consumed at high doses.

Many other recreational drugs, including those not listed above, may cause anxiety or paranoia as long-term side effects or withdrawal symptoms. 

If you have anxiety and think it could be caused by a medication or illicit drug, it’s important to reach out to a mental health provider for assistance.

You can get expert help for mental health by talking to your primary care provider, meeting with a psychiatrist or psychologist in your area, or by talking to a licensed psychiatry provider online using our psychiatry services. 

Your mental health provider may recommend one or several of the following forms of treatment for anxiety to help you get relief from your symptoms and make progress towards recovery.

Switching to a Different Medication

If you’ve recently developed anxiety after starting a medication, your provider may recommend switching to a different type of medication that’s less likely to cause anxiety symptoms. 

In some cases, making small changes such as adjusting your dose or using your medication at a specific time of day may help to reduce the severity of your anxiety or stop it from having an effect on your daily life.

Using Anti-Anxiety Medication

Several medications are available to treat anxiety, including benzodiazepines, antidepressants and beta-blockers. Your mental health provider may recommend using medication for anxiety if switching your current medication isn’t safe or appropriate.

Benzodiazepines work quickly to reduce the severity of anxiety. They’re effective, but they can be habit-forming. To reduce your risk of dependence, your mental health provider may suggest using this type of medication only when needed or for a short period of time.

Antidepressants treat anxiety by increasing your levels of certain neurotransmitters — chemicals that control your stress levels and moods. They’re often effective, but can take several weeks to start working.

Beta-blockers work by reducing the severity of physical anxiety symptoms, such as a fast heart rate or shaking. Your mental health provider may prescribe a beta-blocker such as propranolol for performance anxiety and other forms of situational anxiety.

If you’re prescribed psychiatric medication for anxiety, make sure to use it exactly as directed by your mental health provider. Inform your healthcare provider if you develop any side effects, or if you don’t feel that your medication is effective.

Our guide to anti-anxiety medications goes into more detail about the types of medications used to treat anxiety. 

Taking Part in Psychotherapy

Many people with anxiety disorders benefit from psychotherapy, or talk therapy, which involves talking to a mental health provider about your thoughts, feelings and anxiety symptoms.

Several forms of therapy are used to treat anxiety, including cognitive behavioral therapy (CBT) and exposure therapy. As part of therapy, you may learn new skills for dealing with feelings or thoughts that cause you to feel anxious, or directly confront your fears in a safe environment.

Our guide to therapy for anxiety provides more information about how therapy works, as well as what you can expect from psychotherapy. 

Many forms of psychotherapy can be done one-on-one or in a group setting. We offer individual therapy and support groups for anxiety and other mental health conditions online, allowing you to access help from a mental health professional from your home. 

Entering a Substance Abuse Treatment Program

If your anxiety is related to an alcohol use disorder or substance use disorder, you may benefit from addiction treatment. 

A variety of different methods are used to treat substance addiction, including medications that suppress withdrawal symptoms, behavioral therapy, treatment for mental health disorders such as anxiety and depression, and long-term follow-up to reduce your risk of relapse.

Make sure to tell your healthcare provider if you have a substance use disorder that you think is causing you to experience anxiety. 

Making Changes to Your Habits and Lifestyle

Anxiety often improves with changes to your habits and daily life, including small changes that can be easy to implement. 

Try to exercise regularly, eat a balanced diet, spend time with friends and family and limit your intake of caffeine. Some relaxation techniques, such as diaphragmatic breathing, may help to control some of your anxiety symptoms and allow you to calm your mind.

Your mental health provider may suggest making lifestyle changes while you use medication to control your symptoms or take part in therapy for anxiety. It’s important to remember that these habits can complement the effects of other treatments, not replace them entirely.

Our guide to living with anxiety shares other techniques, habits and lifestyle changes that may help you to gain more control over your anxiety symptoms. 

Anxiety is an extremely common issue that affects people of all ages and backgrounds. Many risk factors are associated with anxiety, including exposure to stressful events, a family history of anxiety disorders, and the use of certain types of medication. 

If you’ve noticed persistent or severe feelings of anxiety after using a new medication, it could be a causative factor. Even then, don’t stop taking your medication — reach out to your healthcare provider and let them know immediately.

The best way to get help for anxiety is to talk to a licensed mental health provider, either locally or from your home via an online psychiatric evaluation. 

By seeking help, you’ll take the first step towards treating your anxiety, getting control over your feelings and improving your quality of life. 

Interested in learning more about anxiety before you take action? Our detailed guide to anxiety discusses what anxiety is, how it can affect your moods and how it’s treated. You can also learn more about dealing with anxiety using our free online mental health resources.