The term “drug-induced anxiety” refers to anxiety symptoms that arise as an unexpected side effect of a therapeutic agent prescribed for a different condition or as a result of withdrawal. This reaction can range from mild jitters to full-blown panic attacks. The likelihood of experiencing this effect is often dose-dependent but is also linked to an individual’s unique biological sensitivity. Medications can inadvertently interfere with the brain’s delicate balance of neurotransmitters, leading to psychological distress. Understanding which medication classes are commonly implicated helps patients and prescribers identify the source of new or worsening anxiety symptoms.
Medication Classes That Increase Anxiety
Central nervous system (CNS) stimulants are a prominent category known to trigger anxiety by increasing alertness and energy levels. Medications for attention-deficit hyperactivity disorder (ADHD), such as amphetamine salts or methylphenidate, boost neurotransmitters like dopamine and norepinephrine, over-activating the nervous system. This overstimulation manifests as restlessness, a rapid heart rate, and worry, particularly if the dosage is too high.
Bronchodilators, including drugs like albuterol, are used to treat asthma and chronic obstructive pulmonary disease (COPD). These medications relax airway muscles by stimulating beta-2 adrenergic receptors. This stimulation can extend to other adrenergic receptors, causing physical symptoms like tremors, palpitations, and a racing heart, which mimic anxiety or a panic attack.
Corticosteroids, such as prednisone, used for inflammation and autoimmune conditions, are frequently associated with mood changes. Studies indicate that up to 28% of patients taking them may experience psychiatric reactions, including anxiety and irritability. The risk of these effects increases with higher doses, as the synthetic hormones interfere with the body’s natural stress response system.
Hormone treatments, specifically synthetic thyroid hormones for hypothyroidism, can induce anxiety if the dosage creates a state of hyperthyroidism. An excessive amount of thyroid hormone accelerates the body’s metabolism and sympathetic nervous system, leading to shakiness and nervousness. Certain over-the-counter (OTC) cold and sinus medications contain decongestants, such as pseudoephedrine, which function as stimulants and can cause jitteriness, restlessness, and sleep disturbances.
How Medications Trigger Central Nervous System Changes
The mechanism by which these substances cause anxiety often involves the overstimulation of the adrenergic system, the body’s “fight-or-flight” response network. Many medications, including stimulants and bronchodilators, work as agonists, mimicking or enhancing the effects of natural stress hormones like epinephrine and norepinephrine. This action floods the nervous system, leading to a heightened state of arousal characterized by a rapid heart rate, increased blood pressure, and panic.
Another pathway involves interference with the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA), which promotes calm and relaxation. Some substances may reduce GABA’s effectiveness or block its receptors, removing the natural dampening effect on neural activity. This disruption results in an over-excited state in the brain, increasing the likelihood of anxiety and agitation.
Drugs that alter the metabolism of other mood-regulating neurotransmitters, like serotonin and dopamine, can also provoke anxiety. Selective serotonin reuptake inhibitors (SSRIs), often prescribed to treat anxiety, can paradoxically worsen anxiety or cause a temporary “jitteriness syndrome” as the brain adjusts to the shift in serotonin levels.
A distinct cause of medication-related anxiety is withdrawal anxiety, which occurs when a person abruptly stops taking a drug they have become physically dependent on. Medications like antidepressants, stimulants, or anti-anxiety drugs can cause a rebound effect as the central nervous system attempts to re-stabilize its chemical balance. This triggers a surge of anxiety that can be more intense than the initial symptoms the medication was treating.
Steps to Take If You Suspect Drug-Induced Anxiety
If you experience new or worsening anxiety symptoms after starting a new medication, first document the pattern of your symptoms. Note the timing of the anxiety relative to the dose, as well as the intensity and type of feelings you are having. This detailed information will help your healthcare provider determine a potential connection between the drug and your symptoms.
Contact the prescribing physician immediately, rather than attempting to self-adjust the dosage. Abruptly stopping a prescribed medication, especially those acting on the central nervous system or hormones, can lead to dangerous withdrawal effects or a severe relapse of the condition being treated. Your doctor can then begin the process of differential diagnosis to determine if the anxiety is a drug side effect, a symptom of an underlying medical condition, or a primary anxiety disorder.
The physician may recommend a dose adjustment, a change in the timing of the medication, or a switch to an alternative treatment. If the drug cannot be easily discontinued, the doctor might prescribe a temporary, low-dose anti-anxiety medication to manage the side effects while your body adjusts. Working closely with your healthcare team ensures that any necessary changes are made safely and with medical supervision.