As if struggling with the varied signs and symptoms of high-functioning anxiety are not enough, the medications I take for my body’s other troubles add more nasty variety to the mix? Are you kidding me?

No. No, I am not kidding you.


Before we get started.  Who came up with the tidy colloquialism known as ‘side effects’?  You know…those effects that are the not-desirable deliverables of the selected pharmaceutical?  Big Pharma knows:  All of the drugs’ effects are effects.  Some are desirable and some are not. 

Pharma calls the desirable effects ‘intended’ (i.e. ‘good’) yet does not refer to the other, undesirable, effects as ‘unintended’ (i.e. ‘bad’), but rather ‘side‘.  It would not be good for business to say it any other way, would it? 

So Pharma coined the handy term ‘side effects’ to explain the undesirable (i.e. bad) effects, as if such things might happen to some people sometimes rather than that which happens to all people to some degree, all the time. 

Then again, says Pharma, some ‘unintended’ effects might be GREAT. Gawd! Way to be negative.

SIDE EFFECTS!  Slick.  Oh, yes.  Pharma admits the term is used predominantly to describe the bad effects (‘adverse’ if you are fluent in Pharma-talk), but is quick to add the term may also apply to beneficial but unintended consequences of the drug.  

BBBBeeeneficial but unintended consequences…HAHAHhahahahahahhhaaaa a behemoth with a sense of humor!!!  And there you have the birth of your off-label prescriptions…those completely unresearched applications for drugs that still have other SIDE EFFECTS! HHAHAHAAhahahahahahahaaaa.  

Let’s not forget.  Some unintended – side – effects have short term ‘consequences’ and others have long-term ‘consequences’.  More Pharma lingo:  CONSEQUENCES!  Oh, that Pharma is just so funny…

So many body processes.  So many possibilities. 

Drugs effects vary from person to person because of obvious factors like body size, general health status, the amount and strength of the drug and what other drugs are operational in the body at the same time…including the body’s independent internal physiochemicals like hormones, digestive enzymes and neurotransmitters.

  • 70% of Americans take at least one prescription drug per day, plus who knows how much coffee, tea, sugar, alcohol, weed or other stimulants or depressants are also included in the daily regimen. 
  • 20% of American take at least five prescription drugs per day.  Remember, then, to include the internal cocktails of hormones, digestive enzymes and neurochemicals, too. 

Who knows how the efficacy or nature of a drug changes when it is combined with one or more other prescription and/or non-prescription drugs? I will tell you: No one. Although, yeah, there is a cause-of-death category knows as CDI (combined drug intoxication, a.k.a. MDI, the acronym for multiple drug intake) that we know is soaring. CDI is due to the simultaneous use of multiple drugs, including pharmaceuticals (over-the-counter and prescription) as well as recreational drugs. This phenomenon of ‘polypharmacy’ seems to mean taking anything from 2 medications to 18 on the same day. There is one thing we do know: To some degree, combining one drug with another changes the function of both.

Then there is this: Until the 90s, the vast majority of drug trials were conducted on adult single white males.  You guessed it:  That’s a problem.  Gender and race do matter with respect to a drug’s physiological impact. 

But let’s not saunter down that path right now.  Let’s stick to the topic of the PHARMA DRUGS THAT CAUSE SIGNS AND SYMPTOMS OF ANXIETY.  WOO WOO!!

Read on to get: Our List of Six Type of Medications that Cause the Signs and Symptoms of Anxiety.  Here we go!

#1 Medications With Caffeine

Did anyone just say DUH?  Thank you.  Yes.  Don’t we all have some reference for the fact that caffeine is one of those chemicals that mimics the physiology of panic attacks?  Good old caffeine!  Capable of sharpening your sense of alertness, revving up your heart rate, increasing your blood pressure, and making you sweat!?  Okay.  Apart from the details, below, we’ve got that one.  Check.

What medications include caffeine within their composition?   Here are two examples:

  • Headache medications.
  • Migraine medications.

That means acetaminophen mixtures like Tylenol and who knows how many of the about 600 other over-the-counter and prescription drugs containing acetominophen – (yes it appears to be the most common drug ingredient in America) plus caffeine are available to kick you into anxiety-gear. 

What can I say?  Pain-killers plus caffeine; it’s a famous pharmaceutical coupling.

You!  High Functioning Anxiety awful?  Look for caffeine in the drugs you are taking or have taken.

  • Some aspirin mixtures include caffeine (like Anacin, for example).
  • Some migraine medications called the Ergotamines (a.k.a. Ergot Alkaloids) are mixed with caffeine.

#2 Medications with Corticosteroids, most commonly called ‘steroids’ that includes ‘glucocorticoids’ or ‘minerocorticoids’. 

Steroids cause what used to be known as ‘steroid psychosis’.  Ooh.  That was a little too harsh for Big Pharma’s ears.  So, bye-bye ‘steroid psychosis’!  Hello ‘unspecified psychosis’ ICD code F19.959 and ‘adverse effects of glucocorticoids and mineralcorticoids’ ICD-10-CM Code T38.0X5A!!

Get this:  Psychiatric symptoms profound enough to be categorized, studied and treated in psychiatry are caused in 5 – 18% of people who take corticosteroids, and it seems to be more risky to those taking higher doses.  What’s a high dose, you ask? Oral dosages of 60 – 80 mg are at the higher end (and relate to the 18% experiencing psychiatric conditions).  Consider: 60 mg (20 mg 3x/day) oral doses are not atypical for things like bursitis or osteoarthritis or psoriasis or as an anti-inflammatory for IBS (Inflammatory Bowel Disease). 

There are intramuscular injections, too, with similar concentrations – and higher.  There are intravenous steroid treatments referred to as ‘pulse steroid treatments” that involve giving 1000 mg of methyl-prednisone intravenously each day for three days. Whoa!

Okay.  So we have mania, irritability, agitation, restlessness, mood swings, insomnia, elevated blood pressure, increased heart rate, heart palpitations, alteration of respiratory rate, irregular menstrual cycles, dysfunctional bowel performance, altered appetite and increased brittleness of the blood sugar handling system…to name a few unintended effects of steroids.

What medications include steroids within their composition?  Oh, I’ll keep this short.  Please recognize how ridiculously general I have to get you started on this list:

  • Asthma medications.
  • Immune (and Auto-Immune) medications.
  • Allergy medications.
  • Arthritis medications.
  • Bronchitis medications.

What can I say?  Corticosteroids are the lovechild of the pharmaceutical industry.  Big sellers with lots of applications. 

My goodness, if you really want to know about the conditions treated by corticosteroids and you are curious about the dosages, go here:

Some corticosteroid drug names you might recognize:

  • Flonase
  • Prednisone.
  • Hydrocortisone.
  • Medrol.
  • Dexamethasone.
  • Flovent.
  • Lanacort.
  • Fluticasone. (Advair.)
  • Pulmicort.

(It’s a partial list, folks.)

…Or maybe you want to know about the prescriptions?  FLONASE is the big seller taking the lion’s share of prescription sales at nearly 33% in 2017! 

You!  Anxiety Functioning Anxiety awful?  Look for corticosteroids (a.k.a. glucocorticoids or minerocorticoids) in your ‘anti-inflammatory’ or ‘immune system’ drugs.  

Oh, wait.  One more thing.  Are corticosteroids addictive?  Well.  I am glad you asked!  No.  No, they are not considered addictive.  However, they do lead to dependence, says the FDA.  Oh!! THAT’S A RELIEF!  Do LLLLLLeeeaaadd to dependence bwaaahhhhaaaHAHA but not considered addddictivvvve hahahahahaha.  Another fancy turn of phrase!!! 

#3 Medications for ADHD

It’s kind of strange that the medicines used to combat hyperactivity are stimulants that cause hyperactivity. 

Got a revved up brain?  Take a medication that revs it up a little bit more. 

Of course these pharmaceuticals change the way your nerve cells send messages.  They act upon your nerve cells. That’s their CHEMICAL TARGET. 

Before listing a few of the ADHD medications that are each composed of nervous system stimulants, let’s have some fun and review what, according to the powers-that-be in diagnostic criterion listing, constitutes ADHD in adults. Shall we?  To keep it short and simple, I shall paraphrase.  The individual struggles with:

  1. Interrupting and or intruding on other’s communications. Finishing other people’s sentences. Anticipating questions/blurting out answers. Butting in.
  2. Being always on the go. Inability to quiet down. Intolerance to waiting in line.
  3. Fidgetiness. A feeling of not being able to sit still. Squirminess that shows up in moving around in a chair, tapping fingers and feet, bouncing legs.
  4. Feeling unsteady inside. Feeling physically shakey or agitated. 
  5. Unfinished tasks. Although the individual may be a good starter, he is a bad finisher. Procrastination.
  6. Lack of focus. Racing mind. Forgetfulness.
  7. Avoidance of tasks requiring extended mental effort. Inability to pay attention outside his own interests. Daydreaming.
  8. Mistakes. Does not want to go step-by-step. Difficulty following  instructions. Impatience.

Is it just me, or does that look like a list of behaviors associated with anxiety?  I can tell you right now those are signs that the mammalian brain of that individual is upset.  How about Taming the Beast Within before calling it ADHD?

Some ADHD medications you might recognize:

  • Amphetamine/dextroamphetamine (Adderall)
  • Dexmethylphenidate (Focalin)
  • Lisdexamfetamine (Vyvanse)
  • Methylphenidate (Concerta, Ritalin)

The two main classes of stimulant medications that make up the ADHD suite of drugs are methylphenidate and dextro-amphetamine — both are generic names.  Call them whatever you want.  All brand-name stimulants are variations of these two medications.

Does anybody know exactly how stimulation of the brain’s neurotransmitters results in calming the brain’s neurotransmitters?  Or when to predict when it will stop working or what’s at risk when it does?  Nope.  But, at some point, it does not surprise anyone that the very thing the medication is meant to stop starts to occur more.

You!  High Functioning Anxiety awful?   Do you really want to be on a stimulant drug?

And, one more question.  Are stimulants addictive?  ‘Schedule II drugs’?? OH, YEAH, BABY. They are addictive.

#4 Asthma Medication

Different chemicals are combined in so many ways to make asthma medicine-cocktails.  Those that target the muscle cells that form your breathing tubes (bronchi) to relax are typically combined with corticosteroids (see #2, above). 

No one understands exactly why the asthma-cocktails can make mood disorders and anxiety so much worse, but those mixtures (with and without corticosteriods) sure do it.  

Though bronchodilators, in fact, can open up airway space in your lungs to help you breathe, they can also have the unintended effects of shakiness, racing heartbeats, panic attacks, nervousness, sweating. Might we say, anxiety?

Asthma medicines you might recognize:

  • Albuterol (Proventil). 
  • Salmeterol (Serevent Diskus​​​​​​​). 
  • Theophylline (Elixophyllin). 

You!  High Functioning Anxiety awful?   Dontcha think it’s worth finding some alternative ways to ease asthma?  It’s a serious condition, but, then, so are the undesirable conditions the drugs used to treat it create.

Since asthma drugs are such a bunch of mix-and-match substances, they vary from causing dependence to being addictive to not.

#5 Thyroid Medicine

When your body has a low thyroid hormone concentration in the blood, it means your thyroid is either ill or dysfunctional.  Thyroid hormone is the handy little hormone we all manufacture inside our bodies that helps us get oxygen into our cells.  Without it, we can’t unload oxygen from the red blood cells trying to deliver it.  

Though not every low thyroid blood value means it’s necessary to take exogenous thyroid hormone, you’d think it does.  Based on the sales of thyroid drugs worldwide, everyone seems to be on Synthroid (synthetic thyroid hormone). 

Besides Synthroid, you might recognize other types of thyroid medicines called thyroid pills that are also used to treat a dysfunctional thyroid gland:

  • Armour Thyroid
  • Nature-Throid
  • NP Thyroid. 

The thyroid is part of a key hormone axis in your body responsible for balance and regulation of all of your daily, cyclic and seasonal hormone cycles.  No surprise, then, that introducing a man-made dose could alter everything from sleep to relaxation to sex drive to energy to concentration.

So even though thyroid imbalance causes many troubles – not the least of which is anxiety – thyroid drugs also cause the onset of shakiness, hyperactivity, racing heart, butterflies in the stomach…yeah…anxiety.

You!  Men and Women!  Do you really want to take a thyroid pill without seeing first if you can kick that thyroid into gear more naturally?  Regulation of thyroid drugs is one of the toughest things to get ‘right’ in medicine.  High Functioning Anxiety awful?  Maybe thyroid meds are making it worse.

#6 Seizure Medicine a.k.a. anti-convulsants.

So many people do not even know they are on anti-seizure medications, a.ka. anti-convulsants.  “I’m on Lyrica.”  It sounds so…lyrical.  Lovely.  LaLa LaLa TraLaLa LaLa.  How bad could a drug called Lyrica be? 

Look.  It cannot come as a surprise that drugs designed to alter the electrical activity of the brain during a seizure are capable of doing some pretty intense things to the brain.  If it’s strong enough to slam dunk the brain into quiet from heightened activity like a seizure, it’s strong stuff.  Yet, it’s used – all the time – to treat everything from migraines to fibromyalgia to chronic back pain to irregular heartbeats to depression to – you guessed it – anxiety.

Anti-seizure drugs are often those ‘off-label’ doozies that are used to treat all kinds of problems even though there is not research to substantiate its safety or efficacy.  But, hey, it’s great for the stock market.

Some names you might recognize:

  • Phenytoin (Dilantin, Phenytek, Pregabalin/Lyrica) 
  • Diazapam (Valium)
  • Gabapentin (Neurontin)
  • Lorazepam (Adivan)
  • Phenobarbitol
  • Topiramate (Topamax)
  • Clonazepam Klonopin

Each of these drugs cause – as unintended consequences – irritability, emotional changes, memory lapses, trouble with concentration, dizziness, blurred vision, restlessness.  Is it just me, or does that list sound like a bad anxiety nightmare?  And if that’s not enough, the other unintended consequences of those drugs are suspicion, distrust of others, crying, aggressive behavior, sleep disturbances, loss of orientation…oh, my fingers hurt from typing so many SIDE EFFECTS.

Honey, most of these anti-seizure meds are used off-label (i.e. without research and approval to treat a disorder or disease) for anxiety.  Here is an excerpt little-ditty for you from one Dr. Daniel Carlat to his peers, reviewing the life of prescription writing of a psychiatrist, firsthand, to treat a patient with anxiety. 

Your patient has anxiety, and you’ve tried the usual medications. You’ve rotated through your favorite SSRIs and SNRIs but none have worked out, either due to efficacy problems or side effects. You’ve tried some of the benzodiazepines, but sedation and dependence have become problematic. You’ve even given buspirone a whirl, with the all-too-common results—suboptimal response, dizziness, and sedation.

It’s time to go off-label. Off-label prescribing refers to the use of medication for a condition not named in its FDA approval. Off-label prescribing has come under fire of late, because some large drug companies have been found guilty of illegal drug promotion, but physicians are free to prescribe any medication they want, as long as there is some evidence for usefulness. And remember that the lack of an FDA indication does not necessarily mean lack of efficacy—it sometimes means that no drug company has deemed the investment in clinical trials worth the eventual pay off.

There are so many troubling statements in these two paragraphs.  I don’t even know where to start.  Let’s just say the “physicians are free to prescribe any medication they want” part sends a chill into my bones. 

I don’t know this guy, but I did read that he did his medical fellowship in Electroconvulsive Therapy (seriously, no joke, there is a whole fellowship to learn how to do this to a human brain) at Columbia University in New York.  I don’t know about you, but someone who is interested in pulling the switch on what I call a crime against humanity is not a guy I want trying to ‘help’ me – or telling other psychiatrists how to ‘help’ me – with anxiety.  Whatdya think? 

By the by, since we are talking about off-label therapies:  Electroconvulsive therapy (ECT) is also permitted to be used off-label.  How about that?  No kidding.  [What is ECT, exactly?  Oh!  Let’s review it.  Here: Electroconvulsive Therapy consists of electricity being passed through the brain with a force of from 70 to 400 volts and an amperage of from 200  to 1600 milliamperes.  ECT (whether inpatient or outpatient) is given two to three times a week for a total of six to twelve sessions.  Procedurally, it’s delivered after a person has had muscle relaxers and anaesthetics so the body does not move too much when the electric shock is delivered.]  It is labeled by the FDA as approved for use for extreme depression, schizophrenia and catatonia.

The FDA order makes it very clear that the FDA does not regulate clinical practice; they actually say this several times in the text accompanying the order: “FDA does not regulate the practice of medicine (see section 1006 of the FD&C Act [21 U.S.C. 396]). Diagnosis and treatment of patients are clinical decisions that fall within the practice of medicine.” In other words, practitioners are free to continue to prescribe ECT for any patient, regardless of diagnosis, whom they feel would benefit from the treatment.

This is similar to the freedom to use a medication for an off-label indication.

And, that, my friend, is the end of this handy review of what common (big seller) pharma drugs may be making someone who struggles with High Functioning Anxiety feel worse. 

The topic of off-label drug use must not fall on deaf ears.  It’s a real thing and it happens all the time.  Not some of the time.  It happens all the time.  So, before you take any prescription, take a moment to find out if it’s something you really want in your body and mind.  Do you want the intended and unintended effects in your. own. body. and. mind.  ???

Better yet. Use Done With Anxiety Methods to thwart the experience of High Functioning Anxiety so the question of prescriptions remains only hypothetical.