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Anxiety And Antibiotics

Grace Lian reviewed
Written by: Marilyn Folk, BScN.
Reviewed by: Grace Lian, BA (Psychology), MDiv (Counseling), DMin - Psychotherapist
Last updated: April 4, 2019


Anxiety And Antibiotics

Can taking antibiotics cause an increase in anxiety and its symptoms, including causing panic attacks?

Anxiety is caused by apprehensive behavior. So, no, taking an antibiotic doesn’t cause anxiety or panic attacks.

Taking an antibiotic, however, can cause anxiety-like symptoms as well as aggravate existing anxiety symptoms, including increasing a sense of nervousness, agitation, danger, and foreboding. If a person has a history of being anxious, these increases could lead to an increase in anxious behavior, including being the cause of a panic attack.

Jim Folk, the president of anxietycentre.com, experienced anxiety-like symptoms and an aggravation of anxiety symptoms when he was struggling with anxiety disorder and took an antibiotic.

While an increase in anxiety and its symptoms may be listed as a side effect of taking an antibiotic, the increase in anxiety is most likely caused by worrying about taking an antibiotic rather than the antibiotic itself. Or, because of worrying about the side effects or the aggravation of existing anxiety symptoms.

Worry is an example of apprehensive behavior that creates the physiological, psychological, and emotional state of anxiety.

So again, no. Taking antibiotics doesn’t cause anxiety. If a person is anxious, being concerned about taking an antibiotic, or being worried about an increase in symptoms because of the antibiotic could be enough to increase apprehensive behavior, including the overly apprehensive behavior that leads to panic attacks.

Common antibiotic side effects

The most common antibiotic side effects include gastrointestinal problems such as:[1][2]

Other side effects include:[1][2]

To name a few.

Notice how many of these side effects are similar to symptoms of anxiety. If a person is already concerned about his anxiety symptoms, experiencing an increase due to an antibiotic could increase his worry, which can cause an increase in anxiety.

Again, while the antibiotic itself doesn’t cause anxiety, worrying about it and the increase in symptoms can cause an increase in anxiety. But this is behavioral-driven and not caused by the medication itself.

How often do antibiotics cause side effects?

Research has found that one in five people experience side effects from taking antibiotics.[4][5]

Moreover, some antibiotics are more prone to causing side effects, with a few causing serious side effects. For example, Fluoroquinolone antibiotics (ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin), commonly used to treat a variety of illnesses such as respiratory and urinary tract infections are known to cause serious side effects, including mental health problems, blood sugar problems, and permanent neurological damage.[6][7][8] It’s our recommendation to avoid these types of antibiotics if possible.

Why antibiotics can cause anxious people to experience an increase in anxiety and its symptoms

There are many reasons why antibiotics can cause an increase in anxiety and its symptoms for some anxious people:

1. Antibiotics cause the “immune response.”

The immune response rallies the body’s defense mechanism to do battle with the infection. Part of this defense mechanism increases metabolism to fight the intruder. Increased metabolism can cause an increase in body temperature, heart rate, and respiration. These increases may seem as if anxiety and its symptoms have increased.

If you are a worrier and worry about anxiety, its symptoms, and how you feel, these increases can cause some anxious people to worry. Worry is an example of apprehensive behavior that creates the physiological, psychological, and emotional state of anxiety.

In this case, it wasn’t the antibiotic that caused the increase in anxiety and its symptoms but the apprehensive reaction to the effects of the antibiotic that caused the increase in anxiety.

2. Antibiotic side effects can mimic and aggravate existing anxiety symptoms.

Antibiotics can cause a wide range of side effects with many similar to symptoms of anxiety and hyperstimulation. For instance, stomach and digestive distress are the most common antibiotic side effects. Stomach and digestive distress are also common symptoms of anxiety and hyperstimulation.

If you are experiencing stomach distress as an anxiety symptom and then experience an increase in stomach distress due to an antibiotic, the increase might be perceived as an increase in anxiety and its symptoms. And if you are a worrier, worrying about the increased stomach distress can cause an increase in anxiety.

In this case, the antibiotic side effects aggravated the existing anxiety symptoms. Then, your worried reaction caused the increase in anxiety.

3. Worried about taking an antibiotic.

Many anxiety disorder sufferers have health and medical sensitivities. These sensitivities often stem from deep-seated cores fears, such as the fear of pain and suffering, fear of dying and death, fear of loss, fear of the unknown, fear of being out of control, and so on.

Health and medical sensitivities can create a fear of taking medication, including antibiotics. When antibiotics are prescribed, health and medical sensitivities can trigger worrisome behavior, which creates anxiety.

Here again, it’s not that the antibiotic itself has caused anxiety but that a worrisome reaction to taking an antibiotic has.

4. A vicious cycle.

Worrying about taking an antibiotic can increase anxiety and its symptoms. And if the antibiotic has caused anxiety-like symptoms or aggravated existing symptoms, worrying about these symptoms can increase anxiety, and therefore, also increase the stress placed on the body. Increased stress can cause an increase in anxiety symptoms. Thus, a vicious cycle can ensue:
Worried about taking an antibiotic creates anxiety, which increases stress → increased stress increases symptoms → taking an antibiotic can cause anxiety-like symptoms and aggravate existing symptoms → worrying about an increase in symptoms can create more anxiety and stress → increased anxiety and stress can create more symptoms, and so on.

5. Some antibiotics irritate the nervous system.

Chronic anxiety can hyperstimulate the nervous system. Hyperstimulation can cause a wide range of nervous system-related symptoms. Taking an antibiotic that also irritates the nervous system can compound hyperstimulation and its symptoms making your anxiety and symptoms feel much worse even though you haven’t experienced an increase in anxiety.

6. Stomach and digestive problems can feel like anxiety.

There is a tight gut-brain connection. Our thoughts and feelings can affect our stomach and digestive system, and our stomach and digestive system can influence our thoughts and feelings.

Many anxiety disorder sufferers experience stomach and digestive problems due to their struggle with anxiety. Consequently, they equate their anxiety to their symptoms.

Antibiotics often cause stomach and digestive problems as side effects. Experiencing an increase in stomach and digestive problems because of antibiotic use could be misconstrued as experiencing an increase in anxiety. If an anxious person worries about an increase in anxiety and its symptoms, this worry will increase anxiety.

Once again, it’s not that the antibiotic has caused an increase in anxiety but that worrisome behavior has.

If you experience an increase in anxiety and its symptoms when taking an antibiotic, consider the above and work to contain your apprehensive behavior. Keeping yourself contained in spite of an increase in symptoms due to the antibiotic can prevent anxiety from escalating, which will prevent panic attacks.

Generally, the side effects of taking an antibiotic subside shortly after stopping the antibiotic (usually within 1 to four days after the antibiotic was stopped). But in some cases (rarely), adverse reactions to antibiotics might take several months to clear. Talking with your doctor AND pharmacist about which medication is best for you could help you steer clear of those antibiotics that have the potential for long-term problems.

As we mentioned earlier, fluoroquinolone antibiotics are known to cause lasting side effects, with some being serious.

If you need to take an antibiotic, discuss the options with your doctor and pharmacist to ensure you get the best results with the least side effects.

Regarding antibiotics causing panic attacks:

Just as antibiotics don’t cause anxiety, they also don’t cause panic attacks. Panic attacks are almost always caused by uncontained apprehensive behavior - the inability to contain (limit/restrict/prevent) anxious behavior. The adverse effects of chronic stress can also cause panic attacks, but these are rare with most panic attacks caused by apprehensive behavior.

Remember, panic is simply a high degree fear accompanied by a high degree stress response and its physiological, psychological, and emotional changes. Everyone experiences intense fear and high degree stress responses at one time or another. However, only a small percentage of people struggle with panic attacks.

Sustained panic attacks — extended periods of intense fear and high degree stress responses —occur because of prolonged apprehensive behavior. It’s our inability to contain our anxious behavior that causes most panic attacks.

Therefore, antibiotics don’t cause panic attacks. Panic attacks are most often caused by apprehensive behavior - scaring oneself into high degree anxiety.

Click the link for more information about the cause, symptoms, and treatment of anxiety and panic attacks.

Even though we might experience an uptick in anxiety-like sensations and symptoms due to taking an antibiotic, we can still contain anxious behavior. As a result, no one needs to have an increase in anxiety or panic attacks when taking an antibiotic.

Overcoming your anxiety issues by addressing both levels of recovery will eliminate increases in anxiety and panic when taking an antibiotic.


The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.


Anxiety attacks can be powerful and overwhelming experiences. But there is help available. We encourage you to explore our website for a comprehensive understanding of anxiety, anxiety attacks, disorders, and their signs and symptoms.

Also, for more information about our Anxiety Counseling option; our Available Anxiety Therapists; to Book An Appointment with one of our anxiety therapists; information about Anxiety Attacks, Symptoms, and Treatment options; the signs and symptoms of panic attacks disorder; anxiety Recovery Support area; information about Anxiety; and our Anxiety 101 section; or click on the appropriate link or graphic below:

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REFERENCES:

1. Cunha, John H. “Common Side Effects of Amoxil (Amoxicillin) Drug Center.” RxList, 16 Jan. 2019, www.rxlist.com/amoxicillin-side-effects-drug-center.htm#overview.

2. Huizen, Jennifer. “Side Effects of Antibiotics.” Medical News Today, MediLexicon International, 23 Aug. 2018, www.medicalnewstoday.com/articles/322850.php.

3. “COMMON ANTIBIOTICS MAY BE LINKED TO TEMPORARY MENTAL CONFUSION.” AAN, 16 Feb. 2016, www.aan.com/PressRoom/Home/PressRelease/1433.

4. Pranita D. Tamma, Edina Avdic, David X. Li, Kathryn Dzintars, Sara E. Cosgrove. Association of Adverse Events With Antibiotic Use in Hospitalized Patients. JAMA Internal Medicine, 2017; DOI: 10.1001/jamainternmed.2017.1938

5. Hub. “Study Finds 1 in 5 Patients Suffers Antibiotic Side Effects.” The Hub, 16 June 2017, hub.jhu.edu/2017/06/16/antibiotics-adverse-effects-study/.

6. Miller, Kelli. “Fluoroquinolone Antibiotics Linked to Serious Nerve Damage.” WebMD, WebMD, 27 Aug. 2013, www.webmd.com/brain/news/20130826/fda-strengthens-fluoroquinolone-warning.

7. FRANCISCO, Estela Miranda. “Disabling and Potentially Permanent Side Effects Lead to Suspension or Restrictions of Quinolone Fluoroquinolone Antibiotics.” European Medicines Agency, 16 Nov. 2018, www.ema.europa.eu/en/news/disabling-potentially-permanent-side-effects-lead-suspension-restrictions-quinolone-fluoroquinolone.

8. Office of the Commissioner. “Press Announcements - FDA Updates Warnings for Fluoroquinolone Antibiotics on Risks of Mental Health and Low Blood Sugar Adverse Reactions.” U S Food and Drug Administration Home Page, Office of the Commissioner, 7 Oct. 2018, www.fda.gov/newsevents/newsroom/pressannouncements/ucm612995.htm.

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