Antidepressants are used to treat depression and anxiety disorders, such as panic disorder. Some antidepressants are considered to be more stimulating than others and may cause an initial increase in anxiety. Sometimes increased anxiety lasts throughout the course of treatment. There is a large degree of individual variability in the response to antidepressant medications, including in the degree of side effects experienced by any one person.
Bupropion
Bupropion, commonly known by is commercial name Welbutrin, is an antidepressant that increases the levels of dopamine and noradrenaline in the synapses between neurons. It's used not only to treat depression, but also as an aid in smoking cessation. Bupropion is considered to be one of the most stimulating antidepressants. Mayoclinic.com lists anxiety as one of its most common side effects. Its stimulating effect is useful when a patient has depression with low energy. It's less useful when treating patients with significant anxiety, which often accompanies depression. Nonetheless, it can be used to treat depression in anxious people, though sometimes another medication is added to counteract the increased anxiety.
Fluoxetine
Fluoxetine, or Prozac, is a serotonin specific reuptake inhibitor, or SSRI. It's considered to be more stimulating than other SSRIs, causing more anxiety and agitation. It's often used in treatment of anxiety disorders such as panic disorder and obsessive compulsive disorder, or OCD. When used to treat these conditions, fluoxetine needs to be started at the lowest dose possible and increased very gradually. Generally, a tolerance builds up to its anxiety inducing properties, and its ability to reduce anxiety come into play. Treatment of OCD often requires high doses, up to 80 mg a day, in contrast to the dose usually used to treat depression, which is 20 mg a day.
Other Antidepressants
Other SSRIs include citalopram, sertraline and paroxetine. These are less likely to cause anxiety than fluoxetine, as shown in "The Primary Care Companion to the Journal of Clinical Psychiatry." Other classes of antidepressants include the serotonin norepinephrine re-uptake inhibitors, or SNRIs, such as duloxetine, known commonly by its commercial name Cymbalta. As Mayoclinic.com explains, increased anxiety is one of the potential side effects, but as with other antidepressants, each person may have a different response, to both the positive effects and the adverse effects of the medication.
References
- "CNS Drug Review"; Review of the pharmacology and clinical profile of bupropion, an antidepressant and tobacco use cessation agent; Dwoskin LP et al,; Fall-Winter 2006
- "Primary Care Companion J Clin Psychiatry"; SSRI Antidepressant Medications: Adverse Effects and Tolerability; James Ferguson; Feb 2001
- Mayoclinic.com: Antidepressants
- "Kaplan and Sadock's Comprehensive Textbook of Psychiatry": Virginia Sadock and Pedro Ruz (eds); 2009
- Mayoclinic.com: Bupropion
