Medicines that affect mood

Some medicines can cause changes in your mood. They may improve your mood but they may also make you feel sad, despairing or depressed. If you are worried about changes in your mood, discuss this with your doctor or pharmacist immediately.

Changes in mood only occur in some people and can vary depending on the individual and the medicine. Some medicines can improve your mood, while others may worsen it. The chance of getting these effects varies greatly from person to person.

Examples of mood changes from medicine

The following are examples of mood changes related to taking medication:

  • Low mood: Some medicines may cause low mood, which may mean that you feel sad, teary and lose interest in activities that you usually enjoy. Low mood usually tends to lift after a few days or weeks. 
  • Depression: If the feelings of low mood don't go away, it can be a sign of depression. This can affect your everyday activities, such as eating, sleeping and concentration. If severe, it could result in having suicidal thoughts or thoughts about harming yourself.
  • Behaviour changes: Some medicines can change your behaviour and cause symptoms such as irritability, agitation, restlessness, euphoria (feeling high), confusion, aggression, hostility and delusional thoughts. 
If you have thoughts of harming yourself or others, call your doctor immediately or phone Healthline 0800 611 116 or text 1737   

Examples of medicines known to affect mood

The following is a list of medicines that are known to cause mood changes. It is important to note that not all people get these effects with these medicines. If you are taking a medicine and are worried about changes to your mood, do not stop taking your medicine suddenly. Instead discuss this with your doctor or pharmacist. Sometimes there might be a different dose or a different medicine that you can take that has less effect on your mood. Keep in mind that people close to you may notice a change in your behavior before you see it in yourself. If other people say they’ve noticed something, it’s probably a good idea to ask for help.

Medicines that are known to cause low mood, depression or behaviour change in some people
  • Steroid medicines such as prednisone, dexamethasone
  • Oral contraceptives (birth control pills)
  • Beta-blockers such as propranolol
  • Varenicline (Champix®) for smoking cessation
  • Isotretinoin for acne
  • Antivirals such as efavirenz
  • Pain medicines such as morphine, oxycodone, tramadol
  • Epilepsy medicines such as levetiracetam
  • Parkinson's medicines such as carbidopa
  • Antidepressants such as SSRIs
Note: This is not a complete list. If you are unsure if the medicine you are taking can cause mood changes, ask your doctor or pharmacist.

Who is most at risk of mood changes caused by medicines?

Medication-related mood changes are more likely in people with a history of mental illness or depression. If you have had mental illness or depression in the past, always ask your doctor or pharmacist about possible side effects before starting any new medicines. 

Taking multiple medications that have the side effect of altered mood can make the problem worse.   

Alcohol and recreational drugs can alter your mood. Taking some medicines together with alcohol and recreational drugs can make changes in mood worse. Read more about alcohol and mental health.

How are medicine-related mood changes diagnosed?

Since not all changes in mood are caused by medicines, working out whether your mood changes are caused by your medicine is not always easy. Sometimes changes in your mood may be related to the underlying condition being treated or other things going on in your life. Your doctor will look at your medicine list to see whether you are taking any that can cause mood changes. If you started getting noticeable mood changes after you began one of these medicines, it could be a reason.

What can I do if my medicines might be affecting my mood?

Talk to your doctor 
If you are worried about changes in your mood, discuss this with your doctor or pharmacist immediately. Sometimes a more suitable dose or medicine can be found. Some medicines need to be stopped gradually, as stopping suddenly can make your symptoms worse, so always ask for advice before you stop.   

Do not drink alcohol
Drinking alcohol can make mood changes worse. 

References

  1. General medical drugs associated with depression Psychiatry (Edgmont). 2008 Dec; 5(12): 28–41.
  2. Spotlight on levetiracetam Medsafe, NZ, 2017
  3. Varenicline and neuropsychiatric adverse reactions Medsafe, NZ, 2017
  4. Inhaled and systemic corticosteroids and mood disorders Medsafe, NZ, 2016
  5. Antiepileptic medicines and suicide Medsafe, NZ, 2016
  6. Can I have a drink with that? Medsafe, NZ, 2014
  7. Anti-epileptics – monitor patients for increased risk of suicidality Medsafe, NZ, 2013
  8. Suicidality – a rare adverse effect Medsafe, NZ, 2010
  9. Impulsive behaviours with dopamine agonists Medsafe, NZ, 2008
  10. Acne, isotretinoin and depression Medsafe, NZ, 2005
  11. HIV and clinical depression American Psychiatric Association, US
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 19 Jul 2019