Can Pantoprazole Cause Anxiety?
Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.
Pantoprazole is a potent acid-reducing drug used to treat chronic gastritis, peptic ulcer disease, and chronic acid reflux (GERD).
The drug achieves excellent results with GERD and gastritis. However, some may abuse it for longer, leading to long-term side effects.
Today, We will explain the possible connections between pantoprazole and psychological dysfunction.
The short answer: Does pantoprazole cause anxiety?
Some studies found a small risk of anxiety with pantoprazole use. However, the link is not well established. Anxiety during pantoprazole treatment can be a sign of brain-gut axis dysfunction. Also, anxiety may result from other side effects of long-term use of pantoprazole, such as magnesium and vitamin B12 deficiency.
- The presence of anxiety during pantoprazole doesn’t always mean that the medication is the cause.
- Anxiety and psychological dysfunction are frequent with GERD and functional dyspepsia. Anxiety is often a sign of brain-gut axis dysfunction rather than a result of pantoprazole use.
- Anxiety is more likely to occur with the long-term use of pantoprazole. However, short-term use (for up to 6-8 weeks) often doesn’t produce such effects.
- Long-term use of pantoprazole can indirectly cause psychological symptoms such as anxiety due to vitamin B12 and magnesium deficiency induction.
- Anxiety is overall rare with pantoprazole use. Therefore, the fear of pantoprazole anxiety shouldn’t be a reason to stop or avoid the drug.
- The drawbacks of stopping pantoprazole may overweight the risks. Always consult your doctor before taking or stopping pantoprazole.
How common is anxiety with pantoprazole?
The connection between anxiety and pantoprazole use is not well established.
Some reports found an association between pantoprazole use and anxiety. However, association doesn’t always imply causation.
Diseases treated with pantoprazole, such as GERD (acid reflux) and functional dyspepsia, are tightly liked to anxiety.
The anxiety can be due to the disease itself (GERD or functional dyspepsia) rather than the treatment with pantoprazole).
- A large study (involving about 30,00 children and adolescents) found that patients taking pantoprazole are 2.6 times more likely to have anxiety than the general population (reference).
- Another study stated that some GERD patients respond poorly to proton pump inhibitors (including pantoprazole) because the root cause is anxiety rather than acid reflux (reference).
- Another study found that anxiety in patients with GERD is a predictor of a poor response to PPIs, including pantoprazole (anxiety is a cause of GERD rather than a result of pantoprazole use) (reference).
According to the Lexicomp® drug database, anxiety is not among the consistently reported nervous system side effects of pantoprazole (reference).
The reported nervous system side effects were as follows:
- Headache (commonest) in more than 10% of patients taking pantoprazole.
- Dizziness (<4%).
- Depression (<2%).
- Less frequent side effects (<1%): Confusion, dementia, drowsiness, hallucinations, and insomnia.
Possible connections between pantoprazole and anxiety?
1 . brain-gut axis malfunction.
One of the most accepted explanations of the concurrence of anxiety with pantoprazole is the brain-gut axis dysfunction.
The brain-gut axis dysfunction is a term that refers to the tight connection between your digestive system and your brain and mental health state.
Many gastrointestinal diseases are tightly linked to anxiety and other psychological comorbidities.
Chronic anxiety can lead to functional gastrointestinal diseases such as:
- Functional dyspepsia.
- Functional abdominal pain.
- Irritable bowel syndrome.
As a result, many patients use proton pump inhibitors such as pantoprazole (Protonix®) to treat digestive system symptoms that are caused initially by anxiety.
In such patients, anxiety is often present before the use of pantoprazole. Also, the use of pantoprazole in patients with brain-gut axis dysfunction is not so effective, leading to the long duration of the treatment.
2. Hypomagnesiema-related anxiety (long-term use).
Hypomagnesemia (low magnesium levels in your body) is a rare but reported side effect of long-term use of pantoprazole (reference). The magnesium depletion in your body leads to physical and psychiatric symptoms, including anxiety (reference).
Other symptoms of hypomagnesemia:
- Muscle tremors
- Muscle weakness
- Irritability and mood swings
- Muscle tetany
- Severe deficiency may end in delirium or coma
- Abnormal heartbeats (irregular or rapid)
3. Vitamin B12 deficiency-related anxiety (long-term use).
In a scenario similar to magnesium deficiency, long-term pantoprazole is linked to vitamin B12 deficiency (reference). Vitamin B12 is one of the vital vitamins to your blood and nervous system.
But you should note that vitamin deficiencies such as vitamin B12 are unlikely to happen with the short-term use of PPIs such as pantoprazole. Durations such as 6, 8, or 12 weeks of pantoprazole are usually safe.
Vitamin B12 deficiency requires long-term use for a year or more to happen.
Symptoms of vitamin B12 deficiency:
- Symptoms of anemia (easy fatigue, dizziness, shortness of breath, fast heartbeats, headaches).
- Sometimes, Jaundice (yellowish discoloration of the skin and eye whites).
- Numbness and tingling of the hands and feet.
- Red, glazed tongue
- In severe cases, The nervous system gets involved causing damage to the spinal cord and psychiatric changes, including anxiety.
MORE: Vitamin B12 101: Benefits, Sources causes of deficiency, & More.
Should you stop pantoprazole due to anxiety issues?
Overall, The incidence of anxiety with pantoprazole is very low. However, anxiety can be present due to causes other than pantoprazole (Associations don’t mean causation).
So, don’t let your anxiety and fear make a wrong move, such as stopping pantoprazole without consulting your doctor.
The harms of stopping pantoprazole may exceed the benefits. For example, Stopppantoprazolezole in patients with GERD or Peptic ulcer disease may lead to:
- Recurrence of the severe symptoms such as severe epigastric pain or heartburn.
- Bleeding peptic or duodenal ulcers.
- Continued esophageal wall damage in patients with acid reflux leads to complications such as Barret’s esophagus, chronic sore throat, or esophageal cancer.
So, don’t overestimate the side effects of the medication. And never stop taking pantoprazole without permission from your doctor.