Which Medications Cause Fatigue?

Many prescription and over-the-counter medications come with a slew of side effects, including making you feel overly tired. Meds affect people in different ways, and the presence and prevalence of side effects can vary.

It’s always a good idea to take your meds and supplements or a list of them to each doctor’s appointment. That way they can assess if your dose can be adjusted to eliminate fatigue while still allowing the medication to do its job. Your physician may also be able to move a morning dose to the evening, so fatigue is less of an issue during the day or switch you to a different medication.

Here are the medication categories that tend to cause the most fatigue and the biggest culprits.

Antianxiety medications: benzodiazepines, including alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazapam (Ativan). Anxiolytics, such as buspirone (BuSpar), hydroxyzine (Atarax), venlafaxine (Effexor XR) 

Antibiotics: Amoxicillin, azithromycin, ciprofloxacin 

Anticonvulsants (epilepsy or seizure medications): Examples include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), topiramate (Topamax), valproic acid (Depakote).

Antidepressants: Many antidepressants are sedating. Here are some examples with long term or short-term sedating effects that may gradually wear off:

• Tricyclic antidepressants, such as amitriptyline, clomipramine (Anafranil), desimpramine (Norpramin), doxepin, imipramine (tofranil), nortriptyline (Pamelor), traxadone and Surmontil)
  SSRIs (Selective Serotonin Reuptake Inhibitors), including paroxetine (Brisdelle, Paxil), fluoxetine (Prozac, Sarafem), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), sertraline (Zoloft), and vilazodone (Viibrid)

Antihistamines: 

• Sedating antihistamines that cause sleepiness: brompheniramine (Bromax), clemastine (Tavist Allergy), diphenhydramine (Benadryl), hydroxyzine (Atarax, Vistaril), triprolidine (Tripohist)
  Nonsedating antihistamines, which may cause sleepiness in some people: azelastine nasal spray (Astelin), cetirizine (Zyrtec), desloratadine (Clarinex), fexofenadine (Allegra), levocetirizine (Xyzal), loratadine (Alavert, Claritin), olopatadine nasal spray (Patanase)

Antinausea medications: metoclopramide, cyclizine, ondansetron 

Antipsychotics: clozapine olanzapine (Zyprexa), perphenazine (Trilafon), quetiapine (Seroquel), risperidone (Risperdal) ziprasidone (Geodon), aripiprazole (Abilify), asenapine (Saphris), cariprazine (Vraylar), haloperidol (Haldol), lurasidone (Latuda), paliperidone (Invega)

• Cholesterol medications: 
  Statins: atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), pitavastatin (Pravachol), rosuvastatin (Crestor), simvastatin (Zocor).
  Fibrates, such as fenofibrate (Tricor)
• Heart medications: Fatigue is a side effect of many heart medications because they slow down the heart, lower your blood pressure, depress the central nervous system, or deplete electrolytes: 
  ACE Inhibitors, such as lisinopril (Prinivil, Zestril)
  Beta blockers, including acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), metoprolol (Lopressor) and sotalol (Betapace)
  Calcium channel blockers, such as amlodipine (Norvasc)
  Diuretics, including HCTZ and furosemide (Lasix) 
  Renin inhibitors, such as aliskiren (Tekturna)
   

Muscle relaxants: baclofen (Lioresal), diazepam (Valium), carisoprodol (Soma), cyclobenzaprine (Flexeril), orphenadrine (Norflex)

Pain medications: Opioids, including morphine, fentanyl, oxycodone, hydrocodone, codeine, as well as tamadol.

Proton pump inhibitors (PPIs): Dexlansoprazole, esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix)