Does Eliquis cause depression or anxiety?

In this article:

• What evidence says
• Indirect links between Eliquis and anxiety or depression
• Known side effects of Eliquis
• What to do about anxiety or depression on Eliquis

In this article

• What evidence says
• Indirect links between Eliquis and anxiety or depression
• Known side effects of Eliquis
• What to do about anxiety or depression on Eliquis

Eliquis (apixaban) is a prescription blood thinner, or anticoagulant, approved by the Food and Drug Administration for the treatment of two of the most serious types of blood clots: deep vein thrombosis (DVT) and pulmonary embolism (PE). It’s also used to prevent blood clots and stroke in people with atrial fibrillation and people recovering from certain types of surgery.

Even though Eliquis isn’t a psychiatric medication or used to treat conditions related to mental health, some people report mood changes while taking Eliquis—particularly, an increase in anxiety and depression symptoms. Even if they’re not direct side effects, it’s worth understanding why you might notice mental health changes when using Eliquis.  

Can Eliquis cause depression or anxiety? What evidence says

Anxiety and depression are not considered common side effects of Eliquis. In fact, they aren’t included in any of the drug’s prescribing information or noted in relevant clinical trials or research studies. This means those symptoms occur or are reported so infrequently that they can’t be measured. 

Although these symptoms aren’t listed as official side effects, some people do notice mood changes after starting the medication, according to Gurpreet Saini, MD, an internal medicine physician at MedStar Health in Maryland. There are some reasons why people taking Eliquis might experience new or worsening anxiety or depression (more on that below), but the evidence we have doesn’t really suggest that the medication is the cause. 

Indirect links between Eliquis and anxiety or depression

If some people taking Eliquis develop symptoms of anxiety or depression, but the drug itself doesn’t cause those symptoms, then what is the connection? 

Per Cynthia Odogwu, MD, family and lifestyle medicine physician and founder of Kambili Health, mental health changes on Eliquis are more likely related to whatever health condition you have that’s requiring you to take this medication in the first place. They could also be secondary to some of the other more common side effects of Eliquis. 

Some indirect causes of depression or anxiety on Eliquis include:

• Related health conditions: Having had a recent PE or DVT can be stressful and scary, and may make you more prone to anxiety about your health and future. It can also be challenging to live with chronic conditions like atrial fibrillation or a blood-clotting disorder, or to know that you now have a higher risk for a blood clot or stroke than you did previously. Health anxiety is a real mental health condition, sometimes fueled by serious illnesses you’ve experienced. It makes sense that major health complications, like a life-threatening blood clot or stroke, might trigger feelings of anxiety and depression.
• Medication concerns: Blood thinners increase your risk of excessive bleeding because they prevent your blood from forming clots when you’re injured. People taking Eliquis are often warned to avoid alcohol, certain medications, supplements, foods, and risky activities like contact sports. These warnings can create a fear of excessive bleeding, per Dr. Odogwu, which can raise your overall level of anxiety or increase feelings of depression, especially if you have to change your lifestyle to accommodate your medication.  
• Other side effects: In addition to excess bleeding, another common side effect of Eliquis is anemia. “Anemia can lead to dizziness and fatigue,” says Dr. Odogwu, “[which] can indirectly make you feel depressed or anxious.” For example, feeling dizzy might trigger ongoing worries about fainting, especially in public places. Daily fatigue can cause you to miss out on social activities or hobbies, which could develop into feelings of depression over time.

Known side effects of Eliquis

Like all medications, Eliquis can cause side effects. The most common include an increased risk of excessive bruising or bleeding, anemia, nausea, dizziness, fatigue, weakness, and headaches. 

If you’re taking Eliquis and experience bleeding that doesn’t stop, persistent nosebleeds, signs of blood in your urine, stool, or vomit, fainting, or shortness of breath, contact your healthcare provider or seek emergency medical care right away.

What to do about anxiety or depression on Eliquis

If you’ve been put on Eliquis, it’s because you have a high risk of a blood clot or stroke—both potentially life-threatening conditions. You should never stop taking Eliquis without talking to your healthcare provider first. 

“Remember, there is a reason to start [taking a] blood thinner, and you can’t risk having another blood clot,” Dr. Saini says. She adds that she wouldn’t typically adjust an Eliquis dose for mood symptoms alone—only if there were signs of other side effects, or if it became clear that the medication was playing a more direct role in mental health changes. 

However, Dr. Saini adds that you shouldn’t ignore new or worsening feelings of anxiety or depression, especially if they’re affecting your daily life. Instead, reach out to your healthcare provider to talk about what you’re experiencing. They can help you take a “big picture” look at your day-to-day life to see if other factors could be causing your symptoms. Per Dr. Saini, this could include major changes or stressors in your life, your mental health history, sleep habits, appetite, energy level, and other medications (some drugs, like dopamine agonists and steroids, are known to contribute to feelings of anxiety and depression). 

It can also be helpful to take a proactive role in managing your health. Dr. Saini says, “Understanding the ‘why’ behind your medication can reduce fear, [and asking] about practical safety tips for bleeding prevention can help you feel more in control.”

Dana Manning, Pharm.D., RD, LDN, associate professor of pharmacy practice at Wilkes University in Pennsylvania, agrees that patient empowerment plays a huge part in reducing feelings of anxiety and depression related to medical treatment. She adds that talking with your healthcare provider or pharmacist so you’re educated about how your medication benefits you—and the potential risks of going without it—can make it easier to work through some of the side effects it causes.

Ultimately, if you are struggling with feelings of anxiety and depression, make an appointment with a mental health provider. They can provide ongoing counseling, recommend local or online support groups, or prescribe medications to treat your anxiety or depression, if needed. Just make sure your mental health provider knows you are taking Eliquis. According to Dr. Manning, some antidepressants further increase the risk for bleeding, so that’s something your provider would need to consider carefully before prescribing anything new.

Bottom line

Eliquis is not known to directly cause symptoms of anxiety or depression, but some people taking this medication report changes to their mood or mental health. This is most likely because the reasons for taking Eliquis—such as a recent surgery, blood clot, or stroke, or major changes to their overall health—are stressful and scary, and can trigger anxiety and depression as you try to navigate your new reality. Sometimes, other symptoms of Eliquis, like excessive bleeding and anemia, can lead to fear, worry, or depression over restrictions on someone’s lifestyle or usual activities.

Whatever the reason, you should never stop Eliquis without talking to your healthcare provider or ignore new or worsening symptoms of anxiety or depression. If your provider thinks Eliquis is causing your symptoms, they will work with you to find another medication, but most often, treating your anxiety symptoms with minor lifestyle changes, counseling, or mental health medications is the better approach.