Based on PubMed | Can omeprazole cause anxiety as a side effect, how common is it, and what should I do if it occurs?

Yes omeprazole can cause anxiety in some people, although it appears to be uncommon. Anxiety is listed among the nervous system and psychiatric adverse reactions for omeprazole in official product information. ^[1] Related psychiatric effects that may cluster with anxiety include insomnia, nervousness, agitation, and mood changes. ^[1]

How Often Does It Happen?

Precise rates for anxiety with omeprazole are not clearly quantified in publicly available labels. Official labeling acknowledges anxiety as a possible adverse reaction but does not specify an exact frequency category. ^[1] In general clinical use, anxiety with omeprazole is considered uncommon relative to more frequent side effects like headache, abdominal pain, or nausea. ^[1]

Why Might Anxiety Occur?

• Direct drug effect on the nervous system: Anxiety is grouped with other central nervous system and psychiatric reactions in the label, suggesting a possible direct or indirect effect in susceptible individuals. ^[1]
• Sleep disturbance link: Insomnia and abnormal dreams are also reported; poor sleep can intensify daytime anxiety symptoms. ^[1]
• Electrolyte shifts in rare cases: Very rarely, low magnesium can develop with prolonged proton pump inhibitor use and may cause jitteriness, palpitations, tremor, or dizziness that can feel like anxiety. ^[2] If symptoms include spasms, seizures, or fast/irregular heartbeat, urgent evaluation is needed. ^[2]

What To Do If Anxiety Appears

• Assess timing: If anxiety started soon after beginning omeprazole (or a dose change), the medicine may be contributing. Because anxiety is a recognized adverse reaction, discuss it with your clinician before continuing long term. ^[1]
• Do not stop abruptly without a plan: Stopping omeprazole suddenly can lead to rebound acid hypersecretion and a flare of heartburn, which itself can worsen anxiety. ^[3] A supervised taper or a step‑down plan may reduce rebound symptoms. ^[4]
• Check for other contributors: Review caffeine, decongestants, stimulants, and other medicines (for example, some sleep or mood drugs) that may interact or add to anxiety. ^[5]
• Consider alternatives: Your clinician may suggest switching to another acid‑suppressing strategy (such as an H2 blocker), using on‑demand therapy, lifestyle changes (weight management, avoiding late meals, trigger foods, alcohol, tobacco), or evaluating for other causes of symptoms. Choice of therapy should balance symptom control and side effects. ^[4]
• Seek urgent care for red flags: If you have severe restlessness, confusion, hallucinations, severe palpitations, fainting, muscle spasms, or seizures, get medical help promptly. ^{[1] [2]}

---

Quick Reference Table

Topic	What the Label Says	Practical Takeaway
Anxiety listed as side effect	Anxiety is included among psychiatric and sleep disturbances (with nervousness, insomnia, agitation, etc.). [1]	Anxiety can occur, though it’s not among the most common side effects. [1]
Frequency data	Not clearly quantified in public label text. [1]	Likely uncommon; monitor if symptoms begin after starting therapy. [1]
Sleep link	Insomnia and dream abnormalities reported. [1]	Sleep issues can worsen or mimic anxiety; address sleep hygiene and timing. [1]
Electrolyte warning	Serious low‑magnesium symptoms include jitteriness, tremor, spasms, seizures, fast heartbeat. [2]	Rare but important; seek care if neurological or cardiac symptoms occur. [2]
Stopping guidance	Withdrawal can produce rebound acid hypersecretion and new/worse reflux symptoms. [3]	Avoid abrupt discontinuation; consider taper/step‑down with clinician. [4]

---

Practical Tips You Can Try Today

• Track symptoms: Keep a short diary noting when you take omeprazole, anxiety intensity, sleep quality, caffeine/alcohol, and heartburn episodes to spot patterns. Clear patterns help your clinician adjust treatment safely. ^[4]
• Adjust timing: Taking omeprazole 30–60 minutes before breakfast (standard guidance) and limiting late‑day caffeine may ease both reflux and sleep. ^[4]
• Plan a safe exit if needed: If anxiety persists and seems related, ask about a taper plan to prevent rebound (for example, alternate‑day dosing, then switch to as‑needed H2 blocker or antacid), tailored to your condition. ^{[3] [4]}

---

Bottom Line

• Anxiety is a recognized, though likely uncommon, side effect of omeprazole. ^[1]
• If it occurs, don’t stop the medication suddenly; speak with your clinician about dose adjustment, switching therapies, and evaluating other causes or contributors. ^{[3] [4]}
• Seek prompt care if anxiety comes with serious neurological or heart symptoms suggestive of low magnesium or other urgent issues. ^[2]