Is apixaban (Eliquis) associated with anxiety or panic attacks?

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Last updated: April 4, 2025View editorial policy

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From the Guidelines

Eliquis (apixaban) is not commonly associated with anxiety or panic attacks, but patients should discuss any new or worsening anxiety symptoms with their healthcare provider to determine the cause and potential need for medication adjustment. The primary studies on apixaban, such as the ARISTOTLE trial 1, focus on its efficacy and safety in preventing stroke and systemic embolism in patients with atrial fibrillation, with major bleeding events being a primary safety outcome. Anxiety or panic attacks are not listed among the common side effects in these studies. However, it's essential for patients to report any changes in their mental health to their doctor, as the relationship between anticoagulant therapy and anxiety could be complex, potentially involving the body's response to altered blood clotting mechanisms or concerns about bleeding risks.

Some key points to consider:

  • The ARISTOTLE trial demonstrated apixaban's superiority over warfarin in reducing stroke and systemic embolism, with fewer major bleeding events 1.
  • Apixaban has been shown to have a favorable safety profile, with less fatal bleeding and less intracranial hemorrhage compared to warfarin 1.
  • Patients with severe or end-stage chronic kidney disease (CKD) were excluded from the main trials, but prescribing recommendations for apixaban in these patients have been revised based on pharmacokinetic data 1.
  • The connection between Eliquis and anxiety, if any, may not be directly related to its pharmacological effects but could be influenced by patient concerns about anticoagulant therapy.

Given the current evidence, the most critical consideration for patients on Eliquis experiencing anxiety or panic attacks is to consult their healthcare provider to assess the cause of these symptoms and determine the best course of action, which may include adjusting their medication regimen or addressing underlying concerns about anticoagulant therapy.

From the Research

Eliquis and Anxiety/Panic Attacks

  • There is no direct evidence in the provided studies that correlates Eliquis (apixaban) with anxiety/panic attacks 2, 3, 4, 5, 6.
  • The studies primarily focus on the efficacy and safety of apixaban in preventing stroke and systemic embolism in patients with nonvalvular atrial fibrillation, as well as its use in treating venous thromboembolism and preventing recurrent events 2, 3, 4, 5.
  • The pharmacokinetic and pharmacodynamic profiles of apixaban are also discussed, including its absorption, distribution, metabolism, and elimination, but no mention is made of anxiety or panic attacks as potential side effects 6.
  • Overall, the available evidence does not suggest a correlation between Eliquis and anxiety/panic attacks, but it is essential to note that this topic is not explicitly addressed in the provided studies 2, 3, 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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