GoodRx for Healthcare Professionals7 Medications That Can Make You Tired — And Why Your Antibiotic Isn’t One of Them

This article targets patients experiencing medication-related fatigue, providing evidence-based guidance on common pharmacological causes of drowsiness. It clarifies misconceptions about antibiotics and acetaminophen while offering practical recommendations for managing medication-induced fatigue in a patient-friendly format that could enhance medication adherence and provider communication.

⚕️Key Clinical Considerations⚕️

• Antihistamines, especially first-generation options like diphenhydramine, cause significant drowsiness compared to second/third-generation alternatives like fexofenadine and loratadine, which are better daytime options.
• Antidepressant-induced fatigue varies by class, with trazodone, mirtazapine, TCAs, and MAOIs causing more sedation than SSRIs and SNRIs; bupropion is highlighted as the least sedating option.
• Benzodiazepines, opioids, and muscle relaxants consistently produce drowsiness, with particular emphasis on the need for caution with activities requiring alertness while using these medications.
• Beta blockers and anti-seizure medications like topiramate commonly cause fatigue that typically improves with continued use, but may require dose adjustment if persistent.
• Contrary to common misconceptions, antibiotics and acetaminophen alone don’t directly cause drowsiness; rather, the underlying conditions they treat (pain, infection) are likely responsible for associated fatigue.

🎯 Clinical Practice Impact 🎯

• Patient Communication: Proactively discuss expected drowsiness with specific medications, particularly distinguishing between temporary adaptation effects versus persistent side effects requiring intervention. Clarify for patients that fatigue during antibiotic treatment likely stems from the infection itself rather than the medication, which may improve adherence to treatment courses.
• Practice Integration: Consider prescribing non-sedating alternatives when daytime alertness is critical (eg, fexofenadine instead of diphenhydramine for allergies; bupropion instead of mirtazapine for depression). Implement gradual dose escalation strategies for anti-seizure medications and advise patients that drowsiness typically diminishes over time.
• Risk Management: Document warnings about driving and operating machinery for patients prescribed benzodiazepines, opioids, and muscle relaxants, with particular emphasis on avoiding alcohol while taking these medications.

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