Is Anxiety a side effect of Jardiance?

Jardiance is a brand-name prescription medication that’s prescribed for people with type 2 diabetes. It’s used to:

• improve blood sugar levels, in combination with improved diet and exercise
• reduce the risk of cardiovascular death in people with heart disease in addition to type 2 diabetes

Jardiance contains the drug empagliflozin. It belongs to a class of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Jardiance comes as a tablet that’s taken by mouth once daily.

Jardiance is also effective when taken in combination with other diabetes medications. It can be taken with drugs such as metformin, insulin, pioglitazone, and glipizide.

Jardiance can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Jardiance. This list does not include all possible side effects.

For more information on the possible side effects of Jardiance, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

One of my patients asked me "Is Anxiety a side effect of Jardiance?". I had heard about most of the side effects of Jardiance but I could not answer this question.

After I reached home, I searched for studies, case reports, and review articles to answer this question.

I am sharing all the articles that mention anxiety as a side effect of Jardiance (empagliflozin).

I have been using Jardiance (empagliflozin) very frequently. I prefer prescribing Jardiance to diabetic patients with the following features:

• Patients with a low risk of urinary tract infections.
• Patients with heart disease especially those with stable heart failure
• Patients with proteinuria
• Patients with hypertension.

Most of these patients lose weight and achieve their metabolic circadian rhythm resulting in the normalization of blood glucose without medicines.

This is associated with a great improvement in the social well-being resulting in improvement in the symptoms of anxiety.

He reported heart sinking, palpitations, headache, tinnitus, irritability, vertigo, restlessness, disturbed sleep, excessive anger, and worries when he took a single dose.

The same symptoms repeated again when he took the dose. He reduced the dose to half but his symptoms would recur.

"Sodium-glucose cotransporter 2 inhibition as a potential treatment for idiopathic edema" hypothesized that SGLT 2 inhibition reduces the adrenergic output resulting in an improvement in anxiety.

Hypoglycemia may manifest as adrenergic symptoms or neuroglycopenic symptoms.Adrenergic symptoms include:

• Palpitations
• sweating
• anxiety
• elevated blood pressure
• insomnia
• irritability

Neuroglycopenic symptoms include:

• Loss of concentration
• drowsiness
• weakness
• confusion
• blurring of vision
• coma
• Those who develop hypoglycemia or hyperglycemia may develop symptoms of anxiety due to the poor control in patients with hyperglycemia and adrenergic symptoms in patients with hypoglycemia.

Patients who develop ketoacidosis may present with anxiety and abdominal symptoms.

Those who develop infections like urinary tract or genital mycotic infections may become anxious because of their illness.

All the studies do not reveal any direct association of Jardiance with anxiety. Patients who have better control of diabetes may report improvement in the symptoms of anxiety.

Those who develop hypoglycemia or hyperglycemia may develop symptoms of anxiety due to the poor control in patients with hyperglycemia and adrenergic symptoms in patients with hypoglycemia.

Patients who develop ketoacidosis may present with anxiety and abdominal symptoms.

Those who develop infections like urinary tract or genital mycotic infections may become anxious because of their illness.

Obese patients may report weight loss with Jardiance and hence report improvement in the symptoms of anxiety.