AARP Hearing Center
4 Types of Medication That Can Make You Tired
Common prescription and over-the-counter drugs may be draining your energy. Here’s how to spot the culprits — and what to ask your doctor before making a change
Brian Scagnelli
Key takeaways
- Fatigue is a common medication side effect that can affect cognition, driving safety and fall risk in older adults.
- Blood pressure drugs, antihistamines, antidepressants, anti-anxiety medications, opioids and muscle relaxants can all contribute to tiredness.
- Do not stop a medication on your own. Talk with your doctor about dose changes, timing adjustments or alternatives.
Tired? You’re hardly alone.
A large review of research published in 2025 in Scientific Reports found that around 43 percent of adults 60 and older are, well, exhausted. Doctors often dismiss fatigue as a natural consequence of aging, but there are other culprits, including one that is widely underrecognized: medications.
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Research shows that around 1 in 3 adults in their 60s and 70s take five or more prescription drugs regularly. And about half of older adults reach for an over-the-counter medication on a daily or weekly basis.
“Many medications, whether over the counter or prescribed, can cause sedation, tiredness and low energy/concentration,” says Dr. Mohammed Issa, medical director of the Pain Management Center at Brigham and Women’s Faulkner Hospital and an assistant professor at Harvard Medical School.
“This is why it’s important for patients to check with their prescribers or primary care physicians if they begin taking a new medicine,” Issa continues. “Even if it doesn’t typically cause side effects, I always recommend my patients start a new medication on a weekend when they don’t expect to work or go out, just to see how their body reacts to it.”
As medication-related side effects go, fatigue may seem like a minor inconvenience that’s tolerated as you manage a chronic condition or muscle your way through what’s temporarily ailing you. But what may sound like a simple quality-of-life issue is actually a gateway to something more menacing.
For older adults in particular, fatigue can affect libido, cognition and the ability to drive safely, says Dr. Steve Levy, a geriatric pharmacy specialist and associate director of pharmacy at New York City’s Mount Sinai Morningside and Mount Sinai West.
“The other risk of fatigue, when it becomes chronic, is the risk of falls and fractures,” he adds, echoing the results of another study in Scientific Reports, also published in 2025, which found that more than 70 percent of adults 60 and older who experienced a fall were taking a so-called fall-risk-increasing drug (most frequently opioids, anticholinergics or antihistamines). Further complicating matters, these drugs can interact with other medications commonly taken by older adults.
“Certain medicines may affect the metabolism of other medicines and cause them to accumulate in our system, which increases the risk of side effects from them,” Issa says. “Different medicines that individually can cause sedation and fatigue can cause more sedation and tiredness than each medicine individually.”
But that’s not to suggest you should just quit taking meds that make you sleepy — or, for that matter, any medicine — without first talking to your doctor about adjusting doses, switching the time of day you’re taking them or trying alternatives.
Here’s what you need to know about some of the most common offenders.
1. Blood pressure medications
More than half of adults with hypertension in the U.S. take medication to lower their blood pressure, according to the U.S. Centers for Disease Control and Prevention. These so-called antihypertensives lower blood pressure in different ways — by slowing the heart rate, relaxing blood vessels or helping the body eliminate excess fluid — and can cause varying degrees of fatigue.
This fatigue can happen as the body adjusts to lower blood pressure, whether it’s in the goal range or dips below it. And it’s possible with any blood pressure medication.
Blood pressure medication classes include:
- Beta-blockers, which lower your heart rate and the force of contractions, “which limits the amount of oxygen-rich blood, and thus energy, delivered to the brain and muscles,” says Issa. “These medicines also affect how the body uses energy by reducing the breakdown of fats and glycogen, and they block adrenaline, which diminishes the body’s natural ‘fight or flight’ energy boost,” he adds. “All these changes cause fatigue and tiredness, especially when first starting the medicines or increasing the dose.”
- ACE inhibitors, which help the body produce less angiotensin, a chemical that causes arteries to become narrow. Relaxing those vessels lowers blood pressure.
- Calcium channel blockers, which prevent calcium from entering the heart’s muscle cells and arteries, causing blood vessels to relax and widen. This lowers blood pressure.
- Diuretics, sometimes called water pills. They help the kidneys flush out excess sodium and fluid, reducing the volume of blood the heart has to pump. Fatigue may occur if the medication lowers blood pressure excessively or contributes to dehydration or electrolyte imbalances.
Blood pressure meds that can make you tired include:
- Beta-blockers: metoprolol tartrate (Lopressor), atenolol (Tenormin), bisoprolol (Zebeta), carvedilol (Coreg)
- ACE inhibitors: lisinopril (Prinivil, Zestril)
- Calcium channel blockers (amlodipine)
- Diuretics: hydrochlorothiazide (HCTZ), chlorthalidone
What to do:
“If you are experiencing fatigue as a side effect of blood pressure medicines, you should notify your doctor,” Issa says.
You may be advised “to decrease the dosage and give your body time to adjust to the medication, and then [increase the dose] very slowly. You should also avoid driving or operating heavy machinery until these side effects improve,” he adds.
2. Antihistamines
If you can’t remember an allergy season that didn’t leave you needing a daily nap, the culprit may not be the allergen itself but the over-the-counter antihistamine you reach for to tame its effects.
“Antihistamines block what’s called the H1 receptor,” explains Levy. “We have H1 receptors in the brain, throughout the central nervous system and elsewhere in the body. When an antihistamine crosses the blood-brain barrier and blocks H1 receptors in the brain, it can cause drowsiness, fatigue and sedation.”
Antihistamines that can make you tired include:
- Diphenhydramine (Benadryl)
- Chlorpheniramine (Chlor-Trimeton)
- Doxylamine (Unisom)
- Hydroxyzine (Vistaril)
What to do:
Talk to your doctor about swapping out any of the above older-generation antihistamines for newer-generation medications such as loratadine (Claritin) and cetirizine (Zyrtec), which have a lower risk of fatigue.
The goal of newer antihistamines is to block H1 receptors in the body without significantly affecting those receptors in the brain, Levy says.
3. Antidepressants and anti-anxiety medications
The most common antidepressant and anti-anxiety medications affect two primary neurotransmitters: serotonin and norepinephrine, Issa says. “They elevate serotonin levels, which elevates mood, but can cause drowsiness, fatigue and low energy,” he adds.
Antidepressants can also disrupt sleep patterns, leading to daytime drowsiness.
Antidepressants that can make you tired include:
- Tricyclic antidepressants: amitriptyline (Elavil, Vanatrip), doxepin (Silenor), imipramine (Tofranil), trimipramine (Surmontil)
- Mirtazapine (Remeron)
Anti-anxiety meds that can make you tired include:
- Benzodiazepines: alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan)
What to do:
Finding the medication that works for you may involve some trial and error. The good news: There are plenty of options.
“It’s hard to know how any of us would react to these medicines and how we may be able to tolerate one versus another,” Issa says. “Sometimes we need to try two, three or four medicines before we find one that a patient can tolerate well and doesn’t cause any fatigue or tiredness.”
Your doctor may also be able to add another medicine that can counteract the fatigue if a certain antidepressant or anti-anxiety medication otherwise works well for you, Issa adds.
4. Pain medications and muscle relaxants
These two types of medication cause fatigue by calming down your nervous system.
Pain relievers (specifically, opioids) do so by turning down your brain’s “stay awake” system. Muscle relaxants go a step further. Despite the name, they generally don’t act on muscles directly. They act on your brain and spinal cord, boosting calming chemicals and, in some cases, working like first-generation antihistamines or even mild sedatives.
The result is a nervous system that’s been told to slow down.
Pain medications that can make you tired include:
- Morphine
- Fentanyl
- Oxycodone
Muscle relaxants that can make you tired include:
- Baclofen
- Cyclobenzaprine (Flexeril)
- Carisoprodol (Soma)
- Methocarbamol (Robaxin)
What to do:
If you’re starting a medication known to cause fatigue — whether it’s an opioid, muscle relaxant or any med — start it at bedtime and switch to daytime after a few days or weeks to give your body a chance to adjust to it, Issa says.
“You also shouldn’t drive for a few weeks until the adjustment happens, although there are some medications, such as benzodiazepines and opioids, which may cause persistent side effects of sedation, drowsiness and fatigue,” he adds. “And therefore, patients are recommended to avoid driving or using heavy machinery during the entire time that they take these medications.”
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