Mental health medication side effectsMental health medication side effects

The dilemma of mental health medication side effects at work

For people working in certain industries, drug side effects can mean avoiding important mental health intervention.

Millions of Americans struggle with mental health conditions such as insomnia, anxiety, or depression. One of the most common treatments for these conditions is medication; and for many, medication is a critical intervention that can improve lives. However, not everyone can take psychiatric medications, because like most drugs, these medications come with side effects that can interfere with the ability to do one’s job safely. Due to regulations in some industries, taking psychiatric medication can even be cause for termination. The result is that for millions of Americans who work in certain industries — aviation, for example — psychiatric medication simply isn’t a treatment option. However, there are alternatives to medication that can keep employees — and the people they serve each day — safe.

Mental health medications can conflict with some skilled professions

Every year, over 20% of people experience a mental health condition. And for those who receive treatment, 82% are prescribed medication, making drugs the most common intervention for mental health conditions such as anxiety, insomnia, and depression. However, 58% of people taking medication for mental health experience moderately severe side effects. Because of the potential for experiencing side effects, pilots and air traffic controllers (ATCs) are almost entirely prohibited from taking medications to treat mental health conditions; the FAA has deemed them not compatible with aviation duties. In certain cases, pilots struggling with anxiety or depression may be permitted to use selective serotonin reuptake inhibitors (SSRIs), but only under strict conditions that include close monitoring by an FAA medical examiner, twice-yearly medical reviews, and cognitive testing to ensure medication is not interfering with the safe job performance.

While none of these medications would be on the market if they were broadly unsafe, regulations do place limits on use for people performing certain duties. Pilots and ATCs have intensive, demanding jobs where thousands of lives are on the line each day and the potential for certain types of side effects pose too much of a risk. Meanwhile, people working in other professions may not be subject to official regulations, but it’s understood that the side effects of medications can impair abilities. Truck and bus drivers, train conductors, those operating heavy machinery, and manufacturing workers all may want to avoid side effects such as drowsiness even if medication isn’t restricted by their employer or industry — meaning they may be avoiding getting care for their mental health condition.

How medication side effects can hold people back from addressing their mental health

While for many, mental health medications represent a path back to healthy living, for others the side effects can be disruptive or even dangerous. The most common side effects of antidepressants, which are prescribed for depression as well as anxiety and insomnia, include nausea and drowsiness. People taking anti-anxiety medication could experience blurred vision, confusion, dizziness, and problems with thinking and coordination. Side effects of prescription sleeping pills include daytime memory and performance problems, dizziness and lightheadedness, and prolonged drowsiness. Research also shows that use of some psychiatric medications can impair cognitive and psychomotor functions, and affect detection, as well information and decision-making processing.

If an employee experiences any of these side effects, it can have a profound impact on their ability to do certain jobs, as the FAA considers drowsiness and impaired cognitive function as risk factors for “seriously degrading pilot performance,” — even if the individual feels like they’re alert and functioning. And with other professions, despite the absence of regulations, certain side effects may pose a risk: Surgeons, for example, can’t take the risk of having blurry vision or impaired coordination. Forklift operators need to avoid anything that might make them dizzy or lightheaded.

Digital therapeutics: a non-drug, safe, and effective mental health treatment option

Medication is the most common intervention for mental health conditions. However, because they can come with side effects, medications are not a viable option for many individuals. While psychiatric drugs can be helpful and even life saving for many people, others are left to grapple with a choice: Take the risk of experiencing side effects while on the job, or forgo what for many, is the only form of mental health treatment available. Side effects may be one of the reasons that as many as 75% of patients say they’d prefer something other than medication for their mental health condition. 

Digital therapeutics lift the barrier to mental health care imposed by medication side effects. Because digital therapeutics are non-drug interventions, they can offer the effectiveness of evidence-based care without the risk of side effects. Employees shouldn’t have to choose between caring for mental health conditions and being safe at work. That’s why, when it comes to mental health care, the more options available to employees, the better. And digital therapeutics like Daylight for anxiety and Sleepio for insomnia are smart, highly effective, convenient, and low-risk solutions for anyone, especially those for whom medication is not an option.


Disclaimer: In accordance with FDA’s Current Enforcement Discretion Policy for Digital Health Devices for Psychiatric Disorders, for patients aged 18 years and older, who are followed by and diagnosed with Insomnia Disorder or Generalized Anxiety Disorder by a medical provider, Sleepio and Daylight can be made available as an adjunct to their usual medical care for Insomnia Disorder or Generalized Anxiety Disorder, respectively. Sleepio and Daylight do not replace the care of a medical provider or the patient’s medication. Sleepio and Daylight have not been cleared by the U.S. Food and Drug Administration (FDA) for these indications. Users are directed to not make any changes to their prescribed medication or other type of medical treatment without seeking professional medical advice.

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About the Author

Juliette McClendon, Ph.D.

Juliette McClendon, Ph.D.

Director of Medical Affairs, Licensed Psychologist

Dr. McClendon is the Director of Medical Affairs at Big Health. She is a clinical psychologist by training; her work emphasizes evidence-based practice, culturally responsive care, and mental health equity. She received her PhD in Psychology from Washington University in St. Louis and a BA in Psychology from Harvard University. She completed her post-doctoral training at VA Boston as an Advanced Women’s Health Fellow. Dr. McClendon studies the impact of stress on racial/ethnic disparities in health. Dr. McClendon has over a dozen peer-reviewed research articles focusing on the impact of stress on health disparities, the impact of racism and discrimination on mental health, and identifying intervention approaches that can mitigate the impact of racism and discrimination on health.

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