Take a Xanax! Before You Laugh at a “Karen”: A Look at her Prescriptions

We’ve all seen the viral videos. A woman — often middle-aged — yelling in a store, arguing in a parking lot, or confronting strangers in public. Online, these women are mockingly labeled “Karens,” a term that has become shorthand for loud, aggressive, or entitled behavior.

But is it really funny? Or could something more serious be happening beneath the surface?

Some advocates, including AbleChild, suggest that this behavior may not simply be a matter of personality or attitude. Instead, they argue that it may be linked to a much larger and rarely discussed issue: the widespread use of psychiatric medications among women in the United States and the potential behavioral side effects of those drugs.

According to data from the Centers for Disease Control and Prevention (CDC), more than 21% of women in the U.S. reported taking at least one psychiatric medication as of 2020. Antidepressants, anti-anxiety medications, and sleep aids rank among the most commonly prescribed drugs. Women ages 40–59 are about twice as likely as men to take antidepressants, and the rate increases further after age 60, where roughly one in four women report using at least one antidepressant.

Spending patterns reinforce how widespread this issue has become. Data from GoodRx in 2024 shows that women spent nearly $2 billion more out of pocket on mental health medications than men. Among women ages 45–64, spending was nearly double that of men, and for women 65 and older, it was more than twice as high. In total, women spent approximately $5.4 billion out of pocket on treatments for mental health conditions compared to $3.6 billion spent by men.

There are many reasons women may seek mental health treatment more often than men. Women are more likely to seek medical care, often serve as caregivers, experience economic stress, and report higher rates of trauma. However, what is less frequently discussed is the potential behavioral side effects of the medications themselves.

For example, publicly available drug information for sertraline (Zoloft) lists possible side effects that include agitation, anxiety, mood changes, irritability, emotional instability, paranoia, hallucinations, and, in rare cases, aggressive reactions. Similarly, alprazolam (Xanax) carries warnings of side effects such as agitation, disinhibition, irritability, altered mood, hallucinations, hostility, and risk-taking behavior.

While these side effects do not occur in everyone, and these medications can be life-changing and beneficial for many people, the possibility that they may contribute to changes in mood and behavior deserves attention — especially when patients may be prescribed multiple medications at the same time.

Women are not only more likely to receive psychiatric diagnoses, but they are also more likely to be prescribed combinations of medications and to remain on them for extended periods. Critics argue that patients may not always be fully informed about the range of behavioral side effects associated with long-term use or drug combinations.

This raises an important question: before laughing at or labeling someone a “Karen,” should we consider whether underlying medical or pharmaceutical factors might be influencing their behavior?

Rather than turning these moments into internet jokes, it may be more constructive to ask whether broader issues in mental health treatment, prescribing practices, and patient education deserve closer examination.

If even a small portion of the aggressive public behavior being mocked online is connected to medication side effects, then the conversation should shift from ridicule to awareness — and perhaps to a deeper look at how psychiatric medications are prescribed, monitored, and discussed with patients.

What may appear as personality or entitlement could, in some cases, be a sign that something more complex is happening.