Yes, tapentadol can cause anxiety as a side effect. Tapentadol is an opioid pain medication that is used to treat moderate to severe pain. Like other opioids, tapentadol can cause several side effects, including drowsiness, dizziness, nausea, vomiting, constipation, and respiratory depression. In some cases, tapentadol can also cause anxiety, confusion, agitation, and other psychological symptoms. If you experience any unusual symptoms while taking tapentadol, it is important to talk to your doctor or healthcare provider as soon as possible.