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Medications for Adults With ADHD and Anxiety

Written by:
Rabia Khaliq
MSc in Applied Psychology
Reviewer:
Dr. Bradley Noon
MD
Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs. Read more

Attention deficit hyperactivity disorder (ADHD) is a mental health condition whose negative effects are often underestimated. Yet, it can significantly impact a person’s life, preventing them from having happy relationships or a successful career. The statistics [1*] say that as many as 80% of adults diagnosed with ADHD also experience additional psychiatric conditions, including depression, substance use disorder, or personality disorders.

The Anxiety and Depression Association of America states that around 50% of adults with ADHD [2*] also struggle with generalized anxiety disorder (GAD), making it even more challenging to manage hard enough ADHD symptoms. 

Read on for insightful information on how these two conditions are interconnected and how to treat ADHD while having anxiety.

See a healthcare professional online to identify and address the symptoms you’re experiencing, be it ADHD, anxiety, or both.

ADHD and Anxiety

What Is ADHD?

ADHD is one of the most common neurodevelopmental conditions, frequently enduring into adulthood. It manifests itself as inattention (inattentive type of ADHD, also called attention deficit disorder (ADD)), hyperactivity (hyperactive-impulsive type), or a mix of both (combined ADHD).

Based on the symptoms and intensity, medical professionals offer personalized ADHD management strategies. These may include certain medications, mental health therapy, and lifestyle changes that imply incorporating new healthy habits.

What Is Anxiety?

Anxiety is an emotion typically arising in reaction to stressful situations. However, excessive anxiety can transform into a disorder. Its symptoms may encompass fear, restlessness, worries, and physical reactions such as headaches, nausea, shortness of breath, or hypertension.

Even though the severity and frequency of these symptoms often vary from person to person, anxiety seriously affects a person’s life and requires professional treatment that refers to therapy and/or medication.

How ADHD and Anxiety Are Linked?

Understanding both ADHD and anxiety and obtaining an accurate diagnosis is essential. However, it’s equally important to learn how to deal with them at the same time.

Anxiety and ADHD can co-exist, but they are distinct conditions. It can be challenging to differentiate them as they share some symptoms. For instance, patients may experience difficulty relaxing, trouble concentrating, and inattention.

Anxiety can also result from the challenges of living with ADHD. Thus, someone with attention deficit hyperactivity disorder might experience anxiety when facing professional or academic troubles due to forgetfulness, which could eventually develop into anxiety disorders if such feelings persist.

Some ADHD medications, especially stimulants, cause anxiety as a side effect or increase anxiety symptoms.

Although ADHD and anxiety have some similarities, the underlying causes may differ. Contact a healthcare professional for an assessment and treatment.

Common ADHD Medications

Treatment for ADHD often involves medications to help people focus better, control impulses, and manage other ADHD symptoms. These medications are traditionally divided into stimulants and non-stimulants. Each category has pros and cons to consider while creating the individual treatment plan.

Stimulant ADHD Medications

Stimulants are the primary medications used to treat ADHD. They increase the amount of dopamine and norepinephrine in the brain, improving attention, motivation, focus, alertness, and energy levels. They can also reduce hyperactivity and impulsivity.

There are two types of stimulants: long-acting and short-acting [3*] . The latter ones are taken as needed and last up to four hours but may lead to a “crash” afterward. Long-acting stimulants are taken once daily, lasting up to 12 hours, resulting in fewer ups and downs.

Common examples are:

  1. Short-acting stimulants:
    • amphetamine and dextroamphetamine (Adderall)
    • dexmethylphenidate (Focalin)
    • methylphenidate (Ritalin)
    • amphetamine (Evekeo)
    • dextroamphetamine (ProCentra, Zenzedi)
    • methamphetamine (Desoxyn)
  2. Long-acting stimulants:
    • amphetamine and dextroamphetamine (Adderall XR)
    • amphetamine (Adzenys ER, Adzenys XR-ODT, Dyanavel XR)
    • methylphenidate (Concerta, Daytrana, Ritalin LA)
    • dexmethylphenidate (Focalin XR)
    • lisdexamfetamine (Vyvanse)
    • dextroamphetamine (Dexedrine)
    • serdexmethylphenidate and dexmethylphenidate (Azstarys)

Side effects of stimulant ADHD medications include:

  • Decreased appetite, potentially leading to weight loss
  • Headaches
  • Anxiety
  • Stomach problems
  • Cardiac risks
  • Dizziness
  • Depression
  • Addiction
  • Irritability
  • Mood changes

Non-Stimulant ADHD Medications

Non-stimulants can be used in combination with stimulants to increase effectiveness. They may also be preferred if a person has an addiction history. Non-stimulants improve overall concentration and impulse control, but they must be taken daily and may take 3–6 weeks to show visible results.

The most common examples include:

  • Atomoxetine (Strattera)
  • Guanfacine (Intuniv XR)
  • Viloxazine (Qelbree)
  • Clonidine ER (Kapvay)

 

Common side effects include:

  • Upset stomach
  • Decreased appetite, potentially leading to weight loss
  • Nausea
  • Dizziness
  • Fatigue
  • Mood swings

ADHD Medications for Adults With Anxiety Symptoms

Stimulants are usually the primary choice for treating ADHD symptoms in adults because of their fast-acting nature and high effectiveness. Non-stimulants are also effective but act more gradually, prolonging the activity of brain receptors. While both can be safe and helpful for adult ADHD, using stimulants for anxiety can sometimes worsen its symptoms, making non-stimulants the preferred ADHD medication for adults with anxiety.

Atomoxetine (Strattera)

Strattera is an immediate-release, non-stimulant medication used to treat ADHD and anxiety symptoms. It acts on a vital brain neurotransmitter norepinephrine, which transmits impulses to the nerves.

The dosage is determined by medical condition and response to treatment. Although it can be taken alone or in combination with other medications, it’s pivotal to inform a healthcare provider about all the medications taken.

Viloxazine (Qelbree)

Qelbree, containing viloxazine, aims to improve attention, concentration, and impulse control by restoring the balance of neurotransmitters in the brain.

However, some people may experience worsening symptoms or mental/mood changes, including suicidal thoughts. Viloxazine’s safety during pregnancy and breastfeeding is uncertain; and older adults may be more sensitive to its effects. Therefore, close monitoring is essential, especially when starting or adjusting the dosage.

Antidepressants

Antidepressants are also effective in alleviating symptoms of anxiety. Two common categories are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).

The following medicines can be recommended to relieve anxiety symptoms:

  • Bupropion (Wellbutrin)
  • Desipramine (Norpramin)
  • Fluoxetine (Prozac
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Sertraline (Zoloft)
  • Venlafaxine (Effexor)

Blood Pressure Medications

Anxiety disorder often leads to symptoms like a racing heart or elevated blood pressure. Blood pressure medications work by reducing blood pressure through the inhibition of the sympathetic (adrenaline-producing) part of the autonomic nervous system. 

Here are some examples of these antihypertensive medications:

  • Methyldopa (Aldomet)
  • Clonidine (Catapres, Duraclon, Kapvay, NEXICLON XR)
  • Guanfacine (Intuniv, Tenex)

To determine the optimal treatment for coexisting ADHD and anxiety, it is crucial to ascertain which condition predominantly impacts the patient’s well-being. Thus, if anxiety is a separate disorder rather than a symptom of ADHD, a patient may need another course of treatment.

Consult a healthcare provider online to get your symptoms assessed and receive a personalized treatment plan.

Lifestyle Changes and Non-medication Treatments for ADHD and Anxiety

Some non-medication treatments may work for both ADHD and anxiety symptoms, such as cognitive-behavioral therapy (CBT) and relaxation techniques.

Cognitive-behavioral Therapy (CBT)

CBT can be helpful whether or not the person is being treated with medication. Still, clinical experience suggests that they have different effects. Whereas one can take medication to help focus and address the core symptoms of distractibility, short attention span, and impulsivity, CBT is more effective at promoting the habits and skills needed for executive self-management.

CBT is rooted in the idea that psychological problems often arise from faulty or unhelpful thinking patterns and learned behaviors. It focuses on helping people recognize and change these patterns, fostering a better understanding of others’ behavior, and equipping them with problem-solving skills.

Relaxation Techniques

While relaxation strategies may not be sufficient for managing severe symptoms, they complement psychotherapy and pharmacological treatments. Although there are various relaxation techniques, one should find and consistently implement what works best. 

Slow diaphragmatic breathing, mindfulness exercises, meditation, progressive muscle relaxation (PMR), and self-care activities are the most popular techniques. 

By incorporating these practices into your life, you can: 

  • Slow down your mental activity to avoid racing thoughts or learn how to better tolerate them.
  • Increase awareness of tension in the body and understand how to cope with it.
  • Reduce the overall voltage level and restlessness in the body.

Challenges in Treating ADHD Symptoms With Co-existing Anxiety

Among the most common challenges for those with ADHD and co-existing anxiety are overstimulation with stimulant medications, side effects of medications, and difficulties in identifying symptoms of these two conditions. 

Risks of Overstimulation With Stimulant Medications

While stimulant medications used to treat ADHD can be helpful, they may lead to overstimulation. This means that people with ADHD become oversensitive to noise, light, touch, smell, or taste, intensifying other ADHD challenges that are hard enough.

The effects of overstimulation may vary depending on the individual. Some common effects include:

  • Anxiety
  • Irritability
  • Fatigue
  • Headache
  • Muscle tension
  • Sleep problems

Side Effects of Medicine

Loss of appetite, weight loss, trouble sleeping, irritability, and tics are the most common side effects of ADHD stimulants. Some non-stimulant medications may increase the risk of suicidal ideation and death by suicide in adolescents. Antidepressants may provoke trouble sleeping, nausea, constipation, dry mouth, sweating, and changes in sex drive. 

In most cases, blood pressure medications do not cause side effects. But some people experience mild adverse reactions, including dizziness, headaches, swelling of the legs or feet, or stomach problems.

Difficulties in Identifying Anxiety and ADHD Symptoms

While both conditions can affect concentration, they have different root causes and require distinct approaches to diagnosis and treatment. Thus, anxiety disorders typically arise from excessive worry and fear, while ADHD is believed to involve difficulties with the brain’s executive functions, such as working memory and self-regulation.

A precise mental health assessment by a healthcare professional is essential to identify the specific factors contributing to ADHD and anxiety symptoms and develop a tailored treatment plan that addresses both conditions.

Consult a medical provider online and learn more about managing adult ADHD and anxiety in your particular case.

Monitoring and Adjusting Treatment While on Medication

The monitoring of medication treatment is pivotal for anticipating or detecting adverse reactions before they become inevitable or irreversible. A healthcare provider should consider factors such as:

  • The severity of the effect.
  • The validity and precision of the monitoring test.
  • Patient’s individual health specifics.
  • Effective interventions in response to positive tests.
  • Cost-effectiveness.

Regular check-ups with a clinician are essential for tracking the effectiveness of prescribed medications. During consultations, it’s possible to detect if a medication is working, make any necessary adjustments to the dosage, or choose another medicine.

In Conclusion

ADHD is manageable with medication and lifestyle changes. Both stimulants and non-stimulants can be used, while non-stimulants may be more appropriate for coexisting ADHD and anxiety in adults.

Still, treatment for ADHD and anxiety should be personalized. First, you need to see a healthcare provider and discuss your symptoms and medical history. Then, you receive recommendations on how to treat ADHD and anxiety effectively in your case. Contact MEDvidi today to go through an assessment and obtain a treatment plan online.

FAQ

People with ADHD are more likely to have anxiety disorders than people without ADHD, with rates approaching 50% [4*] .

Non-stimulant medications [5*] such as atomoxetine, clonidine, and guanfacine may be helpful for people with ADHD and anxiety. However, the treatment should be chosen based on personalized evaluation, so consult your clinician to learn more.

Medications commonly used to treat ADHD, such as stimulants like Adderall, can sometimes lead to anxiety as a side effect or make existing anxiety symptoms more pronounced.
A non-stimulant ADHD medication like atomoxetine (brand name Strattera) is often considered most suitable for adults with ADHD, anxiety, and depression. However, the effectiveness of the same medication may vary from one person to another, so it’s essential to receive personalized treatment from a healthcare provider who will take all your circumstances into account.
Yes, ADHD and anxiety medications can often be taken together, but it depends on the specific medications, the patient’s medical history, and other factors. Some ADHD and anxiety drugs may have opposite effects on the central nervous system; thus, they may be less effective when used together.
No medication for anxiety, depression, and ADHD fits everyone. While prescribing medications, a healthcare provider considers specific symptoms, medical history, and potential interactions and side effects.

If you are currently taking or weaning off Suboxone, healthcare professionals at MEDvidi can prescribe you ADHD medication only if you provide a letter from your clinician indicating that it is safe and appropriate.

Sources

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5 sources
  1. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach
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  2. Adult ADHD (Attention Deficit Hyperactive Disorder)
    Source link
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695738/
    Source link
  4. Mental Health in Adults With ADHD: Examining the Relationship With Cardiorespiratory Fitness
    Source link
  5. Non-stimulant medications in the treatment of ADHD
    Source link
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Written by:
Rabia Khaliq
MSc in Applied Psychology
Reviewer:
Dr. Bradley Noon
MD
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