Certain attention deficit hyperactivity disorder (ADHD) medications can help treat a person’s co-occurring anxiety, while others, including Adderall, may worsen it.
ADHD and anxiety disorders are different conditions with distinct symptoms and presentations.
The two conditions may exist together. This may complicate a person’s diagnosis and treatment. It is also possible for one condition to worsen the other.
This article explores the link between the two conditions and the best ADHD medication for adults with anxiety.
ADHD is a behavior disorder that doctors commonly diagnose during childhood, but it can persist throughout adulthood. A person with ADHD experiences an ongoing pattern of the following symptoms:
- inattention
- hyperactivity
- impulsivity
- organization difficulties
- distractibility
- forgetfulness
Learn more about the three types of ADHD.
People with anxiety experience persistent and excessive worry, restlessness, difficulty concentrating, and irritability.
While a person may have some anxiety, those with anxiety disorders are anxious most of the time and experience anxiety that is out of proportion to the situation or trigger.
In addition to the psychological and cognitive symptoms of anxiety, a person may experience physical symptoms of anxiety, including:
ADHD and anxiety frequently occur together and have overlapping symptoms. According to the Anxiety and Depression Association of America, about 50% of people with ADHD also have an anxiety disorder.
Anxiety can also occur due to having ADHD. Many people with the latter condition find it challenging to perform daily tasks and cope with difficult situations, leading to increased anxiety.
Certain ADHD medications, especially stimulant medications, can cause physical anxiety symptoms such as increased heart rate and difficulty sleeping. They may also worsen anxiety symptoms in people with ADHD and co-occurring anxiety disorders.
Additionally, a
ADHD medications treat symptoms and behaviors that relate to ADHD, such as inattention, impulse control difficulties, and hyperactivity. These drugs target brain chemicals called neurotransmitters.
Most drugs increase the levels of norepinephrine and dopamine in the body. Other medications only increase the levels of norepinephrine.
ADHD drugs fall into two categories: stimulants and nonstimulants.
Stimulant drugs are fast-acting, effective, and the first-line treatment for ADHD. However, these drugs may increase anxiety symptoms, making nonstimulants a suitable option for people with ADHD and anxiety.
Examples of stimulants include amphetamines and methylphenidate.
Learn more about the types of ADHD medications.
Nonstimulants
Nonstimulants are also effective in treating ADHD symptoms but have a slower rate of onset than stimulants and are
Examples of nonstimulants include atomoxetine (Strattera). Atomoxetine is a selective norepinephrine reuptake inhibitor and works by increasing the neurotransmitter called norepinephrine to control ADHD symptoms.
Learn more about Strattera here.
People take atomoxetine
Unlike stimulants, atomoxetine is not a controlled substance and is less likely to cause dependence or misuse. It also does not cause most of the side effects relating to stimulants. Common side effects of atomoxetine include:
In a 2021 study, experts suggest patients could switch from a stimulant to atomoxetine because of its proven ability to manage and decrease ADHD and anxiety symptoms in people with both conditions.
Antidepressants
Antidepressants can also treat ADHD, especially in adults with ADHD and depression or anxiety. Doctors typically prescribe them when a person does not respond well to stimulants or when someone’s depression is not yet under control and contributing to inattention.
Most antidepressants increase the level of neurotransmitters in the brain. This may explain why they may have similar effects to ADHD medications. They also have a low potential for misuse.
Common antidepressants for ADHD include:
- Tricyclic antidepressants (TCAs): TCAs can have unpleasant side effects, such as constipation, urinary problems, and dry mouth. They could also cause serious heart conduction problems, which are issues with the electrical system controlling the heart’s rate and rhythm. Examples of TCAs include:
- Pamelor (nortriptyline)
- Norpramin (desipramine)
- Tofranil (imipramine)
- Wellbutrin (bupropion): People can generally tolerate bupropion well. However, it may cause side effects, such as anxiety, sleep problems, and tremors, which can exacerbate symptoms in people with anxiety disorders.
- Effexor (venlafaxine): Effexor increases the level of serotonin and norepinephrine in the brain. It also improves mood and concentration.
Blood pressure medication
The Food and Drug Administration (FDA) has approved two blood pressure medications to treat ADHD: Intuniv and Kapvay.
Kapvay is an extended-release formulation of clonidine and works on receptors in the central nervous system. A person can take 0.1 to 0.3 milligrams (mg) two to three times a day. This drug has a duration of action ranging from 12 to 16 hours.
Read more about clonidine here.
Intuniv is also an extended formulation of a blood pressure drug known as guanfacine. This drug works on brain receptors to improve attention and memory and decrease distractibility. A person can take 1–4 mg daily. This drug has a duration of action of 18 hours.
These medications lower blood pressure and slow heart rate but may also cause drowsiness. Therefore, people taking them should avoid driving or operating potentially dangerous equipment until they know how the drug affects them.
Doctors will first investigate whether a person’s anxiety symptoms result from ADHD or if they are independent of it. Generally, they will treat someone’s primary condition, which is the condition that causes the person the most issues or discomfort.
Before recommending certain medications, a doctor will consider factors such as the person’s age, overall health, and other existing conditions. They will also consider a drug’s side effects and interactions.
All of the above ADHD medications can cause various side effects and have different interactions and precautions.
For example, doctors should monitor people taking atomoxetine for possible changes in perception and behavior, such as hallucinations and mania. Doctors will also ask to monitor them for suicidal thoughts, aggression, and hostility.
Doctors will monitor blood pressure and heart rate for people taking stimulants.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Aside from medications, nonpharmacological treatments can also help people with ADHD and anxiety symptoms. These include:
- psychotherapy
- behavior therapy
- cognitive behavior therapy
- support groups
Some people may also explore integrative and alternative medication, such as:
- mind-body interventions, such as yoga, biofeedback, mindfulness, meditation, and hypnotherapy
- relaxation techniques
- acupuncture
- Ayurveda, a traditional medicine system using herbs, exercise, diet, and lifestyle changes
- osteopathy
- taking herbal and dietary supplements
Here are some answers to common questions about ADHD medication for people with anxiety.
Can ADHD medication help with anxiety?
Some ADHD medications can help with anxiety, while others, specifically stimulants, may cause or contribute to a person’s anxiety.
Can ADHD cause anxiety?
Yes. Having ADHD often makes day-to-day life stressful and challenging. A person with the condition may experience overwhelming thoughts or worries when facing difficulties in trying to complete tasks. The fear of failing or forgetting tasks can also cause anxiety.
Can you medicate ADHD and anxiety at the same time?
Simultaneously treating both conditions can be challenging. There are medications that can alleviate both anxiety and ADHD symptoms. However, a doctor may choose to focus on the condition that has a more negative effect on a person’s quality of life.
A person who thinks they have both ADHD and anxiety disorder should consult their doctor or psychiatrist. The doctor may check if the ADHD is causing the anxiety or if the person’s anxiety is independent of ADHD.
Because the two conditions may overlap, the doctor may need several consultations before providing a precise diagnosis and treatment plan.
Anxiety and ADHD are two distinct conditions that commonly occur together. While both conditions can disrupt a person’s quality of life, one condition may also worsen the other.
Different treatments, such as prescription medications and psychosocial therapies, may help a person manage both conditions. Moreover, adults with ADHD and anxiety may benefit from combining these treatments.