ADHD and Anxiety Medication
People with ADHD typically suffer from co-occurring anxiety disorders. Anxiety can trigger restlessness, irritability, and difficulty sleeping.
Stimulant medication can help ease these symptoms, but they can also cause side effects such as tics and minor growth reduction in children and adolescents. In addition, some people have anxiety issues while taking stimulant medication.
Stimulants
Stimulants are used to treat ADHD and Narcolepsy. They are also popular among recreational drug users as stimulants and performance-enhancing substances because of their ability to increase energy, alertness and focus. They are available in the form of tablets, capsules or chunky crystals. They can also be found in white or brown dust. Large doses can lead to excessive stimulation, which can cause anxiety, panic, stomach cramps, paranoia and aggression. Long-term stimulant use can lead to addiction, serious side effects like heart problems, high pressure and stroke.
These medications are also proven to reduce anxiety symptoms. They work by increasing brain chemicals like dopamine, norepinephrine, and serotonin. These are lower in ADHD patients. This boosts activity and communication between brain regions that regulate attention and executive function. This results in an improvement in impulse control, and anxiety symptoms are reduced.
Studies have shown that both atomoxetine and the methylphenidate reduce anxiety symptoms in adults with ADHD and comorbid anxiety disorders. Both drugs showed improvement in anxiety symptoms as early as the 4th week of treatment. The benefits continued for 8 weeks.
It is important to note that the type medication that will be most effective in treating anxiety and ADHD symptoms that co-occur could depend on which condition has the greatest impact on the quality of life of an individual. An individual may experience many mini-crises that cause worry throughout the day when they have to rush to make appointments or keep up with tasks at school or at work. These are stressful and cause anxiety more often than the symptoms of a panic attack or fear.
In these situations, it might be best to address the anxiety-related symptoms with antidepressants or SSRIs which have been proven effective in decreasing anxiety levels in adults. They are typically taken orally and may take a bit longer to effect the desired effects, however the most commonly used options are selective serotonin reuptake inhibitors (SSRIs) such as Sertraline and Fluoxetine, as well as serotonin and norepinephrine-reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine. These drugs can be used together with cognitive-behavioral therapy for anxiety. They are particularly useful for patients who have high or racing heart rate.
SSRIs
Antidepressants, such as SSRIs (antidepressant drugs) are commonly used to treat anxiety-related disorders. The drug that is the most popular in this category is fluoxetine, also known as Prozac. The SSRIs are also effective in treating obsessive-compulsive disorder and post-traumatic disorder. These medications are more versatile than the earlier generation antidepressants, and they are less likely to cause serious adverse effects.
The SSRIs block the reuptake of serotonin at synapses. This causes the neurotransmitter inside the synapse to stay active and to signal the post synaptic cells more than would be the case otherwise. This can increase the output of norepinephrine and reduce anxiety. It may also lead to an increase in the levels of neuronal cyclic AMP (cAMP) which can stimulate protein production.
SSRIs also reduce hyperactivity and impulsivity. They also can improve the quality of sleep and reduce agitation for some people with ADHD. However, medication for adhd in adults can increase the risk of suicidal ideas and actions in some people. They also can increase appetite and weight gain at the beginning of treatment.
Another kind of antidepressant, known as SNRIs, functions differently than the SSRIs. SNRIs prevent the reuptake of serotonin as well as norepinephrine. Similar to SSRIs they may influence anxiety, but they can also improve the functioning of the heart muscle and the blood vessels, which may decrease anxiety and stress. They also can enhance the mood of individuals suffering from bipolar disorder.
The most popular SNRIs are duloxetine (Cymbalta), Venlafaxine (Effexor, Effexor XR) and desvenlafaxine (Khedezla, Pristiq). The SNRIs can increase blood pressure in certain individuals and should not be used by anyone with high blood pressure or heart disease.
In addition to medications, there are a number of behavioral therapies that can help with anxiety and ADHD. Mindfulness practices can be helpful in lowering stress and anxiety as can yoga and meditation. Some people have found that tapping on specific points on their body, or Emotional Freedom Techniques, can help reduce the cortisol hormone that causes anxiety. Diet and exercise can also aid in reducing anxiety. Your doctor may recommend you consume whole grains, fruits, and vegetables, and to avoid sugar as it can worsen anxiety for some ADHD children and adults.
Non-stimulant-based medications
While stimulants are very effective in treating ADHD and have been studied extensively, they are not always the best option for those with coexisting anxiety and ADHD. These medications can trigger side effects like jitteriness, rapid heart rate, and nervousness that may resemble or exacerbate anxiety symptoms.
Non-stimulant medications are a more recent option that has been used to treat ADHD since 2002 (under the brand name Strattera). They don't increase blood pressure or heart rate and are less likely to cause anxiety-related side effects such as shaking, sweating or nervousness.
Atomoxetine targets receptors for the brain chemical norepinephrine. It can aid in improving attention and reduce impulsivity as well as hyperactivity. It has also been found to reduce anxiety symptoms in adolescents and children with ADHD. Researchers gathered articles on clinical research from PubMed, EMBASE and PsycINFO to determine whether atomoxetine helped reduce anxiety in children and adolescents with ADHD.
Another drug that can be effective in relieving anxiety symptoms is bupropion which targets the brain chemical dopamine. Bupropion is often recommended for people with co-existing depression and ADHD. It can also improve mood and decrease symptoms of anxiety. It is often best to treat anxiety first before tackling ADHD. This can usually make the anxiety symptoms disappear.
In some cases, anxiety symptoms in ADHD children may be the cause of their anxiety. Cognitive-behavioral treatment and psychostimulants are typically the most effective treatment options for anxiety in this situation. This is because these treatments tackle the root of the issue and decrease ADHD symptoms and, consequently, decrease the anxiety.
Antidepressants are also frequently prescribed to those suffering from coexisting ADHD and anxiety. SSRI antidepressants that target Serotonin, a chemical in the brain, can aid in relieving anxiety symptoms and improve mood. Examples include Zoloft Lexapro and Sertraline.
Your doctor will ultimately decide which medication is most suitable for you. Before recommending a drug, they will consider your symptoms, lifestyle and age, as well as other health conditions. It is very important to discuss your goals for treatment with your doctor and stick to a daily schedule while taking any medication.
Other options
Other treatment options could be beneficial in managing ADHD or anxiety, based on your health goals. These include mindfulness meditation, yoga (Emotional Freedom techniques), tapping sleep, nutrition, exercise, and healthy eating habits.
Dr. Hallowell says that people with anxiety are more prone to develop symptoms of ADHD, which makes it difficult to treat both conditions at the same time. He typically prescribes stimulants first to treat ADHD before turning to non-stimulant medications such as bupropion, atomoxetine or guanfacine for anxiety disorders. These medications work 24/7 and are not controlled substances as stimulants are.