ADHD and Anxiety Medication
Anxiety disorders are frequently co-occurring with ADHD. Anxiety can cause anxiety, restlessness and sleeplessness.
Stimulant medications can ease symptoms, but it can also cause side-effects like tics or small growth reductions in children and adolescents. Many people also experience their anxiety rises when they take stimulant drugs.
Stimulants
Stimulants are drugs that are used to treat attention deficit hyperactivity disorder (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 can be found in capsules, tablets crystals, chunky clear crystals, or a white or brown powder. The use of large doses of stimulants can result in over-stimulation, anxiety and stomach cramps, panic attacks or paranoia. Long-term stimulant use can lead to addiction, serious adverse effects, such as heart issues, high pressure and stroke.
The medications that are typically prescribed to treat ADHD are also proven to have a track record of relieving the symptoms of anxiety. They improve the amount of brain chemicals norepinephrine and dopamine, which tend to be less in people suffering from ADHD. This increases activity and communication between parts of the brain that control attention and executive function. This results in an improvement in impulse control, and anxiety symptoms are reduced.
Both atomoxetine (as as methylphenidate) reduce anxiety symptoms in adults with ADHD who also suffer from anxiety disorders. The improvement in anxiety symptoms was evident as early as the fourth week of treatment for both drugs and the effect was continued for 8 weeks of treatment.
It is important to note that the kind of medication that is most effective for treating anxiety and ADHD symptoms that co-occur may depend on which of the conditions is more detrimental to a person’s quality of living. For example, an individual might be prone to frequent worry-inducing mini-crises on a regular basis when they have to make appointments or try to keep track of projects for work or school. These can be stressful and cause anxiety more often than symptoms of a panic attack or phobia.
In these situations, antidepressants, or SSRIs are the best option to combat anxiety-related symptoms. They have been proven effective at reducing anxiety levels in adults. These are usually taken orally and can take a bit longer to effect the desired effects, however the most commonly used options are selective serotonin reuptake inhibitors (SSRIs) like Sertraline and Fluoxetine, and serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine. These drugs can be utilized together with cognitive-behavioral therapy for anxiety. They are especially beneficial for patients who have a racing or elevated heart rate.
SSRIs
SSRIs, which are antidepressants are commonly used to treat anxiety disorders. Prozac is the first drug of this class, is fluoxetine. The SSRIs are also effective in treating obsessive compulsive disorder, and post-traumatic disorder. They are more versatile than earlier generation antidepressants, and they are less likely to cause severe side effects.
The SSRIs work by inhibiting the reuptake of serotonin at synapses. This causes the neurotransmitter remain active in the synapse and signal the post-synaptic cell for more times than would otherwise occur. This can increase the production of norepinephrine, which can reduce anxiety. It can also lead to higher levels of the neuronal cyclicAMP (cAMP) which stimulates protein synthesis.
Additionally, SSRIs may reduce impulsivity and decrease hyperactivity. They can also improve sleep quality and reduce agitation in some individuals with ADHD. However, these medications can increase the risk of suicidal thoughts and actions in some people. They can also cause an increase in appetite and weight gain, particularly when they are first introduced.
SNRIs are a different type of antidepressant than SSRIs. SNRIs block the reuptake of serotonin as well as norepinephrine. Similar to SSRIs, they can have an effect on anxiety, but they also enhance the functioning of the heart muscle and blood vessels, which may reduce feelings of anxiety and stress. People with bipolar disorder also benefit from their use.
Duloxetine (Cymbalta) and venlafaxine (Effexor XR, Pristiq) and desvenlafaxine are the most popular SNRIs. The SNRIs may raise blood pressure in some people, so they are not recommended for those with high blood pressure or heart disease.
In addition to medication and other treatments, there are a myriad of behavioral therapies that can aid in reducing anxiety and ADHD. Mindfulness techniques can be helpful in lowering stress and anxiety, as can practicing yoga and meditation. Some people find tapping specific body parts, or Emotional Freedom techniques helps reduce cortisol which is the hormone responsible for anxiety. Exercise and diet can reduce anxiety. Your doctor may recommend that you eat whole grains, fruits, and vegetables, and stay away from sugar, as it can increase anxiety for certain ADHD children and adults.
Non-stimulant-based drugs
Although stimulants are highly effective in treating ADHD, and have been extensively researched, they may not be the best choice for those who also suffer from anxiety or ADHD. The stimulant medications can trigger adverse effects like increased heart rate and jitteriness. These symptoms can be similar to or worsen symptoms of anxiety.
Since 2002, non-stimulant medicines are being used to treat ADHD (under the brand name Strattera). They do not raise blood pressure or heart rate, and are less likely than stimulant medications to cause anxiety-related side effects like shaking, sweating or nervousness.
Atomoxetine targets receptors for norepinephrine, a chemical in the brain. It can improve attention and reduce impulsivity and hyperactivity. Studies have also demonstrated that it can effectively improve anxiety symptoms in adolescents and children with ADHD. Researchers gathered articles on clinical research from PubMed, EMBASE and PsycINFO to find out if atomoxetine improved anxiety in adolescents and children with ADHD.
adhd medication for adults is a different medication that can ease anxiety symptoms. It targets the brain chemical dopamine. Bupropion is usually recommended for people with coexisting depression and ADHD. It can also help improve mood and reduce symptoms of anxiety. It is usually best to treat the anxiety first before tackling ADHD. This will usually make the anxiety symptoms disappear.
In some cases anxiety symptoms in ADHD children may be the cause of their anxiety. Psychostimulants and cognitive-behavioral therapy are generally the most effective treatments for anxiety in this situation. This is because these treatments target the root of the problem and decrease ADHD symptoms which, in turn, reduce anxiety.
Antidepressants are also often prescribed for those with coexisting ADHD and anxiety. SSRI antidepressants that target the brain chemical Serotonin can alleviate anxiety symptoms and improve mood. Examples include Zoloft, Lexapro and Sertraline.
The final decision of which medication is best for you will be made by your physician. Before recommending a medication they will consider your symptoms, lifestyle and age, in addition to other health issues. It is crucial to discuss your goals for treatment with your doctor and adhere to a daily schedule while taking any medication.
Other options
Other options for treatment may be beneficial to manage ADHD or anxiety, depending on your health goals. These include mindfulness yoga, meditation, tapping (Emotional Freedom Techniques) sleep and nutrition, as well as exercise and healthy eating habits.
Dr. Hallowell says that people with anxiety are more prone to develop symptoms of ADHD, making it difficult to treat both conditions simultaneously. He prescribes stimulants to treat ADHD first, then non-stimulant medications like bupropion or atomoxetine to treat anxiety disorders. These work around the clock and are not controlled substances like stimulants.