ADHD and Anxiety Medication
People with ADHD typically suffer from co-occurring anxiety disorders. Anxiety can lead to irritation, restlessness, and difficulty sleeping.
The use of stimulants can ease symptoms, but they can cause side effects like tics or slight growth decreases in adolescents and children. In addition, some people experience anxiety-related issues when taking stimulant medication.
Stimulants
Stimulants are a class of drugs 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 are available in tablets, capsules crystals, chunky clear crystals, or a white or brown powder. The use of large doses of stimulants can create over-stimulation and cause anxiety and panic attacks, stomach cramps or paranoia. Long-term use of stimulants can result in addiction and serious side effects like heart problems, high pressure and stroke.
The drugs typically prescribed to treat ADHD also have a proven track record for alleviating the symptoms of anxiety. They help by boosting brain chemicals such as dopamine, norepinephrine and serotonin. These are lower in ADHD patients. This boosts the activity and communication of the parts of the brain that regulate attention and executive functions. This leads to improved impulse control, and anxiety symptoms diminish.
Research has shown that both atomoxetine as well as methylphenidate reduce anxiety symptoms in adults with ADHD and comorbid anxiety disorders. Anxiety symptom improvement was seen from the fourth week of treatment for both medications, and the benefit was sustained through 8 weeks of treatment.
It is important to keep in mind that the kind of medication most effective for treating anxiety and ADHD co-occurring symptoms could depend on which disorder has a larger impact on a person's quality of life. An individual may experience many small-scale crises that cause anxiety in a regular manner as they try to meet appointments or finish assignments at school or at work. These are stressful and can cause anxiety more frequently than signs of panic attacks or anxiety.
In these situations it may be beneficial to treat anxiety-related symptoms by taking antidepressants or SSRIs that have been shown to be effective in decreasing anxiety levels in adults. These are usually taken orally and may take a bit longer to take effect, but the most commonly used options are selective serotonin reuptake inhibitors (SSRIs) like Sertraline and Fluoxetine, and serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine and duloxetine. These drugs can be utilized together with cognitive-behavioral therapy for anxiety. They are particularly useful for patients who have an elevated or racing heart rate.
SSRIs
Antidepressants, like SSRIs (antidepressant drugs), are often used to treat anxiety disorders. The first drug in this class is fluoxetine, also known as Prozac. The SSRIs can also help treat depression, obsessive-compulsive disorder and post-traumatic stress disorder. These drugs are more versatile and have less adverse effects than older generations of antidepressants.
The SSRIs inhibit the reuptake serotonin from synapses. This causes the neurotransmitter remain active within the synapse and communicate with the post-synaptic cell for more times than it would otherwise. This can increase the production of norepinephrine and reduce anxiety. This may also increase levels of neuronal cyclicAMP (cAMP) and stimulate protein synthesis.
SSRIs can also reduce the impulsivity and hyperactivity. They also can improve sleep quality and decrease agitation for some people with ADHD. However, these drugs can increase the risk of suicidal behavior and thoughts among some people. They can also trigger an increase in appetite and weight gain, especially when they are first started.
Another type of antidepressant, known as SNRIs, functions differently than the SSRIs. SNRIs prevent the reuptake of both serotonin and norepinephrine. Similar to SSRIs, they can have an effect on anxiety, but they also enhance the functioning of the heart muscle and the blood vessels, which may reduce anxiety and stress. Some adults with bipolar disorder can also benefit from their use.
The most common SNRIs are duloxetine (Cymbalta) and the venlafaxine (Effexor, Effexor XR) and desvenlafaxine (Khedezla, Pristiq). The SNRIs may raise blood pressure in certain individuals and are not recommended for anyone with high blood pressure or heart disease.
There are many behavioral treatments for anxiety and ADHD that can be utilized in addition to medication. Mindfulness practices can be helpful in reducing stress and anxiety as can yoga and meditation. Some people have found that tapping on specific points on their body, also known as Emotional Freedom Techniques, helps reduce the cortisol hormone that causes anxiety. Diet and exercise can also aid in reducing anxiety. Your doctor may recommend that you consume whole grains, fruits and vegetables, and avoid sugar, as it can cause anxiety in some ADHD children and adults.
Non-stimulant based medicines
While stimulants are very effective in treating ADHD and have been extensively studied but they are not always the best choice for people with anxiety disorders and ADHD. These medications can cause negative side effects, such as jitteriness and rapid heart rate. adhd treatment without medication can mirror or worsen anxiety symptoms.
Since 2002, non-stimulant drugs have been prescribed for ADHD (under the brand name Strattera). They do not cause an increase in heart rate or blood pressure, and they are less likely to cause anxiety-related side effects like shaking, sweating or nervousness.
Atomoxetine targets receptors for the brain chemical norepinephrine. It can aid in improving attention and reduce impulsivity and hyperactivity. It has also been found to reduce anxiety symptoms in children and adolescents with ADHD. Researchers gathered clinical articles from PubMed EMBASE PsycINFO and PsycINFO to determine if atomoxetine reduced anxiety symptoms among children and adolescents with ADHD.
Another drug that can be effective in treating anxiety symptoms is bupropion which is a drug that targets the brain chemical dopamine. Bupropion is typically prescribed to those suffering from ADHD and depression. It can also boost mood and reduce symptoms of anxiety. It is often best to address the anxiety first before treating ADHD. This will usually help to alleviate the symptoms of anxiety.
It is very common for children with ADHD to experience issues with anxiety, and in some instances, the anxiety is caused by their ADHD symptoms. The most effective treatment for anxiety in these situations is usually cognitive-behavioral therapy as well as psychostimulants. These treatments will reduce ADHD symptoms and anxiety by addressing the root cause of the issue.
Antidepressants are also frequently prescribed for those with coexisting ADHD and anxiety. SSRI antidepressants that target Serotonin, the chemical in the brain that is thought to help relieve anxiety symptoms and improve mood. Examples include Zoloft, Lexapro and Sertraline.
Your doctor will ultimately decide what medication is right for you. They will take a look at your lifestyle, symptoms, age and other health conditions before suggesting any medication. It is crucial to discuss your treatment goals with your doctor and adhere to a daily schedule while taking any medication.
Other options
Based on your individual health objectives, there are additional treatment options that can be beneficial in managing ADHD and anxiety. These include mindfulness meditation and yoga (Emotional Freedom techniques), tapping and sleeping, 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 simultaneously. He typically prescribes stimulants to treat ADHD and then shifts to non-stimulant drugs like bupropion, atomoxetine, or guanfacine for anxiety disorders. These medications are available 24/7 and are not controlled substances as stimulants are.