Effective ADHD medications for adults with anxiety

ADHD and anxiety are different conditions with distinct symptoms, but they can coexist and sometimes affect each other.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), ADHD may involve one or more of these features:

• Inattention: Difficulty sustaining focus and organizing tasks, forgetfulness, and getting easily distracted.
• Hyperactivity: Restlessness, fidgeting, difficulty staying in one place or position, and activity or task hopping.
• Impulsivity: Speaking or acting out of turn, and having difficulty assessing the potential risks in a situation before acting.

The DSM-5-TR lists different types of anxiety disorders, but common symptoms may include:

• Excessive worry: Constantly feeling on edge or unable to control worrying thoughts about one or more situations.
• Restlessness: Difficulty relaxing while having a persistent sense of impending doom.
• Physiological changes: Muscle tension, sweating, heart palpitations, shortness of breath, and other physical symptoms.

Living with ADHD and anxiety at the same time may be challenging, potentially leading to increased stress, difficulty focusing, lack of sleep, and heightened restlessness. This may significantly affect daily functioning.

Both ADHD and anxiety may be treated effectively. Still, some ADHD medications may increase anxiety symptoms as a side effect.

Do ADHD medications cause anxiety?

ADHD medications can be either stimulant or nonstimulant drugs. Stimulants are typically the first line of treatment for ADHD.

Some stimulant medications may trigger or intensify physical anxiety symptoms in some people.

Still, side effects vary individually, and experiencing increased anxiety as a result of ADHD medications may depend on factors such as:

• medical history
• sensitivity to medications
• current anxiety treatment
• the specific type of ADHD you have

ADHD medications for adults with anxiety

Only a healthcare professional may accurately assess your symptoms and recommend a treatment that works for your needs.

If you have an anxiety disorder diagnosis, they may consider these nonstimulant ADHD medications to decrease the chance of worsening anxiety symptoms.

Atomoxetine

Atomoxetine (Strattera) works by selectively inhibiting the reuptake (reabsorption) of norepinephrine, resulting in increased neurotransmitter levels in your brain. This may help improve attention and impulse management.

Possible side effects may include:

• nausea
• dry mouth
• insomnia
• decreased appetite

Guanfacine

Guanfacine ER (Intuniv) targets certain receptors in the brain, known as alpha-2 adrenergic receptors, to reduce the release of norepinephrine, a neurotransmitter, leading to improved attention and impulse management in people with ADHD.

Possible side effects may include:

• drowsiness
• dizziness
• low blood pressure
• headaches

ADHD medications that may increase anxiety

Stimulant ADHD medications have been associated with an increased chance of worsening anxiety symptoms.

Stimulant drugs for ADHD may include:

• methylphenidate (Ritalin)
• amphetamine dextroamphetamine (Adderall)
• dexmethylphenidate (Focalin)
• lisdexamfetamine (Vyvanse)

These medications may increase anxiety in some people, but not everyone will experience this side effect. 

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Anxiety medications for people with ADHD

If you have an anxiety disorder diagnosis and psychotherapy alone does not prove effective, your healthcare professional may recommend medications to manage your symptoms. They will check that these do not interact negatively with your ADHD medications and will suggest drugs with a low chance of dependence.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are antidepressants that increase serotonin levels in the brain, helping to regulate mood and reduce anxiety symptoms. Commonly prescribed SSRIs include:

• sertraline (Zoloft)
• fluoxetine (Prozac)
• paroxetine (Paxil)
• escitalopram (Lexapro)
• citalopram (Celexa)

Common side effects may include: 

• nausea
• headaches
• insomnia
• sexual dysfunction

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

SNRIs are another class of antidepressants that increase the levels of both serotonin and norepinephrine in the brain, providing relief from anxiety and enhancing mood.

Commonly prescribed SNRIs may include:

• venlafaxine (Effexor)
• duloxetine (Cymbalta)

Common side effects may include: 

• nausea
• dizziness
• dry mouth
• increased sweating

Tricyclic antidepressants (TCAs)

TCAs modulate neurotransmitters like serotonin and norepinephrine, relieving anxiety symptoms. Commonly prescribed TCAs may include:

• imipramine (Tofranil)
• nortriptyline (Pamelor)
• desipramine (Norpramin)

Common side effects of TCAs may include: 

• dry mouth
• constipation
• dizziness
• drowsiness

Buspirone (Buspar)

Buspirone is a non-benzodiazepine anxiolytic medication that affects serotonin and dopamine receptors, reducing anxiety without sedative effects. It generally has a lower risk of causing sedation or cognitive impairment than benzodiazepines.

Common side effects of buspirone may include:

• dizziness
• headaches
• nausea

As with any medication, anxiolytics can have individual variations in their effectiveness and side effects. Consider talking with a doctor to find the most suitable medication and dosage for managing anxiety if you have ADHD. 

Can you take ADHD and anti-anxiety medications together?

Yes, you can take ADHD and anti-anxiety medications together. Your healthcare professional may want to explore your medical history and current symptoms before choosing one or another.

Some people living with ADHD and anxiety find that combining medications may effectively manage their symptoms. 

If you are receiving treatment from different professionals, it is highly advised that you give them the complete list of medications you are taking.

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Summary

Some ADHD medications may worsen your anxiety symptoms, but other options can effectively manage ADHD symptoms without doing so. Nonstimulant ADHD medications may be recommended with this in mind.

You can treat both ADHD and anxiety at the same time. Letting your healthcare professional know about all of your symptoms and your list of medications will help them tailor the treatment to your needs.