ADHD and Anxiety Medication
People with ADHD frequently suffer from co-occurring anxiety disorders. Anxiety can cause anxiety, restlessness and trouble sleeping.
Stimulant medications can help alleviate these symptoms however, they may also cause adverse effects, such as tics and minor growth reduction in adolescents and children. Some people also find that their anxiety rises when they take stimulant medication.
Stimulants
Stimulants can be 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 can be found in capsules, tablets, chunky clear crystals or a white or brown powder. The use of large doses can result in over-stimulation, resulting in anxiety, panic, stomach cramps, aggression and paranoia. Long-term use of stimulants can cause addiction and serious side effects such as heart problems, high blood pressure and stroke.
The drugs typically prescribed to treat ADHD also have a proven track record of relieving the symptoms of anxiety. They work by increasing the availability of the brain chemicals norepinephrine and dopamine that are generally lower in people with ADHD. This boosts activity and communication between parts of the brain that regulate the executive and attention functions. This leads to increased impulse control and anxiety symptoms are reduced.
Studies have shown that both atomoxetine as well as methylphenidate reduce anxiety symptoms in adults with ADHD and comorbid anxiety disorders. Anxiety symptom improvement was seen as early as the fourth week of treatment for both drugs and the benefits were continued for 8 weeks of treatment.
It is crucial to remember that the kind of medication that may be best for treating anxiety and ADHD co-occurring symptoms could depend on which condition is more affecting the quality of life of a person. For example, an individual might experience a lot of anxiety-inducing episodes on a regular basis when they have to schedule appointments or to stay on top of projects for school or work. These can be very distressing and cause people to be anxious on more of a frequently basis than the symptoms of a particular anxiety or panic attack.
In these situations the antidepressants, or SSRIs are the best option to combat anxiety-related symptoms. They have been proven to be effective at the reduction of anxiety levels among adults. These are usually taken orally and can take a bit longer to effect the desired effects, however the most popular options are selective serotonin reuptake inhibitors (SSRIs) like 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 medications), are often used to treat anxiety disorders. The drug that is the most popular in this group is fluoxetine, more commonly known as Prozac. The SSRIs can also aid in treating depression, obsessive compulsive disorder and post-traumatic stress disorder. They are more adaptable and have less side negative effects than the older generation of antidepressants.
The SSRIs inhibit the reuptake serotonin in synapses. This causes the neurotransmitter in the synapse to stay active and signal the post synaptic cell more than would be the case in other circumstances. This may increase the amount of norepinephrine released which reduces anxiety symptoms. adhd and medication may also increase levels of neuronal cyclicAMP (cAMP), stimulating the synthesis of proteins.
SSRIs also reduce hyperactivity and impulsivity. They can also improve sleep quality and decrease agitation in individuals with ADHD. However, these drugs may increase the risk of suicidal thoughts and behavior in certain individuals. They may also cause an increase in appetite and weight gain, especially when they are first started.
The SNRIs are a distinct type of antidepressant compared to SSRIs. SNRIs block the reuptake of serotonin as well as norepinephrine. Like SSRIs, they can influence anxiety, but they can also enhance the functioning of the heart muscle and blood vessels, which may reduce feelings of anxiety and stress. They can also boost the mood of adults with bipolar disorder.
The most common SNRIs are duloxetine (Cymbalta) and Venlafaxine (Effexor, Effexor XR) and desvenlafaxine (Khedezla, Pristiq). SNRIs may cause blood pressure to increase in some people, so those with high blood pressure and heart disease should not take them.
In addition to medications, there are a number of behavioral therapies that can aid in reducing anxiety and ADHD. Meditation and mindfulness techniques can reduce anxiety and stress. Some people find that tapping specific body points or Emotional Freedom techniques, helps lower cortisol which is the hormone that causes anxiety. Diet and exercise can also reduce anxiety. Your doctor may recommend that you consume whole grains, fruits and vegetables, and stay away from sugar, since it can worsen anxiety for certain ADHD children and adults.
Non-stimulant-based medications
While stimulants are extremely effective in treating ADHD and have been extensively researched, they may not be the best choice for those who suffer from anxiety and ADHD. The stimulant medications can trigger side effects such as increased heart rate and jitteriness. These symptoms can mirror or worsen 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 do not raise heart rate or blood pressure, and are less likely than stimulant medications to cause anxiety-related adverse reactions such as shaking, sweating, or nervousness.
Atomoxetine is a drug that targets receptors for norepinephrine. It is a brain chemical that can enhance attention and reduce hyperactivity and impulsivity. Studies have also proven that it can help improve anxiety symptoms in adolescents and children with ADHD. Researchers gathered clinical articles from PubMed, EMBASE and PsycINFO to determine whether atomoxetine reduced anxiety in children and adolescents with ADHD.
Another medication that can be effective in treating anxiety is bupropion, which is a drug that targets the brain chemical dopamine. Bupropion is usually prescribed to patients suffering from ADHD and depression. It can also improve mood and lessen anxiety symptoms. It is often recommended to investigate and treat the root anxiety-related issue before treating the ADHD, as it can make anxiety symptoms disappear.
In certain cases anxiety symptoms in ADHD children can be the source of their anxiety. The most effective approach to treat anxiety in these circumstances is usually cognitive-behavioral therapies and psychostimulants. This is because these treatments will tackle the root of the problem and help reduce ADHD symptoms and, in turn, reduce anxiety.
Antidepressants may also be prescribed to patients suffering from 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.
Ultimately, the decision of which medication is right for you will be decided by your doctor. Before recommending a drug, they will look at your symptoms, lifestyle and age, in addition to other health conditions. It is important to discuss with your doctor your treatment go als and to stick to a daily routine while taking any medication.
Other options
Other options for treatment may be beneficial for managing ADHD or anxiety, depending on your health goals. These include mindfulness meditation yoga (Emotional Freedom techniques) tapping sleep and nutrition, 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 typically prescribes stimulants first to address ADHD before turning to non-stimulant drugs like bupropion, atomoxetine or guanfacine to treat anxiety disorders. These work around the clock and are not controlled substances as stimulants.