ADHD and Anxiety Medication
People suffering from ADHD frequently suffer from co-occurring anxiety disorders. Anxiety can trigger irritation, restlessness, and difficulty sleeping.
The use of stimulants can ease symptoms, but it can cause side effects like tics or minor growth reductions in children and adolescents. Some people also find that their anxiety rises when they take stimulant medication.
Stimulants
Stimulants are a class of drugs used to treat attention deficit hyperactivity disorder (ADHD) and the condition known as 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 brown or white powder. The use of large doses of stimulants can create over-stimulation and cause anxiety and stomach cramps, panic attacks or paranoia. The long-term use of stimulants could cause addiction and serious side effects such as heart problems, high blood pressure and stroke.
These medicines have also been shown to relieve anxiety symptoms. They help by increasing the supply of brain chemicals norepinephrine and dopamine, which tend to be lower in those with ADHD. This boosts activity and communication between parts of the brain that regulate executive and attention. This leads to improved impulse control, and anxiety symptoms diminish.
Studies have shown that both atomoxetine as well as methylphenidate reduce anxiety symptoms in people with ADHD and comorbid anxiety disorders. Improvement in anxiety symptoms was observed as early as the fourth week of treatment for both medications and the benefits were continued for 8 weeks of treatment.
It is important to note that the kind of medication best for treating anxiety and ADHD co-occurring symptoms could come down to which condition has the greatest impact on the quality of life of an individual. A person may experience a variety of minor crises that create anxiety in a regular manner as they rush to make appointments or keep up with projects at work or school. These can be stressful and cause anxiety more often than symptoms of a panic attack or fear.
In these cases it is possible to address the anxiety-related symptoms by taking antidepressants or SSRIs which have been proven to be effective in reducing anxiety levels in adults. They are typically taken orally and may take a little longer to work, but 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 venlafaxine and duloxetine. These can be taken as a supplement to cognitive-behavioral treatment for anxiety, and are particularly useful when a patient is suffering from an elevated heart rate or blood pressure.
SSRIs
SSRIs are antidepressants, are often used to treat anxiety disorders. Prozac, the prototype drug of this group is fluoxetine. The SSRIs can also help treat obsessive-compulsive disorder, depression and post-traumatic stress disorder. These drugs are a bit more versatile than the earlier generations of antidepressants, and they are less likely to cause dangerous side effects.
The SSRIs work by inhibiting the reuptake of serotonin at synapses. This causes the neurotransmitter inside the synapse and communicate with the post synaptic cells more than is the case with other neurotransmitters. This can increase the output of norepinephrine and reduce anxiety. It could also result in higher levels of the neuronal cyclicAMP (cAMP), which stimulates protein production.
Additionally, SSRIs may reduce impulsivity and decrease hyperactivity. They can also improve sleep quality and decrease anxiety for those with ADHD. However, these medications can increase the likelihood of suicidal thoughts and actions in some people. They may also increase appetite and weight gain at the beginning of treatment.
Another kind of antidepressant, called SNRIs, works differently than SSRIs. SNRIs block the reuptake both of serotonin and norepinephrine. Similar to SSRIs, they can have an effect on anxiety, but they can also improve the functioning of the heart muscle and blood vessels, which may decrease anxiety and stress. They also can enhance the mood of people suffering from bipolar disorder.
The most common SNRIs are duloxetine (Cymbalta) and Venlafaxine (Effexor, Effexor XR) and desvenlafaxine (Khedezla, Pristiq). SNRIs can cause blood pressure to rise in certain individuals, so those with high blood pressure and heart disease should not take these medications.
There are a variety of behavioral treatments for anxiety and ADHD that can be used in conjunction with medication. Mindfulness techniques can be helpful in lowering stress and anxiety, as can practicing yoga and meditation. Some people find tapping specific body parts or techniques for emotional freedom can help lower cortisol levels which is the hormone responsible for anxiety. Exercise and diet can also reduce anxiety. Your doctor may recommend that you eat whole grains, fruits, and vegetables, and to avoid sugar, since it can worsen anxiety for some ADHD children and adults.
Non-stimulant based medicines
Although stimulants are highly effective in treating ADHD and have been extensively researched, they may not be the most appropriate choice for people who suffer from anxiety and ADHD. The stimulant medications can trigger adverse effects like increased heart rate and jitteriness. These symptoms can be similar to or worsen anxiety symptoms.
Non-stimulant medicines are a recent option that has been used to treat ADHD since 2002 (under the brand name Strattera). They don't increase heart rate or blood pressure and are less likely than stimulant drugs to cause anxiety-related side effects such as sweating, shaking or nervousness.
Atomoxetine is a drug that targets receptors for norepinephrine. It is a brain chemical that can improve concentration and decrease hyperactivity and impulsivity. Studies have also shown that it can help improve anxiety symptoms in children and adolescents with ADHD. adhd uk medication collected clinical articles from PubMed, EMBASE and PsycINFO to find out if atomoxetine improved anxiety in adolescents and children with ADHD.
Another drug that can be effective in relieving anxiety symptoms is bupropion which targets the brain chemical dopamine. Bupropion is usually advised for people who suffer from coexisting depression and ADHD. It can also boost mood and lessen anxiety symptoms. It is usually an excellent idea to identify and treat the root causes of anxiety prior to treating the ADHD since that will usually make anxiety symptoms disappear.
In some instances, anxiety symptoms in ADHD children are the cause of their anxiety. The most effective treatment for anxiety in these situations is usually cognitive-behavioral therapy as well as psychostimulants. These treatments can help reduce ADHD symptoms and anxiety by addressing the root cause of the problem.
Antidepressants may also be prescribed to those who have ADHD and anxiety. SSRI antidepressants that target Serotonin, the chemical in the brain that is thought to aid in relieving anxiety symptoms and improve mood. Examples include Zoloft, Lexapro and Sertraline.
Your doctor will ultimately determine which medication is right for you. Before recommending a medication, they will look at your symptoms, lifestyle and age, as well as other health conditions. It is important to discuss with your doctor about your goals for treatment and to adhere to a daily routine while taking any medication.
Other options
Based on your specific health objectives, there are additional treatments that could help you manage ADHD and anxiety. These include mindfulness meditation, yoga (Emotional Freedom techniques), tapping and sleeping and nutrition, exercise and healthy eating habits.
Dr. Hallowell says that people who suffer from anxiety are more likely to develop symptoms of ADHD, making it difficult to treat both conditions at the same time. He typically prescribes stimulants first to address ADHD before turning to non-stimulant medications like atomoxetine, bupropion, or guanfacine for anxiety disorders. These medications are available 24/7 and are not controlled substances similar to stimulants.