ADHD and Anxiety Medication
Anxiety disorders can be co-occurring with ADHD. Anxiety can trigger irritation, restlessness and trouble sleeping.
Stimulant medication can help alleviate symptoms, but it can cause adverse effects, like tics, or slight growth decreases in children and adolescents. Some people also notice that their anxiety levels increase when they are taking stimulant medications.
Stimulants
The use of stimulants is 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 tablets, capsules crystals that are chunky and clear, or a brown or white powder. Large doses can lead to excessive stimulation, resulting in anxiety, panic, stomach cramps as well as paranoia and aggression. Long-term use of stimulants may cause addiction and severe adverse effects such as heart problems, high pressure and stroke.
The medications that are typically prescribed to treat ADHD are also proven to have a track record for alleviating the symptoms of anxiety. They are effective by boosting brain chemical like dopamine, norepinephrine, and serotonin. These are lower in ADHD patients. This increases the activity and communication of the parts of the brain which control executive and attention functions. This leads to improved impulse control, and anxiety symptoms diminish.
Research has shown that both atomoxetine and methylphenidate reduce anxiety symptoms in people with ADHD and other anxiety disorders. Both treatments have shown improvement in anxiety symptoms beginning as early as the 4th week of treatment. The benefits lasted for 8 weeks.
It is important to remember that the type medication that will be most effective in treating anxiety and ADHD symptoms that co-occur may depend on which of the conditions is more detrimental to the quality of life of a person. A person may experience a variety of mini-crises that cause worry in a regular manner when they have to rush to make appointments or keep up with projects at work or school. These can be stressful and can cause anxiety more frequently than signs of a panic attack or phobia.
In these cases antidepressants or SSRIs are the best choice to treat anxiety-related symptoms. These drugs have been proven effective at reducing anxiety levels in adults. They are taken orally and may take some time to take effect. The most common choices are selective serotonin inhibits (SSRIs) that include Sertraline, Fluoxetine and serotonin, norepinephrine reuptake inhibitors (SNRIs) which include duloxetine, venlafaxine and. These drugs can be used in conjunction with cognitive-behavioral treatment for anxiety. They are especially effective for patients who have a racing or elevated heart rate.
SSRIs
SSRIs are antidepressants, are often used to treat anxiety disorders. The first drug in this category is fluoxetine, also known as Prozac. The SSRIs can also aid in treating obsessive-compulsive disorder, depression and post-traumatic stress disorder. These drugs are more versatile and have less side effects than previous generations of antidepressants.
The SSRIs inhibit serotonin's reuptake at synapses. This causes the neurotransmitter remain active in the synapse, and to signal the post-synaptic cell more times than would otherwise occur. This may increase the amount of norepinephrine released which may reduce anxiety symptoms. It can also increase the levels of neuronal cyclicAMP (cAMP) which can stimulate the synthesis of proteins.
In addition, the SSRIs may reduce impulsivity and decrease hyperactivity. They also can improve sleep quality and reduce agitation for some people with ADHD. These medications can, however, increase the possibility of suicidal behavior and thoughts among some people. They can also cause an increase in appetite and weight gain, particularly when they are first started.
Another kind of antidepressant, called SNRIs, works differently than the SSRIs. SNRIs block the reuptake both of serotonin as well as norepinephrine. Like SSRIs they may have an effect on anxiety, but they can also enhance the functioning of the heart muscle and blood vessels, which can reduce anxiety and stress. They also can improve the mood of some individuals suffering from bipolar disorder.
Duloxetine (Cymbalta) and venlafaxine (Effexor XR, Pristiq) and desvenlafaxine are the most commonly used SNRIs. The SNRIs may raise blood pressure in certain individuals, so they should not be used by those with high blood pressure or cardiovascular disease.
There are many treatment options for anxiety and ADHD that can be employed in addition to medication. Meditation and mindfulness techniques can help reduce stress and anxiety. Some people have found that tapping on specific points of the body, also known as Emotional Freedom Techniques, can help reduce the cortisol hormone which causes anxiety. Exercise and diet can reduce anxiety. Your doctor can suggest eating a diet that is based on whole vegetables, fruits and grains and avoid sugar, which can worsen anxiety in some ADHD adults and children.
Non-stimulant-based medications
While stimulants are extremely effective in treating ADHD, and have been extensively studied but they are not the best option for those who also suffer from anxiety and ADHD. The stimulant medications can trigger adverse effects like jitteriness and rapid heart rate. These symptoms can mimic or worsen symptoms of anxiety.
Non-stimulant medications are a more 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 to have anxiety-related adverse effects like shaking, sweating or nervousness.
Atomoxetine targets receptors for the brain chemical norepinephrine. It can help improve attention and reduce impulsivity and hyperactivity. It here has also been proven to improve anxiety symptoms among children and adolescents with ADHD. Researchers collected clinical articles from PubMed EMBASE PsycINFO and PsycINFO to determine if atomoxetine decreased anxiety symptoms in children and adolescents with ADHD.
Bupropion is another medication that can ease anxiety symptoms. It targets the brain chemical, dopamine. Bupropion is typically prescribed to patients suffering from ADHD and depression. It can also boost mood and lessen symptoms of anxiety. It is often best to treat anxiety first before treating ADHD. This will typically help to alleviate the symptoms of anxiety.
It is very common for kids with ADHD to have problems with anxiety, and in some instances, the anxiety is caused by their ADHD symptoms. Psychostimulants and cognitive-behavioral therapy are usually the most effective treatment options for anxiety in this type of situation. This is because these treatments target the root of the problem and decrease ADHD symptoms, which will consequently, decrease the anxiety.
Antidepressants are also prescribed to those who have ADHD and anxiety. SSRI antidepressants that target Serotonin, a chemical in the brain, 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 determined by your doctor. Before recommending a drug, they will look at your lifestyle, symptoms, age, as well as other health issues. It is very important to discuss your goals for treatment with your doctor and stick to a routine daily while taking any medication.
Other options
Based on your individual health goals, there are other treatment options that may also help you manage ADHD and anxiety. These include mindfulness yoga, meditation, yoga, tapping (Emotional Freedom Techniques) sleep and nutrition, as well as exercise and healthy eating habits.
People who are anxious are more likely to suffer from symptoms of attention deficit hyperactivity disorder, Dr. Hallowell says, which makes it difficult to treat both conditions at the same time. He prescribes stimulants to treat ADHD first, then non-stimulant medication like bupropion or atomoxetine to treat anxiety disorders. These work around the clock and are not controlled drugs like stimulants.