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ADHD and Anxiety Medication
People suffering from ADHD often have co-occurring anxiety disorders. Anxiety can lead to restlessness, irritability and sleeplessness.
The use of stimulants can ease these symptoms however, they may also cause side effects such as small growth reductions and tics in children and adolescents. Many people also experience their anxiety rises when they take stimulant medication.
Stimulants
Stimulants are drugs that are 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, chunky clear crystals or a white or brown powder. Large doses of stimulants can result in over-stimulation, anxiety stomach cramps, panic attacks or paranoia. Long-term use of stimulants may cause addiction and serious side effects like heart problems high blood pressure, heart problems and stroke.
The medications that are typically prescribed to treat ADHD also have a proven track record of relieving the symptoms of anxiety. They help by boosting brain chemicals like dopamine, norepinephrine, and serotonin. These are lower in ADHD patients. This boosts the activity and communication of the parts of the brain that control executive and attention functions. This results in an improvement in control of impulses and anxiety symptoms diminishing.
Both atomoxetine (as as well as methylphenidate) reduce anxiety symptoms among adults with ADHD who also have anxiety disorders. Both medications improved anxiety symptoms from the very first week of treatment. The benefit continued for 8 weeks.
It is important to note that the type medication that is most effective for treating anxiety and ADHD symptoms that co-occur may depend on which of the conditions has the greatest impact on a person’s quality of living. One may experience numerous mini-crises that cause worry in a regular manner when they have to rush to make appointments or finish assignments at school or at work. They can be extremely distressing and cause people to be anxious on a more frequently basis than the symptoms of a specific phobia or panic attack would.
In these instances the antidepressants, or SSRIs are the best option to alleviate anxiety-related symptoms. These drugs have been proven to be effective at reducing anxiety levels in adults. They are administered orally and may take a while to take effect. The most popular options are selective serotonin reuptake inhibits (SSRIs) which include Sertraline, Fluoxetine, and serotonin, norepinephrine reuptake inhibitors (SNRIs) like venlafaxine, and duloxetine. These drugs can be used together with cognitive-behavioral therapy for anxiety. They are especially beneficial for patients who have an elevated or racing heart rate.
SSRIs
Antidepressants, such as SSRIs (antidepressant medications) are commonly used to treat anxiety disorders. The prototype drug in this class is fluoxetine, better known as Prozac. The SSRIs are also effective in treating obsessive-compulsive disorder and post-traumatic disorder. These medications are more versatile than the earlier generation antidepressants, and they are less likely to cause severe side effects.
The SSRIs block the reuptake of serotonin from synapses. This causes the neurotransmitter to remain active within the synapse and communicate with the post-synaptic cell more times than it would otherwise. This may increase the amount of norepinephrine released which may reduce anxiety symptoms. This may also increase levels of neuronal cyclicAMP (cAMP), stimulating protein synthesis.
SSRIs also reduce the amount of impulsivity and hyperactivity. They also can improve the quality of sleep and decrease agitation in people with ADHD. However, these drugs may increase the risk of suicidal thoughts and behaviors in some individuals. They can also trigger an increase in appetite and weight gain, especially when they are first introduced.
Another type of antidepressant, known as SNRIs, performs differently than the SSRIs. SNRIs stop the reuptake both serotonin and norepinephrine. Like SSRIs, they can have an effect on anxiety, but they can also enhance the functioning of the heart muscle and blood vessels, which can reduce feelings of anxiety and stress. They can also improve the mood of some individuals suffering from bipolar disorder.
The most common SNRIs are duloxetine (Cymbalta), venlafaxine (Effexor, Effexor XR) and desvenlafaxine (Khedezla, Pristiq). The SNRIs can raise blood pressure in some individuals and should not be taken by those suffering from high blood pressure or cardiovascular disease.
In addition to medications, there are a number of behavioral therapies that can aid in reducing anxiety and ADHD. Mindfulness practices can be helpful in reducing anxiety and stress, as can practicing yoga and meditation. Some people have found that tapping on specific points on their body, also known as Emotional Freedom Techniques, helps lower the cortisol hormone that creates anxiety. Exercise and diet can also reduce anxiety. Your doctor may recommend a diet of whole vegetables, fruits and medication for adhd and anxiety grains and avoid sugar, which can worsen anxiety in certain ADHD children and adults.
Non-stimulant-based medications
While stimulants are highly effective in treating ADHD and have been extensively studied, they are not always the best choice for individuals with coexisting anxiety and ADHD. The stimulant medications can trigger side effects such as anxiety and jitteriness. These symptoms can mirror or worsen anxiety symptoms.
Non-stimulant drugs are a more recent option that has been used to treat ADHD since 2002 (under the brand name Strattera). They don't increase blood pressure or heart rate, and they are less likely to suffer anxiety-related adverse effects like shaking, sweating or nervousness.
Atomoxetine targets receptors for norepinephrine, a chemical in the brain. It can improve attention and reduce impulsivity as well as hyperactivity. Studies have also demonstrated that it is effective in reducing anxiety symptoms in adolescents and children with ADHD. Researchers gathered articles on clinical research from PubMed, EMBASE and PsycINFO to determine if atomoxetine improved anxiety in adolescents and children with ADHD.
Another medication that can be effective in helping with anxiety symptoms is bupropion, which targets the brain chemical dopamine. Bupropion is usually recommended for those suffering from coexisting depression and ADHD. It can also improve moods and help reduce anxiety symptoms. It is usually best to treat the anxiety first before treating ADHD. This will usually reduce the anxiety symptoms.
It is common for kids with ADHD to experience issues with anxiety, and in a few cases the anxiety is actually caused by their ADHD symptoms. Psychostimulants and cognitive-behavioral treatments are generally the most effective treatment options for anxiety in this situation. This is because these treatments will tackle the root of the problem and help reduce ADHD symptoms which, in turn, reduce anxiety.
Antidepressants are also often prescribed to those suffering from coexisting ADHD and anxiety. SSRI antidepressants that target the brain chemical Serotonin can aid in relieving anxiety symptoms and improve mood. Examples include Zoloft, Lexapro and Sertraline.
The final decision of which medication is right for you will be determined by your physician. They will consider your symptoms, lifestyle, age and other health conditions before making a recommendation for any medication. It is important to discuss with your doctor about your treatment goals and to stick to a regular schedule while taking any medication.
Other options
Depending on your unique health goals, there are other treatment options that may also be helpful for 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 who suffer from anxiety are more likely to develop symptoms of ADHD, making it difficult to treat both conditions at the same time. He usually prescribes stimulants first to treat ADHD, and then turns to non-stimulant drugs like bupropion, atomoxetine, or guanfacine to treat anxiety disorders. These work around the clock and are not controlled substances like stimulants.