ADHD
15 min read
Written by Klarity Editorial Team
Published: Nov 19, 2024
Medically Reviewed by Dr. Zoe Russell
Worldwide, an estimated 3.4% of adults have attention-deficit/hyperactivity disorder (ADHD), which is around 15.5 million people in the U.S. Among these adults, about 50% also have an anxiety disorder, which can require the simultaneous management of both conditions. If you’re navigating both ADHD and anxiety, finding the right medication can make a substantial difference in your daily life. So what is the best ADHD medication for adults with anxiety?
In this article, we cover that though ADHD and anxiety share some symptoms, they’re distinct conditions and can require different treatment approaches. We also offer insight into finding the right ADHD medication for adults with anxiety to help you know what to talk to your provider about.
If you have anxiety and ADHD and/or anxiety, find a provider on Klarity Health to help control your symptoms and enhance your quality of life. Appointments are often available in as little as 24 hours.* And many providers offer free consultations so you can assess fit.
Both ADHD and anxiety can affect how you handle tasks, relationships, and stress. ADHD symptoms, like difficulty concentrating or finishing tasks, can sometimes make anxiety worse. On the other hand, the stress from anxiety can make it even harder to manage ADHD symptoms. But with the right treatment approach, managing both conditions is possible.
Certain ADHD medications can help with anxiety, while others — such as stimulants — can increase anxiety symptoms for some people. The good news is some ADHD medications and therapies can address both ADHD and anxiety symptoms to help you feel more in control and balanced.
ADHD medications fall into 2 broad classes: stimulants and non-stimulants.
Strattera (atomoxetine) is a non-stimulant ADHD medication that can benefit adults with ADHD and anxiety. It’s U.S. Food and Drug Administration (FDA)-approved to treat ADHD in pediatric and adult patients. As a selective norepinephrine reuptake inhibitor (NRI), it increases norepinephrine to improve focus and reduce impulsivity. It usually takes 1 to 4 weeks to reach full effect.
Key precautions for taking Strattera include side effects on blood pressure and heart rate, and caution is needed for patients with cardiovascular issues. Common atomoxetine side effects for adults are constipation, dry mouth, nausea, decreased appetite, which may lead to weight loss, dizziness, sexual side effects, problems passing urine, difficulty getting or keeping an erection, and an effect on your ability to drive or operate machinery.
Dose adjustments may be needed if taking atomoxetine with a CYP2D6 inhibitor, such as paroxetine (Paxil), fluoxetine (Prozac), or quinidine (Cardioquin), for people considered CYP2D6 PMs (poor metabolizers). Strattera also has an FDA-boxed warning for suicidal ideation in children and adolescents, so close monitoring is advised.
Note that Strattera, as a brand-name medication, was discontinued. Generic atomoxetine remains available.
Intuniv (guanfacine) is also a non-stimulant ADHD medication. It’s FDA-approved to treat ADHD symptoms in children and adolescents for both monotherapy (use by itself) and adjunctive therapy with stimulants (such as Adderall or Ritalin). It’s used off-label (for something it’s not FDA-approved for) to treat ADHD in adults.
Intuniv is a central alpha2A-adrenergic receptor agonist that can improve focus and reduce distractibility without increasing anxiety. Intuniv is taken once daily, starting at 1 milligram and can be increased weekly up to a maximum of 7 milligrams if needed and as tolerated.
Common side effects of Intuniv include sedation, somnolence (drowsiness), nausea, abdominal pain, low blood pressure, lethargy, headache, and dizziness. Caution is advised for those with cardiovascular issues, as Intuniv may cause hypotension (low blood pressure) and bradycardia (slow heart rate).
If you take Intuniv, you should avoid eating high-fat meals to prevent increased exposure (too much medication in your system).
If you need to stop taking Intuniv, it’s recommended that you gradually taper off of it to avoid rebound hypertension (high blood pressure).
Qelbree (viloxazine) is a non-stimulant NRI FDA-approved to treat ADHD in children 6 and older and adults. It provides a slow, steady effect that can help manage symptoms of both ADHD and anxiety even though it’s not FDA-approved to treat anxiety.
Common side effects of Qelbree include insomnia, sleepiness or tiredness, nausea, dry mouth, headache, decreased appetite, vomiting, and constipation. S
Serious side effects can include manic episodes and increased heart rate and blood pressure. Qelbree also has an FDA boxed warning for an increased risk of suicidal thoughts in children and adolescents, so close monitoring is essential.
Medication is 1 possible treatment for ADHD and/or anxiety. But for many adults with ADHD and anxiety, ADHD therapy, such as cognitive behavioral therapy (CBT), is helpful, especially when used along with medication.
CBT is a structured form of “talk therapy” that focuses on developing practical strategies to manage symptoms. Unlike other types of therapy, CBT is solution-focused, helping you identify thought patterns and behaviors that may contribute to your ADHD and/or anxiety symptoms.
CBT is based on the idea that our thoughts, emotions, and actions are closely connected. By making small, positive changes to our thinking, we can influence how we feel and behave.
A CBT therapist will work with you to create strategies for managing ADHD symptoms — such as impulsivity, inattention, and hyperactivity — and for reducing anxiety through techniques like mindfulness, time management, and coping skills.
Research has shown that CBT can improve executive functioning skills, reduce impulsivity, and lessen symptoms of anxiety. When combined with ADHD medications, CBT is often even more effective than medication alone.
There’s a strong link between ADHD and anxiety. Roughly 50% of adults with ADHD are also diagnosed with an anxiety disorder. While researchers aren’t yet certain of the exact cause, genetics might play a role, as family studies suggest that both conditions can run together.
Living with ADHD often means facing challenges like missed deadlines, frequent forgetfulness, and struggling with organization, all of which can create or add to anxiety. And constant worry from anxiety can make ADHD symptoms harder to manage.
Understanding the relationship between ADHD and anxiety can help you manage both conditions. With a targeted approach that combines medication, therapy, and lifestyle adjustments, adults with ADHD and anxiety can find effective ways to stay focused, calm, and balanced.
Managing ADHD and anxiety treatment together can be challenging, but there are effective treatment options available. Medication and therapy are the primary treatment approaches for adults with both conditions. ADHD medications — whether stimulants or non-stimulants — work by balancing neurotransmitters in the brain to improve focus, attention, and impulse control.
Therapy complements medication by helping individuals recognize and address thought patterns, develop coping skills, and enhance executive functioning. Working with a healthcare provider can ensure you find the most effective combination of medication and therapy tailored to manage both ADHD and anxiety.
Alongside medication and therapy, there are other things you can do to manage symptoms. By incorporating these ideas into your routine, you can enhance overall well-being and improve your day-to-day control over ADHD and anxiety symptoms.
You don’t need to try all of these techniques at once. Start with 1 or 2 and see how they fit into your routine. When combined with medication, if your provider recommends it, and therapy, these strategies can enhance your overall well-being and improve your ability to manage ADHD and anxiety.
ADHD medications work by increasing levels of dopamine and norepinephrine — neurotransmitters that affect attention, motivation, and mood. Stimulant medications, in particular, can improve focus and reduce impulsivity for ADHD, though they may impact symptoms differently depending on the individual.
For some, stimulants like Vyvanse or Ritalin may increase feelings of restlessness or nervousness, potentially worsening anxiety symptoms. But others may find that improved ADHD management leads to reduced anxiety.
If you have ADHD and anxiety, it’s important to work with a healthcare provider to determine if you need ADHD medication. Providers often recommend non-stimulant options or a combination of therapy and medication to manage both conditions effectively.
While ADHD stimulant medications are generally safe and effective, they can lead to side effects that resemble anxiety, such as jitteriness, increased heart rate, nervousness, or trembling. These side effects can worsen pre-existing anxiety for some people.
Because of the potential effects, providers may avoid prescribing stimulants containing mixed amphetamine salts, like Adderall, or other stimulant formulations for people with anxiety. Instead, non-stimulant medications, like SNRIs. such as Qelbree, are often considered.
If you’re experiencing symptoms of ADHD and anxiety, consider connecting with an independent, licensed healthcare provider on Klarity Health. They can work with you to create a personalized treatment plan tailored to your specific needs. Visit Klarity Health today to find a provider for your symptoms.
*Appointments are generally available within 24 hours. Free initial consultations are available only with select providers. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.
The information provided in this article is for educational purposes only and should not be construed as medical advice. Controlled substances, like Adderall, Ritalin, and Vyvanse, may not be appropriate for all patients, and any mention of these medications is for educational purposes only, not for marketing or encouraging self-diagnosis. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage. Not all providers on Klarity Health prescribe all medications, particularly medications that are controlled substances.
If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.
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