Are You Getting The Most From Your ADHD Anxiety Medication?
ADHD and Anxiety Medication
People with ADHD typically suffer from co-occurring anxiety disorders. Anxiety can cause restlessness, irritability, and difficulty sleeping.
Stimulant medication can help alleviate symptoms, but they can also cause side-effects like tics, or small growth reductions in children and adolescents. Some people also find that their anxiety levels increase when they are taking stimulant drugs.
Stimulants
Stimulants are a class of drugs 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 crystals that are chunky and clear, or a brown or white powder. Large doses of stimulants can result in over-stimulation, anxiety, panic attacks, stomach cramps or paranoia. Long-term use of stimulants may cause addiction and severe adverse effects, such as heart issues, high pressure and stroke.
The drugs typically prescribed to treat ADHD are also proven to have a track record for alleviating the symptoms of anxiety. They help by boosting brain chemicals like dopamine, norepinephrine, and serotonin. These are lower in ADHD patients. This boosts activity and communication between brain regions that regulate attention and executive function. This leads to improved impulse control and anxiety symptoms diminishing.
Studies have demonstrated that both atomoxetine as well as methylphenidate reduce anxiety symptoms in adults with ADHD and comorbid anxiety disorders. Anxiety symptom improvement was seen in the first week of treatment for both drugs and the effect was continued for 8 weeks of treatment.
It is important to keep in mind that the type of medication that is most effective for treating anxiety and ADHD co-occurring disorders could depend on which disorder has the greatest impact on a person's quality of life. For example, an individual might be prone to frequent anxious mini-crises on a daily basis when they have to make appointments or try to keep on top of their school or work. They can be extremely distressing and can cause them to feel anxious on a more frequent basis than the symptoms of a specific anxiety disorder or panic attack would.
In these cases the antidepressants, or SSRIs are the best choice to combat anxiety-related symptoms. They have been proven effective at reducing anxiety levels in adults. These are usually taken orally and may take a bit longer to work, but 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 venlafaxine and duloxetine. They can be used in addition to cognitive-behavioral therapy for anxiety and are particularly useful if the patient experiences a racing heart or elevated blood pressure.
SSRIs
Antidepressants, including SSRIs (antidepressant drugs) are commonly used to treat anxiety disorders. Prozac is the first drug of this class, is fluoxetine. The SSRIs can also aid in treating depression, obsessive compulsive disorder and post-traumatic stress disorder. They are more versatile than the earlier generations of antidepressants, and they have fewer and fewer dangerous side effects.
The SSRIs hinder the reuptake of serotonin at synapses. This causes the neurotransmitter in the synapse to remain active and signal the post synaptic cell more than is the case with other neurotransmitters. This can boost the output of norepinephrine which may reduce anxiety symptoms. It could also result in increased levels of the neuronal cyclic AMP (cAMP) which can stimulate protein synthesis.
Additionally, SSRIs can reduce impulsivity and decrease hyperactivity. They also can improve sleep quality and reduce agitation for some people with ADHD. However, these drugs can increase the risk of suicidal behaviour and thoughts among some people. They can also trigger an increase in appetite and weight gain, particularly when they are first started.
Another kind of antidepressant, known as SNRIs, performs differently than the SSRIs. SNRIs block the reuptake both of serotonin as well as norepinephrine. Like SSRIs they may affect anxiety, but they can also improve the functioning of the heart muscle and the blood vessels, which can reduce feelings of anxiety and stress. People with bipolar disorder can also benefit from their use.
The most commonly used SNRIs are duloxetine (Cymbalta) and Venlafaxine (Effexor, Effexor XR) and desvenlafaxine (Khedezla, Pristiq). The SNRIs can raise blood pressure in some individuals and are not recommended for those with high blood pressure or heart disease.
In addition to medication, there are a number of behavioral therapies that can help with anxiety and ADHD. Mindfulness practices can be helpful in reducing stress and anxiety and stress, as can yoga and meditation. Some people find that tapping certain body points or Emotional Freedom techniques, helps lower cortisol which is the hormone that causes anxiety. Exercise and diet can also reduce anxiety. Your doctor may suggest that you consume whole grains, fruits and vegetables, and to avoid sugar, since it can cause anxiety in some ADHD children and adults.
Non-stimulant-based medications
While stimulants are highly effective in treating ADHD and have been extensively researched however they are not the best choice for individuals with anxiety disorders and ADHD. These medications can cause adverse effects like increased heart rate and jitteriness. These symptoms can be similar to or worsen symptoms of anxiety.
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 the heart rate or blood pressure, and are less likely than stimulant medications to cause anxiety-related side effects like sweating, shaking or nervousness.
Atomoxetine targets receptors for norepinephrine, a chemical in the brain. It can improve attention and reduce impulsivity and hyperactivity. Studies have also proven that it can help improve anxiety symptoms in children and adolescents with ADHD. Researchers gathered clinical articles from PubMed, EMBASE and PsycINFO to find out whether atomoxetine helped reduce anxiety in adolescents and children with ADHD.
Bupropion is a different medication that can alleviate anxiety symptoms. It targets the brain chemical dopamine. Bupropion is usually recommended for people with co-occurring depression and ADHD. It can also help improve mood and decrease symptoms of anxiety. It is usually recommended to investigate and address the root anxiety-related issue before treating the ADHD because that will usually help to alleviate anxiety symptoms.
In certain cases, anxiety symptoms in ADHD children may be the cause of their anxiety. Cognitive-behavioral treatment and psychostimulants are typically the most effective methods to treat anxiety in this scenario. This is because these therapies address the root cause of the problem and help reduce ADHD symptoms which, consequently, decrease the anxiety.
Antidepressants are also prescribed to those who have ADHD and anxiety. SSRI antidepressants, which target the brain chemical serotonin can aid in reducing anxiety symptoms and improve mood. Examples include Zoloft, Lexapro and Sertraline.
Ultimately, the decision of the right medication for you will be decided by your physician. Before recommending adhd in adults medication I Am Psychiatry will take into consideration your symptoms, lifestyle and age, in addition to other health conditions. It is very important to discuss your goals for treatment with your physician and adhere to a routine daily while taking any medication.
Other options
Other treatment options could be beneficial to manage ADHD or anxiety, depending on your health goals. These include mindfulness meditation, yoga (Emotional Freedom techniques) tapping sleep nutrition, exercise and healthy eating habits.
People with anxiety are more likely to develop symptoms of attention deficit hyperactivity disorder, Dr. Hallowell says, which can make it challenging to treat both disorders simultaneously. He prescribes stimulants to treat ADHD first, then non-stimulant medications such as atomoxetine or bupropion for anxiety disorders. These medications work 24 hours a day and are not controlled substances, similar to stimulants.