Best ADHD medication for adults with anxiety

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.

What’s the right ADHD medication for you?

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How to treat ADHD and anxiety symptoms

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.

Non-stimulant ADHD medications

ADHD medications fall into 2 broad classes: stimulants and non-stimulants.

• Central nervous system (CNS) stimulants are typically the first-line treatment for ADHD. They’re fast-acting and work by increasing dopamine and norepinephrine in the brain to help boost focus and motivation. But stimulants can sometimes heighten anxiety, so non-stimulants are often recommended for adults who have both ADHD and anxiety.
• Non-stimulants have a slower onset but can be effective without increasing anxiety symptoms. Non-stimulant medications keep activated brain receptors “fired up” longer to help manage ADHD symptoms more gently. And non-stimulants are often a better option for adults managing both ADHD and anxiety.

Understanding Strattera for ADHD and anxiety

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.

How Intuniv Works

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 for ADHD and anxiety

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. 

Cognitive behavioral therapy (CBT) for ADHD and anxiety

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.

How CBT works

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.

CBT’s impact on ADHD and anxiety

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. 

The connection between ADHD and anxiety

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.

How to treat ADHD and anxiety in adults

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.

Practical strategies for managing 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.

• Maintain healthy habits: Establish a regular sleep schedule, eat a balanced diet, and practice relaxation techniques, like deep breathing or meditation. These habits contribute to mental well-being and can help alleviate both ADHD and anxiety symptoms.
• Engage in regular exercise: Physical activity boosts mental health. It helps release dopamine, which is beneficial for managing ADHD. Regular exercise — whether it’s walking, practicing yoga, or engaging in sports — can also help reduce anxiety, lift your mood, and improve focus.
• Practice time management: Effective time management can reduce stress and increase productivity. Use tools like planners, calendars, or ADHD apps to organize tasks and set priorities. (Find 11 tips  for ADHD time management.) 
• Implement stress reduction strategies: Engage in enjoyable activities like hobbies, outdoor activities, listening to music, or practicing mindfulness. Experiment to discover what techniques work best for you. (Find 11 ideas to calm down anxiety.)
• Build a support network: A strong support system of friends, family, or peers can provide encouragement and understanding. Sharing your experiences with others who face similar challenges can offer comfort and valuable insights.
• Explore relaxation techniques: Techniques like progressive muscle relaxation, guided imagery, or aromatherapy can help reduce anxiety and promote calmness.
• Prioritize self-care: Include activities that nurture your mental health, such as taking breaks, engaging in hobbies, practicing self-compassion, and setting healthy boundaries to protect your energy.

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.

Do ADHD medications help with 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. 

Effects of ADHD stimulant medications on anxiety

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.

Find a provider on Klarity Health for ADHD and anxiety

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.