Some medications used to treat ADHD can make anxiety worse, while others may help regulate both attention and mood.

Living with ADHD can create stress in many areas of daily life, such as missed deadlines, disorganization, trouble remembering details, and challenges in relationships. These struggles often contribute to increased anxiety.

On the other hand, anxiety symptoms such as racing thoughts, irritability, or difficulty sleeping can make ADHD symptoms feel more intense. Genetics may also play a role, as both conditions are known to run in families.

Treating both disorders begins with determining which symptoms affect you the most. If anxiety is more prominent, certain medications might be prioritized.

If ADHD symptoms are impairing your ability to function at work, in relationships, or at home, your healthcare professional may start with ADHD medications that also minimize anxiety.

Stimulants are the first-line treatment for adult ADHD because of their rapid effectiveness. These medications increase dopamine and norepinephrine in the brain, improving attention, motivation, and impulse control.

The two main types are methylphenidates and amphetamines.

While effective, stimulants can sometimes trigger or worsen anxiety. Symptoms such as increased heart rate, restlessness, and insomnia may be more intense in people already prone to anxiety.

However, not everyone reacts the same way. In some cases, successfully managing ADHD symptoms reduces anxiety related to inadequate performance or chronic disorganization.

If you and your healthcare professional choose to use a stimulant, long-acting options like Vyvanse or Concerta may offer smoother effects throughout the day, reducing the highs and lows that can intensify anxiety.

Starting at a low dose and increasing slowly can also help manage potential side effects.

For adults with ADHD and anxiety, non-stimulant medications are often a preferred starting point.

These medications work more gradually than stimulants but may be better tolerated if you are sensitive to anxiety-related side effects.

Atomoxetine (Strattera)

Atomoxetine is a selective norepinephrine reuptake inhibitor (SNRI) that increases norepinephrine levels in the brain. It does not carry the risk of addiction or overstimulation that some stimulants do.

It’s particularly useful for individuals whose ADHD symptoms are accompanied by generalized anxiety.

Strattera may take several weeks to reach full effectiveness, so patience is important. Your healthcare professional will determine the dosage based on your needs.

Viloxazine (Qelbree)

Qelbree is a newer non-stimulant medication designed to improve focus, impulse control, and attention by balancing brain neurotransmitters. It can be helpful for adults who experience both ADHD and anxiety, especially if stimulants cause uncomfortable side effects.

However, viloxazine may lead to mood changes or increased anxiety in some people. Because of this, close monitoring is critical, particularly during the first few weeks of treatment or when adjusting your dose.

Qelbree’s safety during pregnancy and while nursing is not yet well established.

While they are not FDA-approved for ADHD, some antidepressants affect dopamine or norepinephrine levels and may help with focus, mood, and anxiety.

Bupropion (Wellbutrin)

Bupropion increases dopamine and norepinephrine, making it one of the few antidepressants that can also treat ADHD symptoms.

It tends to be well tolerated, but in some people, it may cause jitteriness or difficulty sleeping, especially if anxiety is already a factor.

Venlafaxine (Effexor)

This SNRI can improve both mood and attention. Effexor may be beneficial for individuals with both disorders, although side effects can include elevated blood pressure and increased anxiety in some people.

Other medications

Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) and sertraline (Zoloft) are often prescribed for anxiety or depression. While they don’t treat ADHD directly, they may help if anxiety is overwhelming.

SSRIs can be combined with ADHD medications under close supervision.

Tricyclic antidepressants (TCAs) such as nortriptyline, imipramine, and desipramine have also been used for ADHD. However, they’re less commonly prescribed due to side effects like dry mouth, constipation, and in rare cases, heart rhythm changes.

Certain blood pressure medications have shown promise in treating ADHD, especially when anxiety is a concern. These medications reduce nerve signaling in the brain, promoting a calming effect.

Clonidine (Kapvay)

Kapvay is an extended-release version of clonidine, which works on the central nervous system to reduce hyperactivity and improve attention. It may also ease physical symptoms of anxiety, such as a rapid heart rate.

This medication can cause drowsiness, so it’s often taken at night.

Guanfacine (Intuniv)

Guanfacine is another alpha-2 adrenergic agonist approved for ADHD. It helps reduce distractibility and improve memory. Like clonidine, it has a calming effect and may lower blood pressure.

Because of its sedating properties, it’s important to understand how it affects you before driving or operating machinery.

These medications are slower acting than stimulants, but may be better suited if you experience high levels of anxiety or have sensitivity to overstimulation.

Choosing the best medication for ADHD and anxiety is a personalized process. Your treatment plan may depend on whether your anxiety is a direct symptom of ADHD or a separate condition.

It’s essential to work closely with a healthcare professional to evaluate your response to each medication and make adjustments as needed.

Here are some general recommendations to guide you:

  • Start with a clear understanding of your symptoms: Are you more affected by restlessness and inattention or by worry and panic? Identifying the primary concern helps guide medication selection.
  • Track your reactions: Keeping a daily journal of your mood, anxiety levels, focus, and any side effects can help your prescriber evaluate how well your treatment is working.
  • Consider combining medication with therapy: Cognitive behavioral therapy (CBT) is highly effective for anxiety and can also help with ADHD-related skills like time management and organization.
  • Avoid sudden dose changes: Gradual dosage adjustments help your body adapt and reduce the likelihood of side effects.
  • Review lifestyle factors: Sleep, exercise, nutrition, and stress management can significantly affect how well your medication works.

Balancing ADHD and anxiety is possible with the right tools and support.

While stimulant medications are highly effective for ADHD, non-stimulant alternatives and certain antidepressants may offer better results when anxiety is a factor.

Blood pressure medications can also help regulate focus and calmness for some people.

With careful monitoring and a holistic approach, you can find a treatment strategy that supports your mental health, improves your focus, and allows you to feel more in control.