Best ADHD Medication for Adults with Anxiety
Author:
Blossom Editorial
Oct 3, 2025
Managing both ADHD and anxiety simultaneously requires careful medication selection, as some ADHD treatments can worsen anxiety symptoms while others may provide benefits for both conditions. Understanding your options can help you work with your healthcare provider to find the most effective treatment approach.
Key Takeaways
Non-stimulants such as atomoxetine and viloxazine may be preferred for adults with ADHD and anxiety, since they are generally less likely to worsen anxiety. Individual response varies, so treatment should be personalized.
The same medication can affect people differently, making personalized treatment with careful monitoring essential for finding the right balance between ADHD symptom control and anxiety management.
Combining medication with cognitive behavioral therapy, lifestyle modifications, and stress management techniques typically provides the most effective long-term management of both conditions.
Understanding ADHD and Anxiety
Among the millions of U.S. adults with ADHD, experts estimate about half struggle with at least one comorbid anxiety disorder. Research shows that about 25% of individuals with ADHD also have an anxiety disorder, making this one of the most common comorbid conditions.
The relationship between ADHD and anxiety is complex. About half to two-thirds of children with ADHD continue to experience symptoms into adulthood, while complete remission is relatively uncommon. When you have anxiety along with ADHD, it may make some of your ADHD symptoms worse, such as feeling restless or having trouble concentrating.
Genetics may contribute to why ADHD co-occurs with anxiety and depression, though environment and life stressors also play important roles.
How ADHD Medications Affect Anxiety
ADHD medications work by targeting brain chemicals called neurotransmitters, primarily increasing the levels of norepinephrine and dopamine in the body. However, the effects on anxiety can vary significantly depending on the type of medication used.
Stimulant Medications and Anxiety
The most common drugs that doctors suggest for ADHD are stimulants like methylphenidate and amphetamines.
Stimulants can be effective for ADHD even in people with anxiety, but in some individuals, they may cause side effects like increased heart rate, jitteriness, or sleep difficulties. In other cases, effective ADHD treatment can actually reduce anxiety.
Potential anxiety-related side effects of stimulants include:
Increased heart rate and blood pressure
Jitteriness or feeling "wired"
Sleep difficulties
Restlessness
Worry or racing thoughts
Your doctor won't know how a medication will affect you until you take it, but it's possible stimulants may make your anxiety symptoms worse. Anxiety is a common side effect of stimulants, making careful monitoring essential.
Non-Stimulant Medications and Anxiety
However, these drugs may increase anxiety symptoms, making nonstimulants a suitable option for people with ADHD and anxiety. Non-stimulants, such as atomoxetine and viloxazine, are effective for ADHD, though they generally work more slowly than stimulants. Some people with anxiety tolerate these medications better, but individual response varies.
Best Medication Options for ADHD with Anxiety
Research from a major study published in The Lancet Psychiatry looked at how well certain medicines work for adults with ADHD. The study reviewed 113 clinical trials and included over 14,800 adults from many countries, finding that only stimulants and atomoxetine helped reduce ADHD symptoms effectively.
First-Line Non-Stimulant Options
Atomoxetine (Strattera) A non-stimulant ADHD medication like atomoxetine (brand name Strattera) is often considered most suitable for adults with ADHD, anxiety, and depression. Atomoxetine is a selective norepinephrine reuptake inhibitor (SNRI). Some patients notice improvements in anxiety, but atomoxetine is not FDA-approved for anxiety disorders, and effects vary.
Key benefits for anxiety:
Strattera acts on the neurotransmitters norepinephrine and dopamine
Norepinephrine also plays a role in anxiety disorders, not just ADHD
Some people report that taking atomoxetine also helps reduce their anxiety as well as ADHD symptoms
Unlike stimulants, atomoxetine is not a controlled substance and is less likely to cause dependence or misuse
It does not cause most of the side effects relating to stimulants
Timeline and considerations:
While stimulants have an immediate effect, atomoxetine may take several weeks
Common side effects include nausea, decreased appetite, and fatigue
It is important to note that atomoxetine is not FDA-approved for anxiety disorders
Viloxazine (Qelbree) If that's the case for you, your doctor may suggest other medicines, such as the non-stimulant medications atomoxetine (Strattera) or viloxazine (Qelbree). Viloxazine is a non-stimulant whose mechanism is not fully understood, but it appears to inhibit norepinephrine reuptake. It is not specifically approved for anxiety, though some patients tolerate it better than stimulants.
Alpha-2 Agonists
Guanfacine (Intuniv) and Clonidine (Kapvay) These medications are FDA-approved for pediatric ADHD, and evidence for reducing anxiety in adults is limited/off-label. They can have calming effects, but adult use should be discussed with a clinician.
Benefits for dual conditions:
Help with both attention and hyperactivity symptoms
Can reduce anxiety and promote calmness
Lower risk of triggering anxiety symptoms
May help with sleep difficulties common in both conditions
Antidepressants for Dual Treatment
Bupropion (Wellbutrin) Bupropion can help with attention and mood, but carries a seizure risk at higher doses and can destabilize bipolar disorder if present. In a study, adults with ADHD were given either extended-release bupropion (Wellbutrin SR) or a placebo. The results showed people taking bupropion showed more improvement than those taking the placebo.
Advantages:
It's an antidepressant that can also improve focus and attention
Often used for people who have both ADHD and depression
Works on the brain's dopamine and norepinephrine systems
Good option when you need help with more than one condition
Lower risk of sexual side effects compared to SSRIs
Venlafaxine (Effexor) This is the brand name for an SNRI, venlafaxine. It is not FDA-approved for ADHD treatment, but some research shows that the medication can reduce ADHD symptoms in adults. It's also FDA-approved for treating generalized anxiety disorder and panic disorder. Venlafaxine is not FDA-approved for ADHD; evidence is limited and off-label.
Other Antidepressant Considerations: Antidepressants that only work on the serotonin levels in your brain, called selective serotonin reuptake inhibitors (SSRIs), haven't been shown to be effective for treating the main symptoms of ADHD. But they can be helpful in combination with stimulants if you also have a mental health condition such as depression or an anxiety disorder.
Treatment Approach and Timing
Getting the anxiety symptoms under control can make a big difference by freeing up more attention and reducing the distraction of worry. You can even look at anxiety disorders as attentional disorders themselves because attention is a "limited resource," and anxiety can absorb a significant amount of it.
Clinicians often individualize treatment: some treat the most impairing condition first, whether that’s anxiety or ADHD, and monitor effects closely.
Why this approach works:
Simply put, anxiety can be incredibly distracting
Treating anxiety can help reduce ADHD symptoms, as anxiety is distracting and can steal a person's attention
Managing ADHD can help reduce overall anxiety, as treating ADHD symptoms, such as improving executive function, can alleviate stress and anxiety related to time management and organization
Combined Treatment Considerations
It's possible that your treatment for ADHD may ease your anxiety, so you may only need to take ADHD medication. If your anxiety is a separate condition and not a symptom of ADHD, you may need to treat both disorders at the same time.
Yes, ADHD and anxiety medications can often be taken together, but it depends on the specific medications, the patient's medical history, and other factors.
Factors to Consider When Choosing Medication
No medication for anxiety, depression, and ADHD fits everyone. While prescribing medications, a healthcare provider considers specific symptoms, medical history, and potential interactions and side effects.
Individual Response Variations
Everyone's brain is different, so the same medicine doesn't work for everyone. Some meds help with ADHD but not with anxiety or depression, and some may even make one condition worse while helping another. The effectiveness of the same medication may vary from one person to another, so it's essential to receive personalized treatment.
Medical History Considerations
Important factors include:
Previous medication responses
Substance use history
Other medical conditions
Current medications
Severity of symptoms in each condition
Comorbid Conditions
In patients with manic episodes or bipolar disorder and ADHD, therapy with mood stabilizers and/or atypical antipsychotics is indicated before the treatment with stimulants. Stimulants carry a potential risk of worsening or triggering bipolar symptoms.
If a patient is suffering with severe symptoms of other disorders, such as anxiety or depression, we first attempt to address the most severely impairing disorder to determine whether the ADHD symptoms improve.
Non-Medication Treatment Options
Some treatments can work for both ADHD and anxiety, such as cognitive-behavioral therapy (CBT) and relaxation techniques. CBT can be helpful whether or not the person is being treated with medication.
Cognitive Behavioral Therapy (CBT)
CBT is rooted in the idea that psychological problems often arise from faulty or unhelpful thinking patterns and learned behaviors.
It focuses on helping people recognize and change these patterns, fostering a better understanding of others' behavior, and equipping them with problem-solving skills.
Benefits for dual conditions:
Addresses thought patterns that worsen both ADHD and anxiety
Teaches practical coping strategies
Helps develop executive functioning skills
Can be used alongside medication
Lifestyle Interventions
Mindfulness and Meditation: Incorporating mindfulness practices into your daily routine can make a world of difference. These techniques help cultivate a sense of presence and awareness, allowing you to observe anxious thoughts without getting swept away by them.
Nutrition and Diet: Research shows that what you eat can significantly impact both ADHD and anxiety symptoms. A balanced diet rich in omega-3 fatty acids, complex carbohydrates, and lean proteins can help stabilize mood and improve focus, while reducing caffeine and sugar intake helps manage anxiety symptoms.
Exercise and Physical Activity: Regular physical activity can help with both ADHD symptoms and anxiety by:
Increasing dopamine and norepinephrine levels naturally
Reducing stress and anxiety
Improving sleep quality
Enhancing overall mood
When to Consider Changes
Signs you may need medication adjustments:
Worsening anxiety symptoms
Insufficient ADHD symptom control
Intolerable side effects
Changes in other health conditions
Life circumstances requiring different symptom management
Medical Disclaimer
This article is for educational purposes only and does not constitute medical advice. The information provided should not replace consultation with a qualified healthcare provider. Individual responses to medications can vary significantly, and what applies to one person may not be safe for another.
Always consult with your doctor or pharmacist before making any decisions about medication changes, discontinuation, or interactions with other substances. If you're experiencing concerning symptoms or side effects, please seek professional help from a healthcare provider. In case of a medical emergency, contact your local emergency services immediately or call 911. For mental health emergencies, contact the National Suicide Prevention Lifeline at 988.
Important: This information is not a substitute for professional medical advice. Never stop taking prescribed medication or make changes to your treatment plan without consulting your healthcare provider first. Your safety and well-being are the top priorities.
