Does Adderall Help Anxiety?

Can Adderall Help with Anxiety?

While Adderall is primarily used to treat attention deficit hyperactivity disorder (ADHD), it is not typically prescribed for anxiety. However, in children with ADHD, Adderall can manage comorbid anxiety and does not increase anxious feelings. This is distinct from what Adderall does in people without ADHD and anxiety, in whom it can exacerbate anxiety.

Does Adderall Help Anxiety?

Adderall is a central nervous system stimulant drug that is primarily used to treat attention deficit hyperactivity disorder (ADHD) and sometimes narcolepsy, a condition characterized by excessive daytime sleepiness [1]. Adderall is a Schedule II substance, meaning Adderall use is carefully monitored, and it is only available upon prescription. It is most commonly available as Adderall XR, meaning extended-release tablets, which overcome a sudden spike and fall of stimulation.

It is a combination of two amphetamine salts, dextroamphetamine and amphetamine, which are central nervous system stimulants [1]. This means they activate the sympathetic nervous system, which is responsible for the fight or flight response.

Adderall works by increasing the norepinephrine and dopamine levels, two critical neurotransmitters in your brain. This stimulates your central nervous system, increasing energy levels and alertness and improving concentration, memory, and organization [1]. It can, however, also cause side effects and toxicity. Possible side effects can include a rapid heart rate, elevated blood pressure, and, in extreme cases, motor side effects such as dyskinesia and tremor [2].

What is Anxiety?

Anxiety is a state in which a past, present, or upcoming event is perceived as threatening without actually being an imminent threat to our survival. However, it triggers a physiological response involving the sympathetic nervous system activation through the fight-or-flight response. A certain level of anxiety is healthy and normal [4]. However, if your anxious feelings persist for long periods or affect your daily activities, then it may be wise to seek the help of a mental health professional who may be able to prescribe you some anxiety medications.

The mental health diagnosis of Generalised Anxiety Disorder and Social Anxiety Disorder is the most common mental health disorder, with a prevalence of 4%, according to the World Health Organization [5]. Common anxiety medications include Xanax, which also has similar abuse potential to stimulant medications [6].

ADHD and Anxiety

There is a historical link between the incidence of ADHD and anxiety. Previous studies suggested that up to 25% of children with ADHD also have an anxiety disorder [7], highlighting the importance of addressing both disorders in treatment settings. Having anxiety was associated with a lower response to common ADHD medications, including methylphenidate, brand name Ritalin, or Celexa, a commonly used psychostimulant similar to Adderall [8, 9].

Nonetheless, future studies have contradicted this finding, indicating that some children with ADHD may react better to behavioral interventions, such as cognitive behavioral therapy (CBT), if they also have an anxiety disorder [10].

So, what is the link between Adderall and anxiety?

Adderall and Anxiety: Does Adderall Help Anxiety?

Adderall and anxiety are closely related. Anxiety is considered one of the common side effects of Adderall [1]. This is because Adderall triggers a biochemical cascade in your brain, including the release of norepinephrine and dopamine. This increases alertness and reward-related processes in the brain. The flight or flight response underlies key anxiety symptoms and also involves the release of norepinephrine. Therefore, biologically speaking, Adderall and anxiety are very similar, and one's interpretation of Adderal-induced arousal could be misinterpreted as anxiety. Indeed, anxiety is a common side effect of taking Adderall.

One study of students taking Adderall for performance-enhancing purposes found that students taking Adderall without a diagnosis of ADHD increased anxious feelings and the prevalence of anxiety disorders [4].

However, in children with ADHD, the effects of Adderall may be less likely to cause anxiety. This is because Adderall would only 're-balance' the chemicals in the brain to neutral levels, avoiding the excess excitation similar to the fight-or-flight response. A meta-analysis looking at studies focusing on psychostimulants, including Adderall and Ritalin, in children with both ADHD and anxiety found that psychostimulants were just as likely or less likely to cause anxiety than taking a placebo [7]. Therefore, psychostimulants did not make the anxiety worse, contrary to the results in healthy students. The length of taking psychostimulants also didn't affect the risk of experiencing anxiety side effects. Nonetheless, taking higher doses of psychostimulants was more likely to cause anxiety [7].

Summary: Does Adderall Help Anxiety?

Overall, the evidence suggests that Adderall can cause anxiety in people without ADHD, but in people with ADHD, it can actually reduce anxiety if taken at the correct dose. Consulting your healthcare provider will be critical to first determine if you have an ADHD diagnosis, find out about the available treatment options, Adderall doses, or whether a behavioral therapy may be more suitable to manage your ADHD symptoms.