If you have both ADHD and anxiety, you may have already tried a stimulant and noticed something frustrating: your focus improved, but your anxiety got worse. Racing thoughts, a pounding heart, trouble winding down at night, sometimes something close to a panic feeling. If that's happened to you, it's not in your head — and it's not the only option available.
Why this happens.
Stimulants work by increasing dopamine and norepinephrine activity in the brain. For a lot of people, that sharpens focus and settles restlessness. But that same increase in physiological arousal — faster heart rate, more alertness, more "on" — can intensify symptoms for someone who already has an underlying anxiety disorder. It doesn't happen to everyone with ADHD and anxiety; some people do perfectly well on a stimulant, sometimes combined with an SSRI or SNRI for the anxiety piece. But for a meaningful number of people, the stimulant itself is what's making anxiety worse, not better.
ADHD and anxiety commonly overlap.
The two conditions show up together often enough that treating one without asking about the other is a common gap in care. Someone gets evaluated for attention and organization problems, gets a stimulant, and nobody asks whether the racing thoughts and edge-of-your-seat feeling that follow were already there — or brand new.
A different approach: treating both, without a stimulant.
Atomoxetine (Strattera) is an SNRI-class non-stimulant — a different mechanism than a stimulant, and for many people it doesn't carry the same anxiety-amplifying effect.
Guanfacine and clonidine (alpha-2 agonists) are actually used off-label for anxiety and hyperarousal in their own right — they tend to have a calming rather than activating effect.
Bupropion can help ADHD and low mood together, though it's worth knowing it's still a stimulating antidepressant and isn't the right fit for everyone with anxiety — we'll walk through whether it makes sense for you specifically.
Just as important: if you have a diagnosable anxiety disorder alongside ADHD, treating the anxiety directly — with an SSRI or SNRI, therapy, or both — is often part of the plan, not an afterthought.
Individual response to any medication varies, and this page isn't a substitute for an individualized evaluation. If you're currently taking a stimulant and thinking about a change, don't stop anything abruptly — talk to your prescriber first about how to transition safely.
What we do differently.
We evaluate both conditions together, not ADHD in isolation. That means asking specifically about anxiety symptoms, physical symptoms like heart rate and sleep, and what happened the last time you tried a stimulant if you have. From there we build a plan — non-stimulant ADHD treatment, anxiety-specific treatment, or both — and check in early since any medication change deserves close follow-up in the first few weeks.