Can Adderall cause anxiety?

In this article:

• Does Adderall cause anxiety?
• What steps should I take to reduce anxiety or panic attacks from Adderall?
• Are there alternatives to Adderall that have a lower risk of causing anxiety?

In this article

• Does Adderall cause anxiety?
• What steps should I take to reduce anxiety or panic attacks from Adderall?
• Are there alternatives to Adderall that have a lower risk of causing anxiety?

Adderall (amphetamine and dextroamphetamine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Like most drugs, Adderall can cause some side effects. Among the potential side effects of Adderall are anxiety and panic attacks. 

“Adderall can cause anxiety,” says Heather Wilson, LCSW, LCADC, CCTP, the executive director of Epiphany Wellness. “Although it promotes concentration and attentiveness as expected, it may also induce heightened worry in certain individuals due to its stimulating effects.”

Here’s a look at the connection between the use of Adderall and anxiety. 

Does Adderall cause anxiety?

According to Michael O. McKinney, M.D., a family medicine specialist at Healthy Outlook, the use of Adderall can cause anxiety. 

“Those who have already been diagnosed with an anxiety disorder, or are susceptible to it, may find that their symptoms worsen when they take this medicine or even start experiencing these conditions if it was previously dormant in them, “ Dr. McKinney says.

Adderall can affect a person’s mental health, potentially leading to symptoms like anxiety, tremors, insomnia, hostility, and psychosis. 

Other side effects of Adderall can include:

• High blood pressure
• Elevated, fast, or irregular heartbeat
• Bladder pain
• Bloody or cloudy urine
• Difficult or painful urination
• Frequent urge to urinate
• Lower back or side pain

Adderall may cause anxiety due to the way the stimulant drug affects your brain’s chemicals.

“The way Adderall works involves raising levels of certain brain chemicals (neurotransmitters) such as dopamine and norepinephrine,” Dr. McKinney says. “Too much activity along these pathways can result in overstimulation, leading to increased restlessness combined with other signs associated with anxiety disorders becoming more severe than usual.”

Adderall stimulates the nervous system, but also the cardiovascular system. The combination could lead to anxiety symptoms.

“This medication stimulates your CNS (central nervous system), leading to increased heart rate and awareness,” Wilson says. “These physical adjustments could imitate or intensify signs of panic disorder.”

Wilson lists the following as signs and symptoms of anxiety:

• Persistent worry or fearfulness
• Restlessness or being “on edge”
• Rapid heartbeat
• Hyperventilation (fast breathing)
• Sweating
• Trembling or shaking
• Difficulty concentrating
• Trouble sleeping

The relationship between Adderall and anxiety is an example of a substance/medication-induced anxiety disorder. It’s a mental health condition that arises from the use, abuse, or withdrawal of a substance or prescription medication. 

Signs and symptoms of Adderall-induced anxiety or agitation may include:

• Anorexia (no appetite)
• Grandiosity (feeling of being superior to others)
• Distractability
• Impulsivity
• Pressured speech
• Racing thoughts
• Sexual promiscuity
• Irritability
• Increased energy levels

If you stop taking Adderall suddenly, you may experience withdrawal. A research study involving rats found that chronic amphetamine increases anxiety states between 24 hours and two weeks after stopping amphetamine medications. 

Signs and symptoms of Adderall withdrawal can include:

• Excessive sleeping 
• Insomnia
• Fatigue
• Poor concentration
• Decrease in mental and physical activities
• Increased appetite
• Drug craving
• Paranoia

If you’re experiencing Adderall withdrawal, please seek medical attention.

While some may experience anxiety while taking Adderall, this is not the case for everyone. A meta-analysis involving 23 studies of almost 3,000 children found that taking psychostimulants like Adderall significantly lowered the risk of anxiety. 

However, researchers did not rule out the possibility that medications like Adderall may heighten the chances of developing anxiety. 

Can Adderall cause panic attacks?

According to Dr. McKinney, some people may experience panic attacks while taking the stimulant medication Adderall. Dr. McKinney says Adderall can trigger panic attacks in some people due to its stimulant properties acting on the central nervous system (CNS).

Wilson adds that because of Adderall’s effect on the nervous system, it can cause your heart rate to increase. “These physical adjustments could imitate or intensify signs of panic disorder,” Wilson says.

Panic attacks are sudden waves of fear or the feeling of losing control with or without a clear trigger or danger. Panic attacks can be a symptom of anxiety disorder or panic disorder. 

Panic attacks can occur at any time and can feel similar to a heart attack, causing symptoms like trembling, rapid heartbeat, and tingling. 

During a panic attack, there are a few methods you can try:

• Practice mindfulness through meditation, yoga, and deep breathing exercises
• Acknowledge that you’re having a panic attack
• Relax your muscles

It’s also important to talk to your mental health provider if you experience frequent panic attacks. 

What steps should I take to reduce anxiety or panic attacks from Adderall?

There are a few steps you can take to reduce the occurrence of anxiety or panic attacks from Adderall use.

Below are some tips for lowering your risk of anxiety or panic attacks:

• Seek medical care: Speaking with a healthcare provider is a good starting point for getting help. “When taking Adderall, it is important for people who have anxiety or Adderall panic attacks to seek advice from their healthcare provider,” Dr. McKinney says. “They might have to change the dose and time of taking the drug or even try out different medicines altogether.”
• Consider counseling: Seek counseling from a licensed mental healthcare provider. These professionals may recommend therapies, like cognitive behavioral therapy (CBT), to help prevent anxiety attacks and other unwanted feelings that may be affecting your life.
• Reduce caffeine intake: Caffeinated drinks, like coffee and energy drinks, can increase the risk of an anxiety attack. Limiting or avoiding these beverages is recommended. 
• Adopt healthy habits: Eating a healthy, balanced diet and regular exercise can also help with anxiety from Adderall and improve mental well-being. 
• Practice mindfulness: Research shows that mindfulness-based therapies can help manage anxiety. Some examples of mindfulness practices include meditation, yoga, mindful eating, and coloring.

Are there alternatives to Adderall that have a lower risk of causing anxiety?

If your anxiety is unmanageable while taking Adderall, your healthcare provider may recommend alternative medications. Some of these medications may also contain stimulants, but others may not.

Possible alternatives for ADHD medication Adderall include:

• Adderall XR (dextroamphetamine/amphetamine extended-release) capsule
• Concerta (methylphenidate extended-release) tablet
• Evekeo (amphetamine) tablet
• Focalin (dexmethylphenidate) tablet
• Focalin XR (dexmethylphenidate extended-release) capsule
• Intuniv (guanfacine extended-release) tablet
• Jornay PM (methylphenidate) extended-release capsules
• Kapvay (clonidine extended-release) tablet
• Metadate CD (methylphenidate 30% immediate release/ 70% extended release) capsule
• Mydayis (dextroamphetamine/amphetamine extended-release) capsules
• Qelbree (viloxazine extended-release) capsules
• Quillivant XR (methylphenidate extended-release) suspension
• Ritalin (methylphenidate) tablet
• Ritalin LA (methylphenidate 50% immediate release/ 50% delayed-release) capsules
• Strattera (atomoxetine) capsules
• Vyvanse (lisdexamfetamine) capsule or chewable tablet

Dr. McKinney advises patients experiencing unbearable anxiety or other side effects of Adderall to discuss alternative medications with their healthcare provider.