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ADHD Medications for Adults (cont.)

Medical Editor:

ADHD medications for adults with anxiety

Adult patients with an anxiety disorder as well as ADHD should be first treated for the primary condition. ADHD symptoms should be treated if they still persist after resolution of anxiety symptoms. However it is important to first investigate whether the anxiety symptoms are as a result of ADHD. In this case, effective treatment of ADHD would most likely resolve the anxiety as well. However, there is conflicting data on whether stimulant medications can improve anxiety symptoms. A study of 42 patients with ADHD and comorbid anxiety found that treatment with methylphenidate had a beneficial effect on anxiety symptoms. However other studies have shown that stimulants have no effect on anxiety.

ADHD medications for adults with high blood pressure

ADHD medications such as methamphetamine, methylphenidate and atomoxetine can increase blood pressure and heart rate and lead to myocardial infarction and sudden unexplained death (SUD). Although they are contraindicated for use in patients with cardiac disease, hypertension is a precaution, not an absolute contraindication.

If elevation of blood pressure occurs while taking these medications, the dose may need to be reduced or the medication may need to be discontinued. Treatment with an antihypertensive medication may also be necessary. Periodic blood pressure and heart rate monitoring is recommended in all patients taking methylphenidate. For atomoxetine, blood pressure and heart rate testing is recommended when starting therapy, after increase in doses, and periodically throughout therapy. There are no specific guidelines recommending certain medications for adults with ADHD and high blood pressure.

Medically Reviewed by a Doctor on 4/25/2016

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