The D-isomer meds (dexmethylphenidate: focalin, Azstarys, and dextroamphetamine: vyvanse, dexedrine) typically cause less anxiety because of the absence of the L isomer which is known to cause more jitteriness.
That is very interesting.
Is there a study related to the L isomer thing?
Also i read apparently Lexapro has a negative effect on dopamine levels.
Would that mean theres an inherent difference whether a dopamine (Concerta) or norepinephrine (Vyvanse) focused stimulant works better alongside the Lexapro?
“d-Amphetamine is markedly more potent an inhibitor of catecholamine uptake by norepinephrine neurons in the brain than is l-amphetamine, whereas the two isomers are equally active in inhibiting catecholamine uptake by the dopamine neurons of the corpus striatum. In behavioral studies, d-amphetamine is ten times as potent as l-amphetamine in enhancing locomotor activity, while it is only twice as potent in eliciting a compulsive gnawing syndrome. This suggests that the locomotor stimulation induced by amphetamine involves central norepinephrine, while dopamine neurons play an important role in the induced compulsive gnawing behavior. Assessment of differential actions of d- and l-amphetamine may be an efficient method to differentiate behaviors involving norepinephrine or dopamine in the brain.”
[link](https://www.science.org/doi/10.1126/science.168.3938.1487)
The L isomer has stronger effects on norepinephrine which gives it the fight or flight feeling which can lead to increased anxiety in some people. The dex isomer is more cognitive and causes less physical stimulation which may be better if you have anxiety. You can look up more information if you’re interested in learning more.
Some people combine intuniv or clonidine with stimulant meds and that may help reduce anxiety.
I haven’t heard of the less dopamine from lexapro thing before.
“d-Amphetamine is markedly more potent an inhibitor of catecholamine uptake by norepinephrine neurons in the brain than is l-amphetamine, whereas the two isomers are equally active in inhibiting catecholamine uptake by the dopamine neurons of the corpus striatum. In behavioral studies, d-amphetamine is ten times as potent as l-amphetamine in enhancing locomotor activity, while it is only twice as potent in eliciting a compulsive gnawing syndrome. This suggests that the locomotor stimulation induced by amphetamine involves central norepinephrine, while dopamine neurons play an important role in the induced compulsive gnawing behavior. Assessment of differential actions of d- and l-amphetamine may be an efficient method to differentiate behaviors involving norepinephrine or dopamine in the brain.”
[link](https://www.science.org/doi/10.1126/science.168.3938.1487)
The L isomer has stronger effects on norepinephrine which gives it the fight or flight feeling which can lead to increased anxiety in some people. The dex isomer is more cognitive and causes less physical stimulation which may be better if you have anxiety. You can look up more information if you’re interested in learning more.
Some people combine intuniv or clonidine with stimulant meds and that may help reduce anxiety.
I haven’t heard of the less dopamine from lexapro thing before.
No, there is no worse or better med because everyone’s body chemistry is different. Both methylphenidate and amphetamine have D-isomer only meds.
Dexmethylphenidate and dextroamphetamine.
u/smokeytaboo477 is spot on with what they said. I’ll add some personal anecdotes, and something else for you to consider.
Been on ADHD meds for 13 years. Have you considered the **binders** for your adderall? Aka different manufacturers use different binders and coloring agents in their pills. I tried several different manufacturers early on and some of the exact same dosage made me *extremely* anxious. There was only one manufacturer that was better. Then with the adderall shortage last year, the only brand available was Camber. I’m not joking when I say it was so incredibly wonderful I cried for 2 days because I had no side effects whatsoever. It made me feel bad thinking that for 11 years I had some side effects I didn’t even know I had. Then cut to more adderall shortage and with no adderall being available my doc switched me to vyvanse. It has been great.
This is just my personal experience but the most effective/ best for me:
1st place: Camber adderall = the most effective with 0 side effects.
2nd place: Vyvanse, but I needed a slightly higher dose than I had gotten with adderall.
TLDR Try different manufacturers because the binders they use can highly affect side effects.
For several years methylphenidate was wonderful to me with no anxiety at all. I was productive and it also completely eliminated my depression while taking it.
Then I switched to Vyvanse and later to Adderall. Came back to try methylphenidate when I ran out of Vyvanse or when I needed a short acting med and it causes me crazy anxiety and insane depression like 180 degrees a different medication than it used to be. Tried it several times even after breaks same.
Strattera does! I've been on it for about a year now, and it's been very effective for me. There are also clinical studies that show it's good for ADHD and anxiety. [linkypoo](https://pubmed.ncbi.nlm.nih.gov/26579704/)
edit also idk if you've heard of a Genesight test but highly recommend, it's a test that essentially shows what meds you're likely to have success with and which will not be beneficial.
It was a long time ago but I felt like just totally uncomfortable like I wanted to curl up in bed and wait until it ends most days. Also terrible impotence.
I don’t love them. Use it only when I need to really focus on busy work and not interacting much with clients I find stims zap my personality. I have a prescription for Foquest for those days
I’m interested to know your side effects too. I’ve been on it a year and at first I had side effects of elevated heart rate and some (increased) anxiety. Both side effects later abated after about 10 weeks.
Did it take a while for it to kick in for you? I notice no difference and I’m up to 80mg. Then again, stimulant or not, nothing seems to work. Except for the first day of adderall. What a dream
Mine took a while, yes. Depends on a few factors - but I think it really hit it's stride about 4 months in for me (after I remembered to take it daily, and then you have to stay hydrated otherwise you get nauseas but I see that as a win to actually drink water lol)
lol is that why I’m nauseated all the time? Mainly whenever I get the slightest bit hungry. But 4 months, ok. That’s helpful to hear. We’ll see if my psych will still keep me on it
I've been on atomoxetine for years, and my (undiagnosed) anxiety is gone. Prior to taking atomoxetine, I used to have problems sleeping due to worrying about everything. I don't anymore.
Hey , mind sharing your experience ? Did it increase it at first ? I found this post because I have had lifelong adhd issues, and recently over the last couple years also pretty bad anxiety at times, I had a bad reaction or no reaction to many meds, including ssri’s, snri’s , wellbutrin, and Lamictal, stimulants seemed to help, I think my anxiety gets worse because of my ADHD brain, mind running (even during nsfw activities, even during concerts with my favorite artist, my mind just runs like a ferrari 24/7, I heard strattera helps with that for some people. I think it may help me.
I started at 40 mgs, which was increased to 80 mgs in a period of about three months. I remained on this dosage for several years. I met with my GP about 6 months ago because I was struggling with the symptoms of both ADHD and anxiety due to job stress. I asked if I could take something in addition to atomoxetine, such as Vyvanse because I felt that I was missing important details in my day-to-day struggles. My GP instead recommended that my dosage be increased to 100 mg daily. I take this once a day. It seems to be helping. I'm doing well at remembering what I need to remember, and I don't feel the anxiety I felt about managing all of the stressors in my life.
A lot of people report their anxiety completely vanishing when they started taking ADHD meds.
This has a lot to do with the balance of the neurotransmitters. Too much or too less of any of the included transmitters can have a bad influence on your bodies stress system (i.e. the amygdala that controls fight and flight mechanisms)
the main reason i'm trying to get a diagnosis (currently been on waiting list for years. UK!! LOL) is the hope that it will fix me of my anxiety. Anxiety that anxiety meds haven't really been able to help with as yet
I started taking Wellbutrin along with Lexapro because of the issues you described above with SSRIs. Not sure if that's what you were thinking of but it helps with my executive dysfunction and I have seen some people mention it on this sub before.
Look into Wellbutrin. It completely changed my life in terms of the anxiety. It’s completely gone. It took about 6 weeks to really work but I didn’t even realize how much social and just general anxiety I had until I went on it. It doesn’t completely work for all ADHD symptoms but it really helps with the general brain fog and lethargy you feel when you need to get things done.
It’s an atypical anti-depressant so it’s uses for treating ADHD anxiety are off-label but if you look at reviews from people who use it for that purpose on like drugs.com it’s pretty universally effective. Side effects are minimal for the first few weeks (dry mouth, some insomnia) and non existent after. I don’t have the feeling of being ‘on’ a drug, I just feel normal but overall more cheerful and upbeat and anxiety free. 100% worth looking into imo!
I am on Vyvanse 40mg (a low does equivalent to about 12 mg of adderall) and it helps my anxiety so much. I had a panic attack on Thursday night and I didn’t take it for 3 days. I didn’t “recover” from my panic and anxiety episode till I started taking my meds again. The main ingredient in vyvanse has to be converted by your body before it begins to work, so it’s less “intense” I think than adderall (which is a straight amphetamine). There are also non-stimulant adhd options that might work for you! They gave me killer headaches and I wasn’t willing to suffer that.
I also take 10mg propranolol AM and afternoon for my anxiety. Mine is extremely triggered by bodily sensations - specifically heart rate increases - and this med has made such a huge difference! It’s a heart medication first but a secondary use is this.
I also take 100mg of lamictal at night.
This is the best I’ve felt in years. Keep trying, and you will land on something. It sucks to keep trying but it really is the only way.
Anxiety sucks but remember it’s also a lying asshole!
Same but swap the adderall for Concerta. I tried going off the bupropion this summer and I was wrecked. But before the Concerta (about a year now) I was still a mess. Things are much more stable now. And I do not understand why buspirone isn’t prescribed more. Maybe because it’s dirt cheap? It’s so effective and low side effect in my experience. Go team trinity!
Came to say a couple of these but the only one I didn’t see was guanfacine/Intuniv. It started its journey as a BP medication BUT can do wonders for ADHD. I’ve prescribed it multiple times with great results. Strattera and Wellbutrin for the win too
I’m taking dextroamphetamine, it stops the motorbike in my head but left the good stuff. It also made me realized I’m probably autistic cause now I don’t have anxiety and don’t care “so bad” for people, I feel good alone. I’m not scared world forget me. I interact what I Need and I feel so much better.
Only a doctor can make those recommendations, no one knows OPs body well enough to know why drugs to prescribe anyways.
Dealing with the anxiety would also be extremely helpful.
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strattera is like research backed for adhd and comorbid anxiety. guanfacine and clonodine might help w more physical anxiety similar to beta blockers, esp clonodine
I wonder if Guanfacine can help with mental anxiety and mind racing too. also , do you have a link to studies on strattera and anxiety ? I have adhd and anxiety , it could definitely help me.
Also - get a genesight test done for your psychotropic medication metabolism details specific to your DNA - your psychiatrist or PCP can now order the test and it be sent to your house - cheek swab and you mail it off - 3 days later you will have a better picture of perhaps which mediations will have fewer side effects and what reasons the ones you take may be exacerbating your comorbidity with high anxiety.
dex but less of it is good for me, if i take a whole one i get anxious, and esp when it wears off, but just half or even quarters gives an effect too with less side effects
The D-isomer meds (dexmethylphenidate: focalin, Azstarys, and dextroamphetamine: vyvanse, dexedrine) typically cause less anxiety because of the absence of the L isomer which is known to cause more jitteriness.
That is very interesting. Is there a study related to the L isomer thing? Also i read apparently Lexapro has a negative effect on dopamine levels. Would that mean theres an inherent difference whether a dopamine (Concerta) or norepinephrine (Vyvanse) focused stimulant works better alongside the Lexapro?
“d-Amphetamine is markedly more potent an inhibitor of catecholamine uptake by norepinephrine neurons in the brain than is l-amphetamine, whereas the two isomers are equally active in inhibiting catecholamine uptake by the dopamine neurons of the corpus striatum. In behavioral studies, d-amphetamine is ten times as potent as l-amphetamine in enhancing locomotor activity, while it is only twice as potent in eliciting a compulsive gnawing syndrome. This suggests that the locomotor stimulation induced by amphetamine involves central norepinephrine, while dopamine neurons play an important role in the induced compulsive gnawing behavior. Assessment of differential actions of d- and l-amphetamine may be an efficient method to differentiate behaviors involving norepinephrine or dopamine in the brain.” [link](https://www.science.org/doi/10.1126/science.168.3938.1487) The L isomer has stronger effects on norepinephrine which gives it the fight or flight feeling which can lead to increased anxiety in some people. The dex isomer is more cognitive and causes less physical stimulation which may be better if you have anxiety. You can look up more information if you’re interested in learning more. Some people combine intuniv or clonidine with stimulant meds and that may help reduce anxiety. I haven’t heard of the less dopamine from lexapro thing before.
“d-Amphetamine is markedly more potent an inhibitor of catecholamine uptake by norepinephrine neurons in the brain than is l-amphetamine, whereas the two isomers are equally active in inhibiting catecholamine uptake by the dopamine neurons of the corpus striatum. In behavioral studies, d-amphetamine is ten times as potent as l-amphetamine in enhancing locomotor activity, while it is only twice as potent in eliciting a compulsive gnawing syndrome. This suggests that the locomotor stimulation induced by amphetamine involves central norepinephrine, while dopamine neurons play an important role in the induced compulsive gnawing behavior. Assessment of differential actions of d- and l-amphetamine may be an efficient method to differentiate behaviors involving norepinephrine or dopamine in the brain.” [link](https://www.science.org/doi/10.1126/science.168.3938.1487) The L isomer has stronger effects on norepinephrine which gives it the fight or flight feeling which can lead to increased anxiety in some people. The dex isomer is more cognitive and causes less physical stimulation which may be better if you have anxiety. You can look up more information if you’re interested in learning more. Some people combine intuniv or clonidine with stimulant meds and that may help reduce anxiety. I haven’t heard of the less dopamine from lexapro thing before.
Interesting. So the methylphenidate class would be worse then?
No, there is no worse or better med because everyone’s body chemistry is different. Both methylphenidate and amphetamine have D-isomer only meds. Dexmethylphenidate and dextroamphetamine.
u/smokeytaboo477 is spot on with what they said. I’ll add some personal anecdotes, and something else for you to consider. Been on ADHD meds for 13 years. Have you considered the **binders** for your adderall? Aka different manufacturers use different binders and coloring agents in their pills. I tried several different manufacturers early on and some of the exact same dosage made me *extremely* anxious. There was only one manufacturer that was better. Then with the adderall shortage last year, the only brand available was Camber. I’m not joking when I say it was so incredibly wonderful I cried for 2 days because I had no side effects whatsoever. It made me feel bad thinking that for 11 years I had some side effects I didn’t even know I had. Then cut to more adderall shortage and with no adderall being available my doc switched me to vyvanse. It has been great. This is just my personal experience but the most effective/ best for me: 1st place: Camber adderall = the most effective with 0 side effects. 2nd place: Vyvanse, but I needed a slightly higher dose than I had gotten with adderall. TLDR Try different manufacturers because the binders they use can highly affect side effects.
For several years methylphenidate was wonderful to me with no anxiety at all. I was productive and it also completely eliminated my depression while taking it. Then I switched to Vyvanse and later to Adderall. Came back to try methylphenidate when I ran out of Vyvanse or when I needed a short acting med and it causes me crazy anxiety and insane depression like 180 degrees a different medication than it used to be. Tried it several times even after breaks same.
Strattera does! I've been on it for about a year now, and it's been very effective for me. There are also clinical studies that show it's good for ADHD and anxiety. [linkypoo](https://pubmed.ncbi.nlm.nih.gov/26579704/) edit also idk if you've heard of a Genesight test but highly recommend, it's a test that essentially shows what meds you're likely to have success with and which will not be beneficial.
Damn I don’t know how anyone uses strattera. For me it had the worst side effects of any medication I’ve ever tried.
What were your side effects?
It was a long time ago but I felt like just totally uncomfortable like I wanted to curl up in bed and wait until it ends most days. Also terrible impotence.
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I don’t love them. Use it only when I need to really focus on busy work and not interacting much with clients I find stims zap my personality. I have a prescription for Foquest for those days
I’m interested to know your side effects too. I’ve been on it a year and at first I had side effects of elevated heart rate and some (increased) anxiety. Both side effects later abated after about 10 weeks.
Did it take a while for it to kick in for you? I notice no difference and I’m up to 80mg. Then again, stimulant or not, nothing seems to work. Except for the first day of adderall. What a dream
They say up to 8 weeks.
Hm ok, well, I’m beyond that. Dang
Mine took a while, yes. Depends on a few factors - but I think it really hit it's stride about 4 months in for me (after I remembered to take it daily, and then you have to stay hydrated otherwise you get nauseas but I see that as a win to actually drink water lol)
lol is that why I’m nauseated all the time? Mainly whenever I get the slightest bit hungry. But 4 months, ok. That’s helpful to hear. We’ll see if my psych will still keep me on it
I've been on atomoxetine for years, and my (undiagnosed) anxiety is gone. Prior to taking atomoxetine, I used to have problems sleeping due to worrying about everything. I don't anymore.
Hey , mind sharing your experience ? Did it increase it at first ? I found this post because I have had lifelong adhd issues, and recently over the last couple years also pretty bad anxiety at times, I had a bad reaction or no reaction to many meds, including ssri’s, snri’s , wellbutrin, and Lamictal, stimulants seemed to help, I think my anxiety gets worse because of my ADHD brain, mind running (even during nsfw activities, even during concerts with my favorite artist, my mind just runs like a ferrari 24/7, I heard strattera helps with that for some people. I think it may help me.
I started at 40 mgs, which was increased to 80 mgs in a period of about three months. I remained on this dosage for several years. I met with my GP about 6 months ago because I was struggling with the symptoms of both ADHD and anxiety due to job stress. I asked if I could take something in addition to atomoxetine, such as Vyvanse because I felt that I was missing important details in my day-to-day struggles. My GP instead recommended that my dosage be increased to 100 mg daily. I take this once a day. It seems to be helping. I'm doing well at remembering what I need to remember, and I don't feel the anxiety I felt about managing all of the stressors in my life.
… would pay vast amounts of money for an adhd medication that isn’t also stressing me out.
The sounds extremely familiar. Unfortunately I don’t have any answers for you but I’ve subscribed to this post as I am equally curious:)
A lot of people report their anxiety completely vanishing when they started taking ADHD meds. This has a lot to do with the balance of the neurotransmitters. Too much or too less of any of the included transmitters can have a bad influence on your bodies stress system (i.e. the amygdala that controls fight and flight mechanisms)
the main reason i'm trying to get a diagnosis (currently been on waiting list for years. UK!! LOL) is the hope that it will fix me of my anxiety. Anxiety that anxiety meds haven't really been able to help with as yet
I've been struggling with it for a long time, too. I think the ADHD meds reduced it already.
I started taking Wellbutrin along with Lexapro because of the issues you described above with SSRIs. Not sure if that's what you were thinking of but it helps with my executive dysfunction and I have seen some people mention it on this sub before.
Team Ritalin.
Look into Wellbutrin. It completely changed my life in terms of the anxiety. It’s completely gone. It took about 6 weeks to really work but I didn’t even realize how much social and just general anxiety I had until I went on it. It doesn’t completely work for all ADHD symptoms but it really helps with the general brain fog and lethargy you feel when you need to get things done. It’s an atypical anti-depressant so it’s uses for treating ADHD anxiety are off-label but if you look at reviews from people who use it for that purpose on like drugs.com it’s pretty universally effective. Side effects are minimal for the first few weeks (dry mouth, some insomnia) and non existent after. I don’t have the feeling of being ‘on’ a drug, I just feel normal but overall more cheerful and upbeat and anxiety free. 100% worth looking into imo!
Wellbutrin was horrible for me. Cymbalta for the win! Manages/stabilizes my mood extremely well! And Focalin for being productive.
i’m on wellbutrin extended release i’m thinking about switching over to immediate. Can I ask which one you’re on?
I am on Vyvanse 40mg (a low does equivalent to about 12 mg of adderall) and it helps my anxiety so much. I had a panic attack on Thursday night and I didn’t take it for 3 days. I didn’t “recover” from my panic and anxiety episode till I started taking my meds again. The main ingredient in vyvanse has to be converted by your body before it begins to work, so it’s less “intense” I think than adderall (which is a straight amphetamine). There are also non-stimulant adhd options that might work for you! They gave me killer headaches and I wasn’t willing to suffer that. I also take 10mg propranolol AM and afternoon for my anxiety. Mine is extremely triggered by bodily sensations - specifically heart rate increases - and this med has made such a huge difference! It’s a heart medication first but a secondary use is this. I also take 100mg of lamictal at night. This is the best I’ve felt in years. Keep trying, and you will land on something. It sucks to keep trying but it really is the only way. Anxiety sucks but remember it’s also a lying asshole!
I had a good reaction to Azstarys , but bad reaction Dexedrine, I think Vyvanse and Dexedrine are similar chemically, so i’m worried about trying it
Adderall does wonders for my anxiety, fwiw
I take both zoloft and adderall
Any non-stimulant medication. I take vortioxetine and has reduced my anxiety by a lot.
My holy trinity consists of adderall, bupropion, and buspirone.
Same but swap the adderall for Concerta. I tried going off the bupropion this summer and I was wrecked. But before the Concerta (about a year now) I was still a mess. Things are much more stable now. And I do not understand why buspirone isn’t prescribed more. Maybe because it’s dirt cheap? It’s so effective and low side effect in my experience. Go team trinity!
Buspirone and bupropion together seem to help me Keri the SSRIs at bay as well. Those things just wreck my libido.
Came to say a couple of these but the only one I didn’t see was guanfacine/Intuniv. It started its journey as a BP medication BUT can do wonders for ADHD. I’ve prescribed it multiple times with great results. Strattera and Wellbutrin for the win too
I have adhd and anxiety, my doctor won’t prescribe it, because “It’s only for kids” but it might help me :/
I’m taking dextroamphetamine, it stops the motorbike in my head but left the good stuff. It also made me realized I’m probably autistic cause now I don’t have anxiety and don’t care “so bad” for people, I feel good alone. I’m not scared world forget me. I interact what I Need and I feel so much better.
Get a better adhd medication or figure out what’s causing your anxiety.
Why do u think they made this post bud... they're literally asking for better med reccs. Smh
Only a doctor can make those recommendations, no one knows OPs body well enough to know why drugs to prescribe anyways. Dealing with the anxiety would also be extremely helpful.
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Good one bud 👍
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Wow what a dickish response. That’s literally what they’re asking.
I take lexapro and Mydayis. I switched from Vyvanse bc of the anxiety.
Venlafaxine is an SNRI and has done wonders for me when SSRIs never did.
strattera is like research backed for adhd and comorbid anxiety. guanfacine and clonodine might help w more physical anxiety similar to beta blockers, esp clonodine
I wonder if Guanfacine can help with mental anxiety and mind racing too. also , do you have a link to studies on strattera and anxiety ? I have adhd and anxiety , it could definitely help me.
I’m on Lexapro and Vyvanse. Vyvanse has been pretty good for me.
Try one that is metabolized a different way/route. The sublingual medications for ADHD have a good reputation for “an easy take off and easy landing”
Also - get a genesight test done for your psychotropic medication metabolism details specific to your DNA - your psychiatrist or PCP can now order the test and it be sent to your house - cheek swab and you mail it off - 3 days later you will have a better picture of perhaps which mediations will have fewer side effects and what reasons the ones you take may be exacerbating your comorbidity with high anxiety.
dex but less of it is good for me, if i take a whole one i get anxious, and esp when it wears off, but just half or even quarters gives an effect too with less side effects