Stimulants May Actually Lower Anxiety in Kids With ADHD

the Psychiatry Advisor take:

While there have been reports that the use of stimulants in the treatment of attention-deficit/hyperactivity disorder (ADHD) is associated with anxiety in some people, a meta-analysis has found the opposite is true: The drugs may actually lower the risk of anxiety.

Catherine Coughlin, PhD, Michael Bloch, MD, both of Yale University, New Haven, Conn., and colleagues reviewed 23 studies involving nearly 3,000 kids with ADHD. A fixed-effects meta-analysis was performed to examine the risk ratio of anxiety reported as a side effect in children treated with psychostimulants compared with those treated with placebo.

The risk of anxiety associated with stimulant treatment was significantly lower than that experienced with placebo, the researchers reported in the Journal of Child and Adolescent Psychopharmacology.  Also, higher doses of stimulants were associated with a reduced measured risk of anxiety of stimulants when compared with placebo.

While the researchers say that the results don't mean there aren't any children who experience anxiety with stimulants, those risks are outweighed by the number of adolescents who seen an improvement in symptoms of anxiety, perhaps as a result of an improved in ADHD symptoms.

“Clinicians should consider rechallenging children with ADHD who report new-onset or worsening anxiety with psychostimulants, as these symptoms are much more likely to be coincidental rather than caused by psychostimulants,” the researchers conclude.