October 21, 2015
Anxiety Not Always Barrier to Using Stimulants for
Pediatric ADHD

New Haven, CT—Although anxiety has been reported as a side effect of psychostimulant medication, a large new research review suggests that is not the case and proposes that anxiety shouldn’t always preclude use of the drugs to treat attention-deficit hyperactivity disorder (ADHD).

In fact, the meta-analysis of research involving nearly 3,000 children with ADHD, which was published recently in the Journal of Child and Adolescent Psychopharmacology, finds that the stimulants actually reduce the risk of anxiety. The study team, led by Yale University researchers, notes that patient reports of new-onset or worsening anxiety with the use of psychostimulants are not likely due to the medications and should not preclude use of the therapy.

For the study, the researchers conducted a PubMed search to identify all double-blind, randomized, placebo-controlled trials examining the efficacy of psychostimulant medications in the treatment of children with ADHD. With the selection of 23 studies involving 2,959 children with ADHD for inclusion in the meta-analysis, the risk of anxiety associated with psychostimulant treatment was found to be significantly lower than that experienced with placebo, relative risk of 0.86. In addition, the results indicate, higher doses of psychostimulants were associated with a reduced measured risk of anxiety when compared with placebo.

“This finding does not rule out the possibility that some children experience increased anxiety when treated with psychostimulants, but suggests that those risks are outweighed by the number of children who experience improvement in anxiety symptoms (possibly as a secondary effect of improved control of ADHD symptoms),” study authors write. “Clinicians should consider re-challenging 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 posit that, instead of having a direct effect in reducing anxiety, ADHD therapy indirectly reduce anxiety symptoms by improving the patients’ symptoms.

“Improving ADHD symptoms in children with ADHD, likely decreases the number of anxiogenic situations they experience; children with ADHD successfully treated with psychostimulants experience fewer academic problems and peer and parental conflict that may cause them anxiety,” study authors explain.

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