Does Vyvanse help with anxiety?

In this article:

• How Vyvanse works
• ADHD and anxiety
• Vyvanse for anxiety
• Can Vyvanse cause anxiety?
• Alternatives
• The bottom line

In this article

• How Vyvanse works
• ADHD and anxiety
• Vyvanse for anxiety
• Can Vyvanse cause anxiety?
• Alternatives
• The bottom line

Many people who take Vyvanse for ADHD or binge eating disorder (BED) also live with anxiety, and might wonder how the medication might affect their symptoms. Vyvanse (lisdexamfetamine) is a central nervous stimulant (CNS) approved by the U.S. Food and Drug Administration (FDA) to treat attention deficit hyperactivity disorder (ADHD) in adults and children over six, as well as for moderate to severe binge eating disorder (BED) in adults. Because it’s a Schedule II controlled substance, Vyvanse has a high potential for misuse and dependence—especially when used outside of the prescribed guidelines.

While Vyvanse isn’t prescribed to treat anxiety, it can affect anxiety levels in different ways. For some, treating ADHD or BED with Vyvanse may actually reduce anxious feelings. For others, the stimulant effects can make anxiety worse. Understanding how Vyvanse and anxiety interact can help you and your healthcare provider find the right balance.

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How Vyvanse works in the brain

Vyvanse is a central nervous system stimulant approved to manage symptoms of attention deficit hyperactivity disorder (ADHD) and moderate to severe binge eating disorder (BED). ADHD symptoms often include trouble focusing, impulsivity, restlessness, and difficulties with executive functioning. BED, on the other hand, involves recurrent episodes of eating unusually large amounts of food accompanied by a feeling of loss of control.

Vyvanse works by boosting certain brain chemicals that help regulate attention and behaviour. “Vyvanse increases the levels of dopamine and norepinephrine in the brain, which work to improve attention, focus, and impulse control,” explains Jeffrey Ditzell, DO, a psychiatrist based in New York, New York.

However, this same mechanism can also influence anxiety. “Vyvanse, like other stimulants, increases what is called catecholamine activities in the brain, such as dopamine and norepinephrine, which can lead to increased arousal, restlessness, and anxiety in patients who are susceptible,” adds Consuelo Corazon Cagande-Maestrado, MD, a child and adult psychiatrist at Northwell Health.

Relationship between ADHD and anxiety

ADHD and anxiety frequently occur together, even though they’re distinct conditions. Research shows that anxiety affects about 18% of children with ADHD and more than half of adults with ADHD, suggesting that many people manage symptoms of both at once.

Because ADHD and anxiety share similar features, distinguishing between them can be challenging. “The main symptoms that overlap are fidgetiness or restlessness, inattention, and decreased concentration,” says Dr. Cagande-Maestrado. These similarities can make it difficult to tell whether someone’s difficulty focusing stems from ADHD, anxiety, or both.

 Treatment strategies also tend to overlap. “In general, the preferred approach for these patients is integrative, often combining medication, therapy, and behavioral or lifestyle changes to target both executive functioning and anxiety symptoms,” says Dr. Ditzell. He adds that treatment typically focuses on reducing ADHD symptoms while supporting overall nervous system regulation. Understanding how ADHD and anxiety interact can help guide safer, more effective use of meds like Vyvanse.

Can Vyvanse help with anxiety? 

Vyvanse is not approved by the FDA to treat anxiety, and providers generally don’t prescribe it for that reason. However, some people find that their anxiety improves once their primary condition, such as ADHD or binge eating disorder (BED), is effectively managed.

For instance, a small study on adults taking Vyvanse for BED found mixed results: while some participants experienced increased anxiety, others reported their anxiety improved alongside a reduction in binge eating episodes. Those who saw the greatest improvement in anxiety also tended to experience the most progress in controlling their eating behaviors.

 Dr. Ditzell notes that a similar effect can occur in people taking Vyvanse for ADHD. “Some patients with ADHD have reported significant reductions in anxiety symptoms while taking Vyvanse,” he explains. “For example, if an individual with ADHD experiences anxiety when they miss a work deadline due to an inability to concentrate and manage time effectively, then improvement in ADHD symptoms may result in a significant reduction of anxiety symptoms for that individual.”

Still, Vyvanse’s stimulant effects can have different impacts from person to person. While it may ease anxiety for some, it can intensify it for others. Understanding whether Vyvanse helps or worsens anxiety depends on individual brain chemistry, dosage, and the presence of coexisting conditions. Because of this, Vyvanse should not be used to treat anxiety on its own.

Although Vyvanse may help reduce anxiety in people with ADHD or binge eating disorder, “it can also worsen anxiety, as all stimulants can,” explains Dr. Cagande-Maestrado, MD. “So, it should not be used for treating anxiety alone.”

Can Vyvanse cause anxiety? 

Anxiety is a possible side effect of Vyvanse, particularly for people who are sensitive to stimulants or taking higher doses than prescribed. Because Vyvanse increases brain activity and raises levels of dopamine and norepinephrine, it can sometimes heighten physical or mental symptoms of anxiety.

Common side effects associated with overstimulation from Vyvanse include:

• Anxiety
• Trouble sleeping
• Irritability
• Increased blood pressure
• Jittery feelings
• Racing heart
• Dizziness
• Dry mouth
• Nausea
• Digestive issues like constipation or diarrhea
• Weight loss
• Decreased appetite or loss of appetite

Still, serious anxiety is relatively uncommon. “The benefits over risks need to be considered with each case,” Dr. Cagande-Maestrado explains.“The increased anxiety is dose-dependent, meaning the higher the dose of a stimulant is, the greater the risk for worsening anxiety.” Adjusting Vyvanse dosage under medical supervision often helps to reduce these symptoms.

Certain individuals are more prone to stimulant-related anxiety. “For some people, particularly for those without a diagnosis of ADHD, or whose nervous system is already overactive as a result of trauma, stimulants can exacerbate anxiety symptoms by increasing heart rate, triggering racing thoughts or restlessness, causing panic, or disrupting sleep,” notes Dr. Ditzell.

People with mental health conditions such as generalized anxiety disorder (GAD), panic disorder, or trauma-related disorders may be more likely to have anxiety on Vyvanse. If you experience anxiety on Vyvanse, small adjustments to dosage, timing, or complementary treatments can make a meaningful difference.

How to manage anxiety alongside ADHD

For people living with anxiety and ADHD, there are several effective ways to manage symptoms and improve overall functioning. The best approach depends on which condition is more prominent and how the two interact.

When ADHD symptoms are the main source of distress, clinicians typically start by treating ADHD first. Stimulant medications like Vyvanse, Adderall (amphetamine dextroamphetamine), and Ritalin (methylphenidate) are first-line treatments. “If anxiety symptoms are severe, the treatment plan would be to stabilize anxiety first before introducing stimulant medications to address the symptoms of ADHD,” Dr. Ditzell explains. If stimulant drugs make your anxiety worse, other ADHD options can be explored.

Non-stimulant medications include:

• Strattera (atomoxetine)
• Intuniv (guanfacine)
• Kapvay (clonidine)
• Wellbutrin (bupropion)

For the most successful results, medication is often combined with therapy and lifestyle interventions. Dr. Cagande-Maestrado, MD, recommends the following complementary strategies:

• Cognitive behavioral therapy (CBT): A primary treatment for anxiety that can also help people with ADHD manage attention and emotional regulation.
• Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs): These can reduce anxiety and often can be used alongside ADHD medication, though people need to be monitored for side effects.
• Lifestyle modifications: Changes such as eating a balanced diet, engaging in regular physical exercise, and mindfulness and breathing exercises help with ADHD, anxiety, and overall well-being.

The bottom line

Vyvanse isn’t approved to treat anxiety and isn’t recommended for use on its own for that purpose. However, when prescribed for conditions like ADHD or binge eating disorder, some people find that their anxiety improves as their underlying symptoms become better managed. 

That said, stimulants such as Vyvanse can also heighten anxiety in certain individuals, particularly those who already live with an anxiety disorder. Because everyone’s response is different, it’s crucial to work closely with a qualified healthcare provider, such as a psychiatrist, who can evaluate your symptoms, consider your medical history, and monitor your progress throughout treatment.

A personalized treatment plan, which may include medication, therapy, and lifestyle changes, offers the safest and most effective path toward managing both ADHD and anxiety.