Who’s on First? Case Report on Prioritizing Treatment for Comorbid Attention-Deficit/Hyperactivity and Anxiety Disorders

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Published Oct 22, 2024
DOI: https://doi.org/10.18103/mra.v12i10.5906

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Main Article Content

Kelly C. Lee, Pharm.D., MAS, BCPP
Professor of Clinical Pharmacy and Associate Dean, University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA
Natasha Bilinsky
Research Assistant, University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA
Jamie Kneebusch, Pharm.D., BCPS, BCPP
Assistant Clinical Professor, University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA

Abstract

Early and optimal treatment of attention-deficit/hyperactivity disorder (ADHD) has been shown to prevent comorbid conditions. Unfortunately, due to delayed diagnosis or treatment of ADHD, psychiatric comorbidities often emerge that can also result in more disabling symptoms. Stimulants remain the gold standard for treatment of ADHD whereas serotonergic antidepressants are first line for anxiety disorders. Treatment of patients with ADHD and anxiety disorders presents a clinical conundrum due to the potential for stimulants to worsen anxiety symptoms. Many clinicians may defer treating ADHD initially and treating the anxiety disorder first. Unfortunately, untreated ADHD may worsen anxiety symptoms and expose patients to long-term treatment with anxiolytics that may be unnecessary. In this Clinical Case Discussion, we present the clinical and pathophysiological overlap between ADHD and anxiety disorders along with a clinical case. We present how a complete evaluation of the patient, including disturbance of symptoms on functioning and symptom onset, may help prioritize treatment strategies. Despite the reluctance to prescribe stimulants especially to adults due to stimulant misuse and exacerbation of other disorders, it may be optimal to treat ADHD first in order to reduce other manifestations.

Keywords: attention-deficit, hyperactivity, ADHD, anxiety, insomnia

Article Details

How to Cite
LEE, Kelly C.; BILINSKY, Natasha; KNEEBUSCH, Jamie. Who’s on First? Case Report on Prioritizing Treatment for Comorbid Attention-Deficit/Hyperactivity and Anxiety Disorders. Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5906>. Date accessed: 22 dec. 2024. doi: https://doi.org/10.18103/mra.v12i10.5906.
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Issue
Vol 12 No 10 (2024): October Issue, Issue 10, VOl.12
Section
Case Reports

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