Can Lexapro make ADHD worse?
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
Can Lexapro make ADHD worse?
Lexapro doesn’t necessarily make your ADHD worse and it is not something prescribed for ADHD. Lexapro is an antidepressant which has no activity against the symptoms associated with ADHD. (1)
However, some people may take this antidepressant with other medications for the management and treatment of ADHD comorbid with depression. Even in that case, most doctors adjust the dose and timings of these meds to ensure safe and effective treatment.
Lexapro is associated with some early side effects, which may make people think that their ADHD is getting worse (1). Most of the early side effects of Lexapro begin to subside within a few weeks of your treatment.
However, every individual is unique and some people may not function well on Lexapro. Make sure you only take this antidepressant if your mental healthcare professional has prescribed it.
If you feel unusual on this med, reach out to your doctor. Don’t make any changes to your prescription on your own.
What does research suggest?
Research studies have explored the use of Lexapro in individuals with ADHD, but the findings have been mixed. SSRIs, in general, have not been specifically approved by regulatory authorities for treating ADHD (2).
However, some studies have examined its effects in managing ADHD symptoms. The impact of Lexapro on ADHD symptoms can vary among individuals.
While some studies suggest that Lexapro may provide modest improvements in certain aspects of ADHD, such as reducing anxiety or irritability associated with ADHD (3), other studies have not shown consistently positive effects on core ADHD symptoms like inattention, hyperactivity, and impulsivity (2).
It’s important to note that treating ADHD typically involves a comprehensive approach that may include behavioural interventions, counselling, and, in many cases, stimulant medications like methylphenidate or amphetamines (4).
These stimulant medications are considered the first-line treatment for ADHD due to their well-established effectiveness in improving attention and reducing hyperactivity and impulsivity. Antidepressants like Lexapro, Celexa, or Zoloft are not generally prescribed for ADHD.
What to do if you are concerned about taking Lexapro while having ADHD?
If you or someone you know is concerned about taking Lexapro while having ADHD, it’s crucial to consult with a healthcare provider.
They can evaluate your specific situation, discuss the potential benefits and risks of using Lexapro, and help determine the most appropriate treatment approach for managing ADHD symptoms.
Your healthcare provider will consider factors such as the severity of ADHD symptoms, co-existing conditions, individual response to medications, and the overall treatment goals.
Suitable treatment strategies for ADHD
There are several treatment strategies for ADHD, including:
Medication
Stimulant medications, such as methylphenidate (Ritalin) or amphetamines (Adderall), are commonly prescribed to manage ADHD symptoms. These medications help improve attention, reduce impulsivity, and decrease hyperactivity (5).
Non-stimulant medications like Atomoxetine (Strattera) may be recommended for individuals who cannot tolerate or do not respond well to stimulants. (6)
Behavioural Therapy
Behavioural therapy plays a crucial role in managing ADHD. It involves teaching individuals with ADHD skills to improve organization, time management, and task completion. (7)
Techniques like goal-setting, creating routines, and using rewards or consequences can help individuals develop effective strategies for coping with their symptoms.
Psychoeducation
Educating individuals with ADHD and their families about the disorder is essential. Learning about ADHD, its symptoms, and how it affects daily life can help individuals understand themselves better and develop strategies for success. (8)
Psychoeducation also helps family members provide appropriate support and create an environment that promotes positive behaviour.
Parent training
Parent training programs can equip parents with techniques and strategies to effectively manage their child’s ADHD symptoms (9).
These programs focus on promoting positive behaviour, setting clear expectations, implementing consistent routines, and fostering effective communication within the family.
It’s important to remember that treatment for ADHD should be personalized to meet individual needs. A combination of medication, therapy, and supportive strategies often yields the best results.
Working closely with healthcare professionals, including doctors, therapists, and educators, can help develop a comprehensive treatment plan that addresses specific symptoms and improves overall functioning.
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References
1.-
Landy K, Rosani A, Estevez R. Escitalopram. 2022 Oct 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32491666. https://www.ncbi.nlm.nih.gov/books/NBK557734
2.-
Popper CW. Antidepressants in the treatment of attention-deficit/hyperactivity disorder. J Clin Psychiatry. 1997;58 Suppl 14:14-29; discussion 30-1. PMID: 9418743. https://pubmed.ncbi.nlm.nih.gov/9418743/
3.-
Lenze EJ, Dixon D, Nowotny P, Lotrich FE, Doré PM, Pollock BG, Hinrichs AL, Butters MA. Escitalopram reduces attentional performance in anxious older adults with high-expression genetic variants at serotonin 2A and 1B receptors. Int J Neuropsychopharmacol. 2013 Mar;16(2):279-88. doi: 10.1017/S1461145712000351. Epub 2012 Apr 17. PMID: 22717018; PMCID: PMC3967864. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967864/
4.-
Groom MJ, Cortese S. Current Pharmacological Treatments for ADHD. Curr Top Behav Neurosci. 2022;57:19-50. doi: 10.1007/7854_2022_330. PMID: 35507282. https://pubmed.ncbi.nlm.nih.gov/35507282/
5.-
Arnsten AF. Stimulants: Therapeutic actions in ADHD. Neuropsychopharmacology. 2006 Nov;31(11):2376-83. doi: 10.1038/sj.npp.1301164. Epub 2006 Jul 19. PMID: 16855530. https://pubmed.ncbi.nlm.nih.gov/16855530/
6.-
Garnock-Jones KP, Keating GM. Atomoxetine: a review of its use in attention-deficit hyperactivity disorder in children and adolescents. Paediatr Drugs. 2009;11(3):203-26. doi: 10.2165/00148581-200911030-00005. PMID: 19445548. https://pubmed.ncbi.nlm.nih.gov/19445548/
7.-
Lopez PL, Torrente FM, Ciapponi A, Lischinsky AG, Cetkovich-Bakmas M, Rojas JI, Romano M, Manes FF. Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev. 2018 Mar 23;3(3):CD010840. doi: 10.1002/14651858.CD010840.pub2. PMID: 29566425; PMCID: PMC6494390. https://pubmed.ncbi.nlm.nih.gov/29566425/
8.-
Powell LA, Parker J, Weighall A, Harpin V. Psychoeducation Intervention Effectiveness to Improve Social Skills in Young People with ADHD: A Meta-Analysis. J Atten Disord. 2022 Feb;26(3):340-357. doi: 10.1177/1087054721997553. Epub 2021 Mar 5. PMID: 33666104; PMCID: PMC8785297. https://pubmed.ncbi.nlm.nih.gov/33666104/
9.-
Morgan TC, O’Keefe LC. Does a Behavioral Parent Training Program for Parents of ADHD Children Improve Outcomes? A Pilot Project. Compr Child Adolesc Nurs. 2021 Jun 15:1-11. doi: 10.1080/24694193.2021.1933263. Epub ahead of print. PMID: 34130566. https://pubmed.ncbi.nlm.nih.gov/34130566/
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