What neurotransmitters are involved in ADHD-related mood swings?

PostedOctober 28, 2025

UpdatedOctober 29, 2025

ByMy Patient Advice

Author: Phoebe Carter, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Mood swings are a common challenge for individuals with ADHD, marked by intense emotional reactions and rapid shifts in mood. These fluctuations are primarily driven by dysregulation in key neurotransmitters, dopamine and norepinephrine, which are essential for emotional regulation, attention, and motivation. According to NICE NG87 and RCPsych, understanding the role of these neurotransmitters is key to addressing mood instability in ADHD.

The role of neurotransmitters in mood regulation

In ADHD, dopamine and norepinephrine act as chemical messengers that influence the prefrontal cortex (self-regulation) and the limbic system (emotion processing). Dopamine dysregulation leads to poor control over emotional responses, making individuals more reactive to stress, frustration, or perceived failure. Norepinephrine helps with attention and stress regulation, and imbalanced norepinephrine can contribute to impulsivity and emotional reactivity. Both contribute to mood swings and emotional dysregulation (NHS ADHD in Adults, 2025, RCPsych ADHD in Adults, 2025).

While dopamine and norepinephrine are the primary players, serotonin also plays a role. Serotonin interacts with dopamine systems, affecting emotional stability, especially for comorbid anxiety and irritability. NICE NG87 highlights serotonin’s involvement, although it is less central than dopamine and norepinephrine in regulating emotional reactivity in ADHD.

Clinical evidence supporting neurotransmitter dysregulation

Recent research shows that dopamine transporter dysfunction in ADHD leads to impaired reward processing and increased emotional volatility. Studies from PubMed (2025) confirm that norepinephrine dysfunction contributes to emotional overwhelm and mood swings (PubMed, 2025).

Neuroimaging studies confirm reduced dopamine activity in key brain areas that regulate emotion control, which leads to mood lability and impulsivity (Frontiers in Psychiatry, 2025).

Treatment Approaches Targeting Neurotransmitter Balance

Approach	Mechanism	Evidence Source
Stimulant medications (methylphenidate, lisdexamfetamine)	Increase dopamine/norepinephrine availability, improving mood stability	NICE NG87 (2025); Right Decisions NHSL, 2024
Non‑stimulant medications (atomoxetine, guanfacine)	Target norepinephrine pathways to reduce emotional reactivity	NICE NG87, 2025
Psychological therapies (CBT, DBT, mindfulness)	Strengthen self-regulation, emotional awareness, and coping strategies	RCPsych ADHD in Adults, 2025

Takeaway

The key neurotransmitters involved in ADHD-related mood swings; dopamine, norepinephrine, and serotonin, significantly affect emotional regulation and impulsivity. Dysregulation of these neurotransmitters leads to heightened emotional reactions, irritability, and mood swings. Medication, especially stimulants and non-stimulants, can help restore balance and improve emotional control. Complementary therapies like CBT, DBT, and mindfulness enhance self-regulation and coping mechanisms, supporting overall emotional stability. Effective management of mood swings requires a combination of pharmacological treatment, therapy, and lifestyle adjustments to support long-term emotional wellbeing.

Phoebe Carter, MSc

Author

Phoebe Carter is a clinical psychologist with a Master’s in Clinical Psychology and a Bachelor’s in Applied Psychology. She has experience working with both children and adults, conducting psychological assessments, developing individualized treatment plans, and delivering evidence-based therapies. Phoebe specialises in neurodevelopmental conditions such as autism spectrum disorder (ASD), ADHD, and learning disabilities, as well as mood, anxiety, psychotic, and personality disorders. She is skilled in CBT, behaviour modification, ABA, and motivational interviewing, and is dedicated to providing compassionate, evidence-based mental health care to individuals of all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.