What is the role of antidepressants in treating emotional symptoms of ADHD?

PostedOctober 29, 2025

UpdatedOctober 29, 2025

ByMy Patient Advice

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

People with ADHD often experience intense emotions, from frustration and irritability to low mood and anxiety. While antidepressants are not a first-line treatment for ADHD, they can be helpful when emotional symptoms or coexisting conditions such as depression or anxiety are present.

When antidepressants are used in ADHD

Antidepressants may be considered when ADHD is accompanied by depression, anxiety, or emotional dysregulation that doesn’t respond fully to stimulants or non-stimulant medication.
The Cleveland Clinic (2024) notes that medications such as SSRIs (like sertraline) or atypical antidepressants (like bupropion) can help manage co-occurring emotional symptoms, particularly when irritability or rejection sensitivity persist despite standard ADHD treatment.

NHS and NICE guidance

The NICE ADHD guideline (NG87) does not recommend antidepressants as a core ADHD treatment. However, it acknowledges that coexisting depression or anxiety should be identified and treated separately — often with talking therapies or antidepressants.
Similarly, NHS guidance explains that emotional and mental health conditions are common in ADHD, and treatment may involve antidepressants alongside behavioural support and CBT.

What research says

A PubMed (2023) review found that bupropion (Wellbutrin) improved mood regulation and irritability in adults with ADHD, with some benefit to focus and motivation.
Meanwhile, Frontiers in Psychiatry (2024) reported that combining SSRIs with ADHD medications reduced anxiety and emotional volatility in adolescents, though these drugs had little direct impact on inattention or hyperactivity.

The Royal College of Psychiatrists (RCPsych) and Mayo Clinic both highlight that antidepressants can support emotional stability when low mood or anxiety co-occur with ADHD, but they should be used alongside ADHD medication, not instead of it.

Bupropion and other off-label options

Some antidepressants, such as bupropion or duloxetine, act on both dopamine and norepinephrine, neurotransmitters also involved in ADHD.
Research published in The Lancet Psychiatry (2024) found that bupropion produced modest improvements in motivation and emotional self-regulation, but requires monitoring for side effects such as insomnia or anxiety. It is not licensed for ADHD in the UK, so is prescribed off-label in select adult cases.

Safety and monitoring

Antidepressants can cause temporary side effects, including sleep disturbance, anxiety, or irritability, especially early in treatment.
The RCPsych advises careful monitoring, particularly for young people, due to the small risk of agitation or suicidal thoughts during the first few weeks.

Takeaway

Antidepressants are not prescribed for ADHD itself but can be valuable when emotional symptoms, depression, or anxiety are part of the picture. SSRIs, SNRIs, or bupropion may be added alongside ADHD medication and therapy to help improve mood stability and reduce stress reactivity.
If you’re living with ADHD and notice persistent low mood or anxiety, speak to your GP with the right combination of treatment and support, emotional wellbeing can improve alongside attention and focus.

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.