how do psychiatrists think about ADHD meds when someone also has panic episodes?

This is such a valid concern. A lot of adults with ADHD also experience anxiety or panic, so this is something clinicians think about carefully. Stimulants can sometimes increase physical sensations like a faster heart rate or jitteriness, which for someone prone to panic can feel triggering. That said, untreated ADHD can also worsen anxiety because of constant overwhelm and feeling behind. Psychiatrists usually go slowly. They may start with a low dose, monitor closely, or consider non stimulant options. Sometimes treating ADHD actually reduces panic because the nervous system feels less chaotic. It is very individualized, and safety and comfort always come first.