Do meds ever worsen anxiety temporarily?

Yes, this can happen, especially early in treatment or during dose changes. Stimulants can increase alertness, which some people experience as tension or anxiety at first. For many, this settles as the nervous system adjusts. Clinicians monitor closely and adjust dose, timing, or medication type if anxiety persists. Importantly, untreated ADHD itself often causes chronic anxiety, so long term anxiety may actually improve once regulation stabilizes. Temporary tension does not automatically mean meds are the wrong choice, but it should always be discussed.