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"My 18-year-old becomes very anxious as her long-acting stimulant wears off. She asked about taking a higher dose. What do you think is going on here?"
The anxiety might be a rebound effect, which sometimes happens as medication wears off, or it might be her reaction to the return of her symptoms (especially if it wears off during class or at another inconvenient time).
You may want to discuss a dose increase with her doctor. See if this lasts longer and doesn't cause anxiety. One other caution: If your daughter has an anxiety disorder [see "When AD/HD Is Only Part of the Story"], the stimulant could be exacerbating this. If so, this condition must be treated in addition to AD/HD.
Larry Silver, M.D., is the author of Dr. Larry Silver's Advice to Parents on AD/HD and The Misunderstood Child: Understanding and Coping with Your Child's Learning Disabilities. He is also a clinical professor of psychiatry at Georgetown Medical Center in Washington, D.C.