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Medication Options for RSD

10 min read

Important: This information is educational only and not a substitute for professional medical advice. Always consult with a qualified healthcare provider before starting, changing, or stopping any medication.

While there's no medication specifically for RSD, several medications can help reduce rejection sensitivity. Most work by treating underlying ADHD, anxiety, or depression, which often reduces RSD symptoms as well.

ADHD Medications

If your RSD is connected to ADHD, treating the ADHD often helps with rejection sensitivity:

Stimulants (Methylphenidate, Amphetamines)

Examples: Ritalin, Concerta, Adderall, Vyvanse, Elvanse

How they may help

  • • Improve emotional regulation
  • • Reduce impulsive reactions
  • • Help with rumination and spiral thinking
  • • Increase dopamine (which RSD brains lack)

Considerations

  • • Some people experience emotional blunting
  • • May increase anxiety in some
  • • Effects wear off when medication does
  • • Requires titration to find right dose

Non-Stimulants

Examples: Atomoxetine (Strattera), Guanfacine (Intuniv), Clonidine

How they may help

  • • Alpha-2 agonists (guanfacine) specifically noted for emotional dysregulation
  • • 24-hour coverage (unlike stimulants)
  • • May work better for emotional symptoms
  • • Can be combined with stimulants

Considerations

  • • Take longer to work (weeks rather than hours)
  • • Side effects differ from stimulants
  • • May cause sedation
  • • Less effective for attention symptoms

Other Medications That May Help

Antidepressants

SSRIs, SNRIs - Examples: Sertraline, Fluoxetine, Venlafaxine, Duloxetine

  • May reduce anxiety and depression that amplifies RSD
  • Some people report reduced emotional sensitivity
  • Take 4-6 weeks to show full effects

Mood Stabilisers

Examples: Lamotrigine, Lithium (in specific cases)

  • May help with emotional volatility
  • Sometimes used when mood swings are prominent
  • Usually considered after other options

MAOIs (Rarely)

Specifically mentioned by Dr. William Dodson as particularly effective for RSD

  • Some evidence for effectiveness specifically in RSD
  • Significant dietary restrictions required
  • Drug interactions are serious concern
  • Usually only considered when other treatments haven't worked

Working with Your Doctor

1

Describe symptoms specifically

Don't just say "I have RSD." Describe what happens: emotional flooding, rumination, physical pain, duration.

2

Mention ADHD connection

If you have ADHD, make sure your doctor understands RSD is often part of it.

3

Track your symptoms

Keep a log of RSD episodes - triggers, intensity, duration. This helps guide treatment.

4

Be patient with trials

Finding the right medication often takes several attempts. This is normal.

5

Report side effects

Some medications may make emotional symptoms worse initially. Communicate openly.

6

Consider combination approaches

Medication often works best alongside therapy and lifestyle changes.

Medication Is One Tool Among Many

Medication can be incredibly helpful for RSD, but it's rarely the complete answer. Combining medication with therapy, self-help strategies, and lifestyle changes usually provides the best results. Work with your healthcare team to find what works for you.