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Using Wellbutrin For ADHD
Wellbutrin is an antidepressant that doctors sometimes prescribe off-label for people with attention deficit hyperactivity disorder (ADHD). Doctors usually prescribe stimulant drugs, such as Ritalin, Concerta, or Vyvanse, for ADHD. However, not everyone can tolerate these stimulant medications. This article shall look to explore using Wellbutrin for ADHD.
Non-stimulant treatments, such as Wellbutrin, are common alternatives that doctors can prescribe to people with ADHD. Wellbutrin is an antidepressant that researchers have tested for the treatment of ADHD in adults.
Wellbutrin (bupropion) is an antidepressant sometimes prescribed off-label to treat attention deficit/hyperactivity disorder (ADHD). Although stimulants are a typical first-line treatment, taking Wellbutrin for ADHD has been found to improve symptoms without exposing patients to stimulants’ adverse effects, also providing an alternative for the one in five people who don’t respond to that category of drugs.
In certain instances, people may be prescribed both a stimulant and Wellbutrin for ADHD. If a person with ADHD also has depression, for example, a clinician might prescribe Wellbutrin in conjunction with a stimulant such as Adderall (amphetamine and dextroamphetamine) or Ritalin (methylphenidate) to treat both conditions at the same time.
How Wellbutrin Works for ADHD
Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI). It helps improve concentration and focus by keeping the neurotransmitters norepinephrine and dopamine available to the brain’s neurons for a longer time. Wellbutrin does not influence serotonin, so it works differently than many other types of antidepressants.
Effectiveness
Studies of Wellbutrin’s effectiveness are ongoing but generally positive about ADHD. One review of the research found that Wellbutrin showed potential benefits for treating adult ADHD.
One review of recent research found that Wellbutrin decreased the severity of ADHD better than a placebo. Other studies have been promising, too, with many indicating that Wellbutrin works as well for some people as a stimulant.
For this reason, many clinicians continue to prescribe Wellbutrin as an off-label treatment for ADHD.
Off-label treatment is the practice of prescribing a medication for a condition other than that for which the FDA originally approved it. It’s a common, legal practice. For example, Wellbutrin XL is FDA-approved to treat depression and seasonal affective disorder (SAD), and the SR form is approved for depression and smoking cessation, but clinicians often prescribe these medications off-label for ADHD.
How Long Does It Take to See Results?
In contrast to stimulant medication, which starts to work in about an hour, like other antidepressants, Wellbutrin can take several days to produce noticeable benefits and up to six weeks to reach full effect. This means it can take several weeks to find the most effective therapeutic dose.
Why Take Wellbutrin for ADHD?
Although stimulants are the most effective treatment for ADHD, your doctor might prescribe a non-stimulant, second-line medication like Wellbutrin for a few reasons:
- Effectiveness: Not everyone who takes stimulant medication experiences changes in their ADHD traits.
- History of medical conditions: Sometimes, an underlying medical condition makes the use of stimulant medications problematic. Such conditions include heart problems, sleep disorders, and psychiatric conditions such as substance use disorder and bipolar disorder.
- Tolerance: Some people do not tolerate stimulant medications and experience severe side effects.
Other non-stimulant medications for ADHD include Strattera (atomoxetine) and Catapres (clonidine).
Wellbutrin and Smoking Cessation
Wellbutrin and Zyban are brand names for bupropion. Wellbutrin has been approved by the FDA as an antidepressant, and Zyban has been approved to help people stop smoking.8 If you smoke cigarettes and are prescribed Wellbutrin, you might find that it also helps you cut back or quit. It does not contain nicotine, but some people who smoke report that it decreases their desire to smoke.
How to Take Wellbutrin for ADHD
Wellbutrin is available as a tablet that you can take with or without food. Swallow the tablet whole, without crushing or breaking it.
Don’t take more than your prescribed dose; doing so raises your risk of seizures and other side effects. If you have trouble remembering when to take Wellbutrin, set an alarm on your phone or clock, use a pillbox, or ask a friend or family member to remind you.
Forms of Wellbutrin
Wellbutrin comes in three formulations, all in tablet form:
- Wellbutrin (bupropion): Immediate release, taken two to three times daily
- Wellbutrin SR (bupropion SR): 12-hour extended release, taken twice per day
- Wellbutrin XL (bupropion XL): 24-hour extended release, taken once per day
Wellbutrin SR and Wellbutrin XL are time-release formulations. This means the drug is slowly released into the body over many hours and stays at a consistent level in the blood. The SR formulation lasts 12 hours and is taken twice a day, while the XL version lasts 24 hours and is taken once a day. Taking the XL version can help a person comply with the dosing regimen because there is less opportunity to miss a dose.
Doctors most commonly prescribe Wellbutrin XL so that it’s most effective throughout the day and the possibility of side effects is reduced. Generic versions are available and cost less than Wellbutrin.
Don’t stop taking Wellbutrin abruptly. Although this medication is not habit-forming, stopping suddenly can cause withdrawal symptoms such as irritability, anxiety, achiness, and sleeplessness.11 Instead, talk with a healthcare provider first; they will likely decrease your dose safely and gradually to help you avoid withdrawal symptoms.
Wellbutrin Dosages for ADHD
A typical daily dose is around 150 mg per day, although the starting dose is often lower.
For ADHD, clinical trials suggest that a dose of between 150 mg and 450 mg per day can be helpful. Your doctor will start you at a low dose and gradually increase it over time until the maximum efficacy has been achieved.
For smoking cessation or depression, the typical dose is 300 mg daily, split into 100 mg doses taken three times daily. The sustained-release formulation is usually taken as a 150 mg dose once or twice daily. The extended-release formulation is taken as a 300 mg dose once per day.
The maximum daily dose of Wellbutrin is 450 mg per day. A single dose of immediate-release or sustained-release Wellbutrin should not exceed 150 mg.
Wellbutrin Side Effects
People taking Wellbutrin, Wellbutrin SR, and Wellbutrin XL have reported:
- Agitation
- Anxiety
- Constipation
- Dizziness
- Dry mouth
- Excitement
- Headaches
- Increased motor activity
- Insomnia
- Joint aches
- Nausea
- Tics
- Tremors
There is also a risk of seizures in people who are susceptible to them or who have a history of eating disorders.
Notably, Wellbutrin is much less apt to cause sexual side effects such as erectile dysfunction and decreased libido than other antidepressants.
Wellbutrin Warnings and Interactions
All drugs have risks, which clinicians weigh against benefits when they prescribe them. Wellbutrin is no exception.
Warnings
Like other antidepressants, Wellbutrin carries the FDA’s black-box warning for the increased risk of suicidal thoughts or behaviors in children, teens, and young adults.
Wellbutrin hasn’t been tested adequately in children or adolescents, so the FDA has not formally approved it for pediatric use; however, existing research indicates it’s safe, effective, and well-tolerated in these groups,15 so clinicians frequently prescribe it.
You should not take Wellbutrin if you have an eating disorder, angle-closure glaucoma, or seizure disorder. Wellbutrin may also increase the risk of manic, hypomanic, or mixed-mood episodes in people who have bipolar disorder. If you have a history of kidney or liver problems, your doctor may suggest taking a lower dose. Older adults with reduced kidney function may also require lower doses.
Studies on Wellbutrin’s effects on human pregnancy are lacking, but animal studies suggest that this drug may affect fetal development. Wellbutrin is passed into breast milk, but current research, although limited, suggests it’s not harmful to nursing babies.
As a result, Wellbutrin is generally not contraindicated if you’re nursing,16 but as with any medication, you and your doctor must weigh possible risks against benefits. If you’re pregnant, trying to become pregnant, or breastfeeding, talk with a healthcare provider about your options.
Wellbutrin has not been found to worsen ADHD, but you should talk to your doctor if you begin to notice any concerning changes.
Always discuss the benefits and risks of Wellbutrin (or any medication) with your healthcare provider and inform them of any side effects you experience while taking it.
Interactions
Wellbutrin is known to interact with about 100 other drugs, so make sure to tell your healthcare provider about any other drugs you take. For example, you risk severe effects if you take Wellbutrin with:
- Eliglustat
- Isocarboxazid
- Phenelzine
- Pimozide
- Rasagiline
- Selegiline
- Selegiline transdermal
- Tranylcypromine
Also, be sure to tell your doctor if you are currently taking any other medication that also contains bupropion in order to avoid overdose. This includes the smoking cessation medication Zyban and Contrave, a weight-loss medication containing bupropion and naltrexone.
Drinking alcohol while taking Wellbutrin increases your risk for seizures and suicidal thoughts.
I hope you find this article helpful.
