Treating ADHD With Wellbutrin

Wellbutrin (bupropion) is an antidepressant sometimes prescribed to adults with attention-deficit/hyperactivity disorder (ADHD). Although stimulants are the first-line treatment for ADHD symptoms such as impulsivity, hyperactivity, and inattentiveness, second-line treatments such as Wellbutrin are more appropriate for some people.

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), or alone to address both conditions.

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 with regard to ADHD. One review of recent research found that, overall, Wellbutrin decreased the severity of symptoms better than a placebo. Other studies have been promising, too, with many indicating that Wellbutrin works as well for some people as stimulants. For this reason, many clinicians continue to prescribe Wellbutrin as an off-label treatment for ADHD.

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 finds relief from their ADHD symptoms.
• 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).

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 (buproprion): Immediate release, taken two to three times daily
• Wellbutrin SR (buproprion SR): 12-hour extended release, taken twice per day
• Wellbutrin XL (buproprion 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. A typical daily dose is around 150 mg per day, although the starting dose is often lower. The upper dosage limit is 400 mg per day.

Generic versions are available and cost less than Wellbutrin.

Stopping 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. Instead, talk with a healthcare provider first; they will likely decrease your dose safely and gradually to help you avoid withdrawal symptoms.

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.

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, so clinicians frequently prescribe it.

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, 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.

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

Drinking alcohol while taking Wellbutrin increases your risk for seizures.

A Word From Verywell

Although Wellbutrin is not a first-line medication for ADHD, it can be helpful in treating ADHD symptoms, particularly if you have coexisting conditions such as depression or anxiety. If you are interested in Wellbutrin as part of your ADHD treatment, discuss it with a healthcare provider to decide if it is a good option for you.