Wellbutrin (Bupropion) for Anxiety: Expert Guidance

Whether you've been diagnosed with an anxiety disorder or think you may be experiencing anxiety, medication can be an effective part of your treatment plan. Wellbutrin is a medication most often used to treat depression, but in some cases, doctors may prescribe it for anxiety symptoms.

At Next Step Psychiatry in Lilburn, we help patients throughout the Atlanta metro area find the right treatment approach for their mental health needs. Here's what you should know about Wellbutrin and anxiety.

What Is Wellbutrin and How Does It Work?

Wellbutrin is the brand name for bupropion, an "atypical" antidepressant that belongs to a class called aminoketones. Unlike SSRIs and SNRIs that primarily affect serotonin, Wellbutrin works by increasing levels of dopamine and norepinephrine in the brain—two neurotransmitters that help regulate mood.

FDA-Approved Uses

• Major depressive disorder (MDD)
• Seasonal affective disorder (SAD)
• Smoking cessation (under the brand name Zyban)

Off-Label Uses

Wellbutrin is sometimes prescribed off-label for:

• ADHD
• Anxiety symptoms
• Depressive episodes in bipolar disorder

Is Wellbutrin Good for Anxiety?

Using Wellbutrin for anxiety is considered an "off-label" use, meaning the FDA has not specifically approved it for this purpose. However, research suggests it may be helpful for some patients:

• A 2023 review concluded that bupropion may be a good option for people with generalized anxiety disorder (GAD) who don't respond to other medications like SSRIs
• A 2008 pilot study showed promising results for bupropion in treating anxiety
• Research has found that bupropion helped reduce anxiety symptoms in people with major depressive disorder

Does Wellbutrin Make Anxiety Worse?

There's been a long-held belief that Wellbutrin might worsen anxiety because it increases norepinephrine levels. However, a 2023 study found this isn't necessarily true—there was no increase in anxiety symptoms in people taking bupropion compared to those on other antidepressants.

Potential Benefits of Wellbutrin

• No weight gain: Unlike many other antidepressants, Wellbutrin typically doesn't cause weight gain
• No fatigue: It doesn't usually cause the drowsiness associated with some other medications
• Low risk of sexual side effects: Sexual dysfunction is less common with Wellbutrin than with SSRIs
• May help with focus: Some patients find it helps with concentration and energy

How Quickly Does Wellbutrin Work for Anxiety?

For patients with depression, Wellbutrin may take up to 4 weeks to take full effect. It's likely to work in a similar timeframe for anxiety symptoms. Your psychiatrist will help you track your symptoms to evaluate how well the medication is working.

Common Side Effects

Like any medication, Wellbutrin can cause side effects. Most are mild and tend to improve as your body adjusts:

• Drowsiness or insomnia
• Dry mouth
• Headache
• Nausea
• Dizziness
• Loss of appetite
• Excessive sweating

Serious Side Effects (Rare)

• Seizures (risk increases at higher doses)
• Suicidal thoughts, especially in young adults
• Allergic reactions
• Rapid or irregular heartbeat

If you experience any serious side effects, contact your healthcare provider immediately.

How to Take Wellbutrin

Wellbutrin comes in several forms:

• Wellbutrin (immediate release): Usually taken 2-3 times daily
• Wellbutrin SR (sustained release): Typically taken twice daily
• Wellbutrin XL (extended release): Usually taken once daily

Follow your psychiatrist's instructions carefully. The dose, frequency, and timing will depend on which form you're prescribed and your individual needs.

What Other Medications Treat Anxiety?

Wellbutrin is just one option for treating anxiety. Other medications commonly used include:

• SSRIs: Lexapro, Zoloft, Prozac
• SNRIs: Effexor, Cymbalta
• Buspirone: A non-addictive anti-anxiety medication
• Beta-blockers: Can help with physical symptoms of anxiety
• Benzodiazepines: For short-term use during acute anxiety

The Bottom Line

Wellbutrin may be helpful for anxiety in some patients, particularly those who haven't responded to other medications or who want to avoid certain side effects like weight gain or sexual dysfunction. However, it's not a first-line treatment for anxiety, and its use for this purpose should be discussed thoroughly with your psychiatrist.

Anxiety treatment is highly personal, and what works for one person may not work for another. At Next Step Psychiatry, we work with each patient to develop a comprehensive, individualized treatment plan that may include medication, therapy, or both.