Can I Use Wellbutrin for ADHD?

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Wellbutrin is an antidepressant medication that is sometimes prescribed to treat ADHD symptoms.

Wellbutrin might be prescribed in conjunction with a stimulant medication, such as Adderall or Ritalin, if a person has ADHD and a co-existing condition of depression, or it could be prescribed as a single medication to try and address both conditions.

Stimulant medications are the first line of treatment as they are known to be the most effective medication in reducing ADHD symptoms such as impulsivity, hyperactivity, and inattentiveness.

Non-stimulant medications are second line treatment options for ADHD. Wellbutrin, Strattera and Clonidine are examples of non-stimulant medication options for the treatment of ADHD.

Why Take a Second Line Medication?

If stimulants are known to be the most effective treatment, why would someone take a second line medication? There are three common reasons why a person living with ADHD would be prescribed a second line medication:

  • Not everyone who takes stimulant medication finds relief for their ADHD symptoms. If this is the case for you or a loved one, your doctor will explore second line medication options with you.
  • You may not able to tolerate stimulant medication and could experience severe side effects.
  • Sometimes there is an underlying medical condition that make the use of stimulant medications more problematic. For example, a heart condition, sleep disorders, a history of addiction, and some psychiatric conditions such as bipolar disorder.

    The History of Wellbutrin

    Wellbutrin is the trade name for the drug bupropion. It was approved by the FDA to treat depression in 1985. From 1986 to 1989 it was removed from the market due to reports of epileptic seizures. The seizures were found to be dose related, so when Wellbutrin returned to the market in 1989 the maximum dose was lowered.

    Wellbutrin SR, the sustained-release version, was approved in 1996, and Wellbutrin XL, the extended release version, in 2003. In 2006 it became the first medication approved to treat seasonal-affective disorder (SAD).

    The FDA has not approved Wellbutrin for the treatment of ADHD. However, it is prescribed by doctors as an off label treatment option.

    Research on Wellbutrin for ADHD is being carried out. For example, one study found it significantly lessened ADHD symptoms when compared to a placebo. Other studies on the effectiveness of Wellbutrin in aiding ADHD symptoms in adults have been promising.

    Dose and Forms

    Wellbutrin comes in 3 forms:

    • Wellbutrin
    • Wellbutrin SR (sustained-release)
    • Wellbutrin XL (extended release)

    Usually Wellbutrin XL is prescribed for ADHD so that the medication is effective throughout the day and the possibility of side effects is reduced.

    A typical daily dose for someone who is 12 years and older is 3 to 6 mg per kg of body weight per day, although the starting dose is usually lower. 

    In contrast to stimulant medication, which starts to work within approximately an hour, Wellbutrin (like other depressants) can take approximately 3-7 days before you notice the benefits.

    In addition, it can take 4-6 weeks to reach full effect. This means it can take several weeks to find the right therapeutic dose for you or your child.

    What Is the Difference Between XL and SR?

    Both Wellbutrin SR and Wellbutrin XL are time controlled release formulations. This means the drug is slowly released in the body over many hours, and there is a consistency of the drug in the bloodstream.

    The Sustained Release formation 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 usually means better patient compliance as there is less opportunity to miss a dose.

    How Does Wellbutrin Work?

    Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI), and it works by keeping the neurotransmitters norepinephrine and dopamine available to the brain’s neurons for longer. This helps improve concentration, focus, and other ADHD symptoms.

    Since Wellbutrin does not influence serotonin, it works differently than many other antidepressants. For example, selective serotonin reuptake inhibitors (SSRIs) affect serotonin whereas tricyclic antidepressants [TCAs] increase norepinephrine and serotonin levels as well as blocking acetylcholine which can lead to side-effects. Monoamine oxidase inhibitors (MAOIs)—the first antidepressants—increase norepinephrine, serotonin, and dopamine by suppressing the enzyme monoamine oxidase.

    Side Effects

    Possible side effects include anxiety, excitement, agitation, increased motor activity, insomnia, tantrums, tremors, tics, dry mouth, headaches, and nausea. There is also a risk it can increase seizures in people who are susceptible to them or who have a history of eating disorders.

    Wellbutrin is a Category C drug, which means it is considered unsafe to take during pregnancy or while breastfeeding. It is important to talk to your doctor if you are pregnant or planning to become pregnant.

    Black Box Warning

    The FDA puts a black box warning on certain prescription drug labels to bring attention to any serious or life threatening risks that you need to be aware of.

    Wellbutrin, like some other antidepressants, carries a black box warning for the possible increased risk of suicidal thoughts or action in children, teens, and young adults. It is important to talk to your doctor to discuss the benefits versus the risks of this medication and to remain in close contact with them while taking Wellbutrin. In addition, parents and caregivers are encouraged to keep an eye on any possible changes in their child’s behavior.

    Will Wellbutrin Help Me Quit Smoking?

    Wellbutrin and Zyban are both brand names for the drug bupropion. Wellbutrin has been approved by the FDA as an antidepressant, and Zyban has been approved to help people stop smoking. If you smoke cigarettes and are prescribed Wellbutrin, you might find that it also acts as a smoking cessation drug. It does not contain nicotine; however, some smokers report that it removes their interest or desire to smoke.

    A Word From Verywell

    While Wellbutrin is not a first line medication for ADHD, it can be helpful in treating ADHD symptoms, particularly if you have co-existing conditions of depression and anxiety. It might be prescribed in combined with another ADHD medication or as a stand-alone option.

    If you are interested in Wellbutrin as part of your ADHD treatment, discuss it with your doctor. They will be able to help you decide if it is a good option for you.

    Sources:

    Hamedi,M., M. Mohammdi, A. Ghaleiha, Z.Keshavarzi, M. Jafarnia, R. Keramatfar et al 2014 Bupropion in  Adulths With Attention-Deficit/Hyperactivity Disorder: A Randomized, double-blind study. Acta Medica Iranica 52(9): 675-680

    Maneeton, N., B. Maneeton, M. Srisurapanont, and S.D. Martin. 2011 Bupropion for adults with attention-defict hyperactivity disorder. Meta-analysis of randomized placebo-controlled trails. Psychiatry and Clinical Neurosciences 65(7): 611-617

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