Using Wellbutrin for ADHD

Wellbutrin (bupropion) is an antidepressant sometimes prescribed off-label for 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.

Keep reading to learn more about how Wellbutrin may help people manage some characteristics of ADHD. Also, find out more about the efficacy, potential side effects, and typical dosages in treating ADHD.

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 for ADHD

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 stimulants.

For this reason, many clinicians continue to prescribe Wellbutrin as an off-label treatment 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).

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. Generic versions are available and cost less than Wellbutrin.

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.

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, 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.

Wellbutrin has not been found to worsen ADHD, but you should talk to your doctor if you begin to notice any concerning changes.

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:

• Cerdelga (eliglustat)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Orap (pimozide)
• Azilect (rasagiline)
• Zelapar (selegiline)
• Emsam (selegiline transdermal)
• Parnate (tranylcypromine)

Also, be sure to tell your doctor if you are currently taking any other medication that also contains bupropion to avoid overdose. This includes the smoking cessation medication Zyban and Contrave, a weight-loss medication containing bupropion and naltrexone.

Other Treatments for ADHD

Wellbutrin is not the only treatment for ADHD. ADHD traits are most often managed using medications, therapy, accommodations, and other forms of support. Stimulant medications are often prescribed, which may include:

• Ritalin (methylphenidate)
• Concerta (methylphenidate)
• Dexedrine (dextroamphetamine)
• Vyvanse (lisdexamfetamine)
• Adderall (amphetamine and dextroamphetamine)

Non-stimulant medications may also be prescribed, such as:

• Strattera (atomoxetine)
• Kapvay (clonidine)
• Intuniv (guanfacine)

Different types of therapy, such as cognitive-behavioral therapy (CBT) and mindfulness-based therapy, can also be helpful.