Psychiatry

What Is Wellbutrin® (Bupropion)? Wellbutrin® is the original brand name for bupropion. It is a medication most often prescribed for depression and smoking cessation, and FDA-approved for those indications. While it is not FDA-approved for ADHD, I frequently turn to it as an off-label option in my practice. Individuals with ADHD often need alternatives when stimulants don’t work well for them, and bupropion can be one of those options. How Wellbutrin Treats ADHD Unlike most antidepressants that target serotonin, bupropion primarily impacts norepinephrine and dopamine—the two neurotransmitters most implicated in ADHD. These chemicals play a central role in attention, executive function, and impulse control. Whereas “stimulant” medications like Adderall®(mixed amphetamines) stimulate the release of these neurotransmitters, bupropion blocks their reuptake. Both approaches affect the same systems but in different ways. This unique mechanism is why bupropion can be effective and safer than stimulants in reducing ADHD symptoms, particularly in adults. Clinical studies support this use: A meta-analysis of bupropion for adult ADHD found significant symptom reduction compared to placebo in participants, making it a reasonable alternative for those who cannot take stimulants (Verbeeck et al., 2017, CNS Drugs). An open-label trial also showed that sustained-release bupropion improved ADHD symptoms in adult participants (Wilens et al., 2001, Biol Psychiatry). When I Consider Prescribing Wellbutrin (bupropion) for ADHD I usually consider Wellbutrin when: An individual has had negative experiences with stimulants, such as side effects or poor tolerance. ADHD coexists with depression. An individual strongly prefers a non-stimulant option for personal or medical reasons. Individuals often tell me stimulants left them feeling overstimulated, emotionally flat, or too anxious. In those cases, bupropion can offer another pathway for relief. I find it to be a particularly suitable option for individuals who describe a combination of ADHD symptoms with mood-related struggles. For example, individuals often tell me stimulants left them feeling overstimulated, emotionally flat, or too anxious. In those cases, bupropion can offer another pathway for relief. Effectiveness of Wellbutrin (bupropion) for Anxiety Wellbutrin is a well-studied and often effective antidepressant, and one of its strengths is that it tends to be well tolerated. It is not associated with weight gain or sexual side effects—two of the most common reasons people stop taking antidepressants. Although it is not FDA-approved for, nor does it directly treat, anxiety, I’ve seen it help individuals whose anxiety stems from untreated ADHD symptoms. Consider an individual who feels intense anxiety every time they forget an important deadline or miss an appointment. For them, addressing the root ADHD symptoms with Wellbutrin can reduce the secondary anxiety. I would not prescribe bupropion to treat anxiety alone in the absence of ADHD. LifeStance Health is a national leader in mental, behavioral, and emotional wellness with multiple locations in 33 states. Services vary by location. Find a provider near you: Wellbutrin vs Adderall®: Understanding the Differences When individuals ask me how Wellbutrin compares to Adderall, I explain it this way: Mechanism: Adderall and other stimulants stimulate the release of neurotransmitters, while bupropion blocks their reuptake. Both target dopamine and norepinephrine but through different pathways. Effectiveness: For patients without co-morbid depression or contraindications, Adderall and other stimulants usually provide a stronger and more immediate reduction in ADHD symptoms, with duration of effect lasting several hours, depending on the particular version of stimulant. When working properly, bupropion takes at least 3-4 weeks (at the correct dose) for the effect to become noticeable but has a lasting effect. Side effect profile: Bupropion tends to be easier to tolerate, with fewer issues like appetite suppression or jitteriness, and it does not have the reputation for risk of addiction or abuse commonly associated with Adderall and other stimulants. One very visible difference right now (as of publication date) is that bupropion is widely available, whereas Adderall has faced shortages in recent years. This unfortunate shortage may lead to more bupropion prescriptions. The American Psychiatric Association’s ADHD guidelines recommend stimulants as first-line therapy, but list bupropion as a potential non-stimulant option when stimulants aren’t tolerated or appropriate (APA Practice Guideline, 2019). Side Effects of Wellbutrin (bupropion) Like any medication, bupropion can cause side effects. The ones I most commonly discuss with individuals include: Dry mouth Insomnia Restlessness or anxiety Dizziness Increased sweating Weight loss Nausea In my experience, dosage adjustments often help improve these side effects. Most significantly, just like stimulants, bupropion is not recommended for people at risk for seizures. Also importantly, Wellbutrin does not usually cause weight gain or sexual side effects, which supports long-term adherence. Final Thoughts on Use of Wellbutrin (bupropion) for ADHD Bupropion can be a valuable option in ADHD treatment, especially for patients who cannot tolerate stimulants or who also struggle with depression. However, it is important to remember that bupropion should only be taken as and when prescribed by a licensed medical professional. A thorough evaluation is essential before deciding on the right treatment plan. At LifeStance, we provide a full spectrum of support for individuals navigating ADHD and related conditions. From evaluation and testing to therapy and psychiatric care, our clinicians are here to guide you through every step of the process. With more than 550 mental health clinics across the U.S. and online appointments, our high-quality mental health care is widely accessible. References American Psychiatric Association. (2019). The American Psychiatric Association practice guideline for the treatment of patients with attention-deficit/hyperactivity disorder (ADHD). American Psychiatric Association Publishing. https://aapp.org/resource/patients/stimulants-nonstimulants U.S. Food and Drug Administration. (2023). FDA Drug Shortages: Adderall (amphetamine mixed salts). Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-announces-shortage-adderall Verbeeck W, Bekkering GE, Van den Noortgate W, Kramers C. Bupropion for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev. 2017 Oct 2;10(10):CD009504. doi: 10.1002/14651858.CD009504.pub2. PMID: 28965364; PMCID: PMC6485546. Wilens TE, Prince JB, Waxmonsky J, Doyle R, Spencer T, Martelon M, Evans M. An Open Trial of Sustained Release Bupropion for Attention-Deficit/Hyperactivity Disorder in Adults with ADHD plus Substance Use Disorders. J ADHD Relat Disord. 2010 Apr 1;1(3):25-35. PMID: 22500195; PMCID: PMC3322541.

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