Wellbutrin for anxiety: Can Wellbutrin be used to treat anxiety? How does it work?

What Is Wellbutrin?

Wellbutrin is an antidepressant that works lifts mood and increases energy. Specifically, Wellbutrin works by increasing the availability of norepinephrine and dopamine in the brain. Norepinephrine is a naturally occurring brain chemical that supports focus, attention, and energy. Dopamine is also a naturally occurring brain chemical that plays an important role in our brain’s reward center and in motivation. Wellbutrin is typically used to treat depression, but it may be prescribed to treat anxiety.

Does Wellbutrin Work for Anxiety?

Yes, Wellbutrin can be used to treat certain symptoms of anxiety, particularly those related to energy, motivation, and mood regulation. That said, Wellbutrin is primarily used to treat depression. Due to the unique way Wellbutrin works, using Wellbutrin to treat anxiety may exacerbate symptoms like worry, fear, and nervousness. For that reason, it’s especially important to discuss if Wellbutrin is right for you with your healthcare provider. 

How Bupropion Works for Anxiety

Wellbutrin works by boosting the levels of two neurotransmitters: dopamine and norepinephrine. These chemicals help regulate mood but are often out of balance in people with certain mental health conditions. Wellbutrin blocks the reuptake of norepinephrine and dopamine, helping them stay active in the brain for longer. By increasing their levels, Wellbutrin helps alleviate symptoms of depression.

Wellbutrin Differs From Other Antidepressants

Unlike many antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), Wellbutrin doesn’t directly impact serotonin or other neurotransmitters. Instead, as a norepinephrine–dopamine reuptake inhibitor (NDRI), it targets dopamine and norepinephrine, which can help boost a person’s mood and energy without altering their serotonin levels. This difference often means that Wellbutrin is less likely to cause some of the side effects commonly associated with serotonin-based medications, such as weight gain or sexual dysfunction.

How Wellbutrin Interacts With Different Types of Anxiety Disorders

Anxiety disorders can present in various ways, and the effectiveness of Wellbutrin may vary depending on the specific type of anxiety disorder and its symptoms. For some individuals, Wellbutrin may alleviate certain symptoms, while for others, it could potentially worsen them. Below is a closer look at how Wellbutrin interacts with different types of anxiety disorders:

1. Generalized Anxiety

Wellbutrin’s impact on generalized anxiety disorder (GAD) depends on the individual’s specific symptoms. For people who experience low energy, fatigue, or rumination due to depression, Wellbutrin can help. That’s because it can work to improve energy levels and mood. However, for people with GAD whose symptoms include heightened worry or physical restlessness, the stimulating effects of Wellbutrin could intensify those feelings. In some cases, Wellbutrin is used in combination with medications like SSRIs. This strategic pairing can help manage depressive symptoms while reducing certain anxiety-related concerns.

2. Panic Attacks

Wellbutrin may have limited utility in preventing panic attacks and could potentially worsen them in some individuals. However, it may be used alongside an SSRI to address SSRI-related side effects, such as low sex drive. In these cases, Wellbutrin might not pose as significant a risk for aggravating anxiety symptoms.

3. Social Anxiety

Wellbutrin’s effectiveness against social anxiety is largely dependent on what symptoms and fears one’s anxiety is causing. For individuals whose social anxiety stems from fear of judgment or excessive self-consciousness, Wellbutrin may be less effective and could even heighten feelings of vigilance or hyper-awareness. However, if anxiety makes it difficult to get to a social event, but once you’re there it’s enjoyable and fun, Wellbutrin’s activating effects might help motivate participation. 

4. Intrusive Thoughts

Wellbutrin may help address intrusive thoughts linked to depression, such as thoughts of death, provided these thoughts do not stem from fear or worry. However, if intrusive thoughts are driven by anxiety, where worry and fear dominate, Wellbutrin is less likely to be effective and might not be a suitable choice.

If you have anxiety and feel an anxiety medication prescription could help you with your symptoms, it’s best to speak with a mental health professional about your symptoms and previous treatment. Using their experience and expertise, they can provide you with treatment plan options that will be the most effective in improving your symptoms.

How Fast Does Wellbutrin Work for Anxiety?

The time it takes for Wellbutrin to help with anxiety can vary from person to person. While some may notice improvements within a week or two, it more commonly takes four to six weeks to feel the full effects of Wellbutrin. That’s why it’s so important to take Wellbutrin consistently as prescribed by your doctor. If you aren’t feeling the effects of Wellbutrin after about six weeks, check in with your healthcare provider as they may suggest adjusting your dosage.

Benefits and Drawbacks of Using Wellbutrin for Anxiety

If you are trying to decide if Wellbutrin is right for you, consider the pros and cons. For some, Wellbutrin might be an effective method for treating anxiety, but for others, it could actually make their symptoms worse. Here’s a breakdown of the benefits, drawbacks, and potential side effects to consider when using Wellbutrin for anxiety.

Benefits

• Boosts mood, energy, and motivation: Wellbutrin helps increase dopamine and norepinephrine, which can help mood and energy. This can be particularly good for those who experience depression along with anxiety, as lack of energy and motivation are often symptoms of depression, too.
• Fewer side effects than SSRIs and SNRIs: Because Wellbutrin doesn’t impact serotonin levels, it may cause fewer side effects than SSRIs and SNRIs, which are known to potentially cause sexual dysfunction, weight gain, or fatigue. 
• Can be used with SSRIs: Wellbutrin is sometimes prescribed alongside SSRIs to counteract side effects like low libido or fatigue. 
• Good for people who also experience depression: Wellbutrin may effectively address both anxiety and depression, especially when a person experiences symptoms like low energy and lack of pleasure. 

Drawbacks

• Exacerbates some anxiety symptoms: Many people with anxiety symptoms may experience fear, worry, and nervousness in everyday settings. Wellbutrin boosts dopamine and norepinephrine levels, which can increase alertness, energy, and vigilance. This may exacerbate certain anxiety symptoms rather than help keep them under control. 
• Not specifically meant for anxiety: Unlike SSRIs and SNRIs, Wellbutrin is not designed to treat anxiety. As a result, it may be less effective for people whose primary issue is anxiety rather than depression. Because it’s more targeted for depression, it can help anxiety symptoms that may stem from depression.

Potential Side Effects of Wellbutrin

While Wellbutrin can have fewer side effects than SSRIs and SNRIs, it still does have side effects. That said, most are relatively mild or rare. If you experience side effects when taking Wellbutrin, discuss it with your healthcare provider who can either adjust your medication or help you find a different treatment plan. Here are some potential side effects of Wellbutrin. 

• Dry mouth
• Headaches
• Difficulty falling asleep or insomnia
• Anxiety
• Agitation
• Loss of appetite and weight loss
• Constipation, nausea, or vomiting 
• Excessive sweating
• Drowsiness and fatigue 
• Shaking 

In more extreme cases, Wellbutrin may cause suicidal ideation, seizures, hallucinations and confusion, rapid heartbeat, or an allergic reaction. For this reason, Wellbutrin may not be a good choice for those susceptible to seizures, and for those who experience bipolar disorder or eating disorders. Be sure to seek immediate medical attention if you experience any severe side effects of Wellbutrin. 

What Is the Number One Anxiety Medication?

There isn’t necessarily a “number one” or “best” medication for treating anxiety disorders as everyone has different needs, but SSRIs and SNRIs are usually the first line of treatment for anxiety. Common brands include Celexa, Lexapro, Luvox, Paxil, Zoloft, Pristiq, Cymbalta, and Effexor. 

Wellbutrin is overall better for treating depression than anxiety, which is why it’s almost always best to start with SSRIs like Zoloft for treating anxiety. For those who have difficulty tolerating the side effects of SSRIs and SNRIs, however, Wellbutrin may be a good alternative. Wellbutrin can also be used in combination with other medications to treat anxiety. 

What Can Be Combined With Wellbutrin for Anxiety?

Wellbutrin is often used as part of a broader treatment plan for anxiety as it’s not primarily meant to be used for treating anxiety. To enhance its effectiveness or address symptoms more comprehensively, Wellbutrin can be combined with other medications, such as SSRIs like Zoloft, Prozac, and Lexapro. You can also use it alongside benzodiazepines, such as Ativan and Klonopin, which are meant for short-term relief of acute anxiety symptoms. 

Signs Wellbutrin Is Working

When Wellbutrin is taking effect, you can tell it’s working when it starts targeting the symptoms that you want it to target. For people with depression, Wellbutrin might provide:

• Less fatigue
• Increased enjoyment of things you used to like
• Lift in low mood
• More energy during the day

When people first start Wellbutrin, some may feel side effects like jitteriness or lots of energy, feeling like they’re bouncing off the walls a bit. Others tend to feel irritable or anxious, or they experience things like dry mouth and increased heartbeat. 

Since anxiousness is one of the common side effects of Wellbutrin, it’s not often prescribed to treat anxiety. For those with anxiety, Wellbutrin can worsen picking or anxiety tics, feeling nervous, and uncontrollable worry.

Is Wellbutrin Right for Me?

To determine if Wellbutrin is right for you as a treatment for anxiety, discuss options with your healthcare provider. Your provider will consider your medical history, symptoms, family medical history, allergies, and more. Here are more factors to consider when deciding if Wellbutrin is right for you. 

• You experience side effects from other antidepressants. Many antidepressants have side effects such as weight gain and loss of sex drive. If you have tried other antidepressants and feel you have intolerance, it could be worth trying Wellbutrin as an alternative. 
• Your anxiety is related to depression. Wellbutrin is used to treat depression, but there are many anxiety symptoms associated with depression. For example, lack of motivation can be a depressive symptom that can also manifest as anxiety. If there is a party you are meant to attend, you may feel anxiety about leaving the house, Wellbutrin could help. 
• Your anxiety is related to ADHD. Wellbutrin is not an FDA-approved medication for ADHD, but similar to how Wellbutrin can help with anxiety, it can also help with some ADHD symptoms. If your anxiety is related to having a lack of focus, energy, and motivation, Wellbutrin may help. 
• You are seeking long-term treatment. With a track record of safe, long-term use, Wellbutrin is a viable option for those seeking a sustained treatment plan without known long-term complications.

How Much Does Wellbutrin Cost?

The price of Wellbutrin can vary based on your insurance, dosage, and pharmacy. While you’ll always need a prescription to get Wellbutrin, how you pay (through insurance or out of pocket) will impact the cost. Without insurance, a generic version of Wellbutrin (bupropion) can cost $12-$20 for a 30-day supply. The brand name will be more expensive, though most insurance plans and Medicare will cover it. 

Therapeutic Alternatives to Wellbutrin for Anxiety

If you are looking to treat your anxiety without medications like SSRIs, SNRIs, or Wellbutrin, consider finding a therapist who specializes in an approach that will help you manage your anxiety symptoms. Here are a few therapeutic alternatives to Wellbutrin. 

• Cognitive behavioral therapy (CBT): This evidence-based approach can help you identify and adjust unhelpful thought patterns and behaviors. 
• Exposure therapy: Aimed at gradually confronting anxiety-provoking situations, exposure therapy can help you overcome fears in a controlled setting. 
• Mindfulness-based cognitive therapy: This method emphasizes cultivating awareness and acceptance of anxious thoughts, behaviors, and situations, fostering a sense of calm and resilience.

The Bottom Line

As with any medication, the decision to use Wellbutrin for anxiety should be guided by a healthcare professional who can help you weigh its benefits and drawbacks based on your specific needs and medical history. Open communication with your doctor and a tailored treatment plan are essential to finding the most effective and safe approach to managing your mental health. If you think Wellbutrin might be right for you, consider speaking to a psychiatrist.