Wellbutrin for ADHD: Pros & Cons

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is frequently diagnosed during childhood and can continue into adulthood. Common symptoms include problems with focusing and paying attention, being overactive, and having difficulties controlling impulsive behaviors. 

In addition to behavior therapy and skill training, stimulant medications are frequently used in combination with counseling for treating ADHD. However, an antidepressant medicine called bupropion hydrochloride (brand name Wellbutrin) has shown promising benefits and is sometimes used for off-label treatment of ADHD. 

Wellbutrin is approved by the U.S. Food and Drug Administration (FDA) as the treatment for depression and seasonal affective disorder (SAD). In addition to the approved indications, healthcare providers may prescribe Wellbutrin as an off-label treatment to improve ADHD symptoms in adults who do not respond to or cannot tolerate stimulant medications.  

Please continue reading to find out more about the pros and cons of taking Wellbutrin for ADHD.

What are the pros and cons of taking Wellbutrin for attention deficit hyperactivity disorder?

Pros

• Wellbutrin (generic drug: bupropion hydrochloride) is a non-stimulant medication and does not carry a risk of dependence and abuse.

• It may be a good choice for people who cannot tolerate stimulants or have not responded to stimulants.

• Taking Wellbutrin at the prescribed dose may increase the effectiveness of other medications used to treat ADHD, including stimulants.

• The extended-release form (Wellbutrin XL) and sustained-release formulation (Wellbutrin SR) only need to be taken once or twice a day.

• Using Wellbutrin for adult ADHD may help to treat coexisting psychiatric conditions such as depression and anxiety.

Cons

• Wellbutrin is not FDA-approved for ADHD. While there are clinical trials evaluating the efficacy and safety of this medication in people with ADHD, more research is necessary to establish the role of Wellbutrin in ADHD treatment, along with its long-term effects.

• Wellbutrin is not a first-line treatment for ADHD. It is unlikely to be as effective as stimulant medications in controlling symptoms.

• The immediate-release formulation of Wellbutrin needs to be taken in three daily doses.

• Like most antidepressants, Wellbutrin is associated with an increased risk of suicidal thinking. Suicidal thoughts and behaviors are more likely in children, teenagers, and young adults below the age of 24 years.

• Wellbutrin is not approved for use in people younger than 18 years old. It also may not be right for adults with certain medical conditions such as eating disorders, seizure disorders, and glaucoma.

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Does Wellbutrin actually help ADHD?

Wellbutrin may help to improve symptoms of ADHD. As mentioned, this medication is not FDA-approved to treat ADHD. It is a norepinephrine dopamine reuptake inhibitor (NDRI) that is prescribed for treating depression and seasonal affective disorder. However, Wellbutrin works by increasing the levels of natural brain chemicals called norepinephrine and dopamine in the brain. These same brain chemicals play a role in attention and focus. 

Other antidepressants called tricyclic antidepressants (imipramine, desipramine, nortriptyline, amitriptyline) have also been used off-label for ADHD.

Why take Wellbutrin for ADHD?

Your healthcare provider may give you Wellbutrin for ADHD if: 

• You have not responded to stimulants

• You have intolerable side effects from stimulants

• You cannot take stimulants due to other health conditions

• You have other psychiatric conditions, such as anxiety and depression in addition to ADHD, that may benefit from Wellbutrin.

What are the risks of taking stimulant medications to treat ADHD symptoms?

Stimulants such as methylphenidate (Ritalin, Concerta), dexmethylphenidate (Focalin), and dextroamphetamine salts (Adderall) are commonly prescribed as first-line treatments for ADHD. Read about the benefits of Ritalin vs. Adderall on our blog.

However, these drugs carry certain risks. They are controlled substances due to a potential for drug abuse. People with a history of substance use disorder are at a particularly high risk of stimulant misuse. Some states have laws regulating stimulant medications, and you cannot get more than a 30-day supply at a time. 

Common side effects of stimulants include sleep disorders, upset stomach, decreased appetite, weight loss, growth delay, changes in heart rate and blood pressure, tic disorder (repetitive movements), and anxiety. In addition, there can be rebound ADHD symptoms when a stimulant drug wears off.

There are non-stimulant medications for treating ADHD symptoms as well. Examples include atomoxetine (Strattera), viloxazine (Qelbree), clonidine (Kapvay), and guanfacine (Intuniv). Non-stimulant ADHD medications take longer to start working and may not be as effective as stimulants. However, they do not carry a risk of misuse and dependence. Read our blog about the pros and cons of Strattera for ADHD.

Is Wellbutrin a stimulant medication?

No, Wellbutrin is not a stimulant medication. It is an antidepressant and belongs to a drug class called norepinephrine dopamine reuptake inhibitors (NDRIs). 

Wellbutrin is used to treat depression and mood changes associated with seasonal affective disorder. In addition to treating depression, it is also prescribed to aid smoking cessation. The FDA-approved dosage of Wellbutrin depends on the formulation (Wellbutrin, Wellbutrin SR, Wellbutrin XL) and the condition being treated. 

What does it mean to use Wellbutrin as “off-label” for ADHD?

While Wellbutrin is FDA-approved to treat depression and seasonal affective disorder (SAD), it is sometimes prescribed off-label for ADHD symptoms.

 “Off-label” drug use means prescribing medications for medical conditions that the FDA has not approved. These are FDA-approved medications, but they are just not approved for those specific indications. 

Other times, “off-label” use involves treating particular health conditions using doses or dosage forms of a drug that the FDA has not approved for that particular health condition. 

Doctors can prescribe medications for “off-label” use when they deem it beneficial for the patients using their clinical judgment. 

Clinical trials have been conducted on Wellbutrin for ADHD. However, they don’t provide all the information required by the FDA to approve the use of Wellbutrin for ADHD. Wellbutrin may be a safe and effective treatment for ADHD, but there may be risks involved. 

When deciding to prescribe a specific medication for off-label use, healthcare providers use their clinical judgment. Therefore, using Wellbutrin for ADHD may be a good option for you, but it may not be for the next person. 

Is Wellbutrin better than Adderall for ADHD?

Wellbutrin is unlikely to be better than Adderall for ADHD in most people. There is low-quality evidence that Wellbutrin can lead to an improvement in ADHD symptoms. 

A placebo-controlled trial also found that adverse effects were similar in people who took bupropion (Wellbutrin) and placebo (inactive medicine), and Wellbutrin resulted in improvements in ADHD symptoms. 

Another finding is that people who took the long-acting form of Wellbutrin were 50% more likely to improve than those taking a placebo. Notably, the length of these clinical trials was only 6 to 10 weeks. 

Read about Strattera vs. Adderall for ADHD treatment. 

Can you take Wellbutrin and Adderall together for ADHD?

Adderall is a stimulant medication and is a first-line treatment for ADHD. 

Doctors use Wellbutrin off-label for ADHD. Taking Wellbutrin along with a stimulant ADHD medication such as Adderall may increase the effectiveness of the stimulant. 

Some people may be prescribed Wellbutrin for ADHD if they do not wish to take a stimulant, have not responded to stimulants in the past, or have intolerable side effects from stimulants. 

The addition of a drug to the usual treatment should be evaluated and indicated by a medical professional.

How long does it take for bupropion to help ADHD?

It can take 4-6 weeks for bupropion (Wellbutrin) to improve ADHD symptoms. 

Studies that have evaluated bupropion (Wellbutrin) for ADHD have found the most effective therapeutic dose ranges between 150 milligrams (mg) and 450 mg daily for 6-10 weeks. 

One study found that many people who responded to Wellbutrin for ADHD received a starting dose and maximum dose of 300 mg and took it daily for 4 weeks. 

Does Wellbutrin give me energy like Adderall? 

Wellbutrin may give you energy. It is an antidepressant medication, and its effects include increased energy, improved mood, reduced feelings of sadness, and an enhanced interest in professional and social activities.