Wellbutrin for Anxiety: What You Need To Know

By Terez Malka, MD
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July 29, 2021

More than 30 percent of Americans will be diagnosed with an anxiety disorder in their lifetime, experiencing persistent emotional symptoms like constant worrying, tension, or irritability.

But anxiety can also cause physical symptoms, such as a racing heart, shortness of breath, sweating, shaking, and insomnia. 

Fortunately, there are many ways to manage and treat anxiety, including prescription anxiety medications.

Wellbutrin, the brand name for bupropion hydrochloride, is an antidepressant medication that is most commonly used for depression, bipolar disorder, and seasonal affective disorder.

But doctors may also occasionally recommend Wellbutrin for treating certain types of anxiety. For example, it can reduce anxiety symptoms associated with depression, and it can help people manage the stress involved with quitting smoking. 

Like any medication, Wellbutrin has risks and side effects. If you’re experiencing anxiety, speak with your primary care provider or a K doctor, who can help you pinpoint the best solution for your condition.

In this article, I’ll discuss whether Wellbutrin is used for anxiety, and if it can cause anxiety. I’ll explain what Wellbutrin is, and outline its side effects.

I’ll talk about what to take with Wellbutrin for anxiety. Finally, I’ll explore when to talk to a doctor, and alternatives to Wellbutrin for anxiety patients.

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Is Wellbutrin Used for Anxiety? 

Antidepressant medications are not just for depression—they are also a common treatment for patients with anxiety.

Currently, Wellbutrin––also known as Zyban––is approved by the Food and Drug Administration (FDA) for treating depression, seasonal affective disorder, smoking cessation, and sexual side effects related to selective serotonin reuptake inhibitor (SSRI) medications.

Depending on the circumstance, doctors may also prescribe Wellbutrin for certain types of anxiety. 

Wellbutrin XL has been shown in one clinical trial to be as effective for anxiety as escitalopram (Lexapro), a common antidepressant doctors prescribe for patients with anxiety.

Some research also suggests Wellbutrin can help mitigate anxiety symptoms related to depression. If you’re using Wellbutrin to quit smoking or help with sexual dysfunction from an SSRI, it may also help reduce situational sources of stress and anxiety.

For some people, however, wellbutrin can make anxiety worse, especially for the first few weeks after starting the medication, or just after a dose change.

Whether your provider recommends Wellbutrin for anxiety depends on a number of factors, including your specific diagnosis, symptoms, and potential drug interactions. 

Can Wellbutrin Cause Anxiety? 

For people with depression or attention deficit hyperactivity disorder (ADHD), Wellbutrin can be energizing and motivating.

That’s because it helps to increase the neurotransmitter norepinephrine, which is in part responsible for the body’s “fight or flight” response to anxiety-provoking events.

For a person who has anxiety but not depression, Wellbutrin can increase anxious feelings, including:

  • Restlessness
  • Irritability
  • Excitement
  • Difficulty sleeping or insomnia 
  • Shaking or trembling 

Typically, anxiety-related effects increase right after a person starts taking Wellbutrin, or when increasing their dose.

These symptoms may resolve after a few days. About 2% of people stop taking Wellbutrin due to increased anxiety symptoms.

If your provider prescribes Wellbutrin and you’re experiencing symptoms of anxiety that don’t go away after a few days, talk to your provider about finding the right dosage and medication for you. 

What Is Wellbutrin? 

Wellbutrin is part of a class of antidepressants called norepinephrine-dopamine reuptake inhibitors, or aminoketones.

It works by changing the way your brain uses the neurotransmitters dopamine and norepinephrine. Dopamine helps regulate learning and pleasure. Norepinephrine helps keep the body awake and alert.

By regulating the amount of these chemicals in the body and brain, Wellbutrin can improve mood, especially for people with major depressive disorder (MDD), seasonal affective disorder, and even ADHD.

Wellbutrin is not FDA-approved for treating anxiety, and it can actually lead to increased risk of certain anxiety symptoms in some patients.

But it can be prescribed off-label, at a physician’s discretion, for anxiety related to depression, smoking cessation, or sexual dysfunction caused by an SSRI, another type of antidepressant.

Benefits of Wellbutrin

Wellbutrin’s ability to improve mood is one of its main benefits.

Doctors also prescribe Wellbutrin in place of other antidepressants because unlike SSRIs, it may not cause weight gain, fatigue and drowsiness, or sexual dysfunction.

What are the Side Effects of Wellbutrin? 

All medications come with side effects, and it’s important to understand the risks before you start taking them.

The most common side effects reported by patients taking bupropion hydrochloride are:

In very rare cases, Wellbutrin may cause more serious side effects, like worsening depression, suicidal ideation, or increased seizures in people with a history of seizures.

People with pre-existing liver disease may also experience worsening liver problems while taking Wellbutrin. 

For some people—especially those who don’t have depression—Wellbutrin can cause anxiety symptoms, as discussed above. 

If you take Wellbutrin and your side effects or anxiety are interfering with your ability to function, talk to your healthcare provider as soon as possible. 

What to Take With Wellbutrin for Anxiety? 

If you and your provider determine that Wellbutrin is the best prescription medication for your unique circumstance, you may experience anxiety from time to time.

Should the anxiety symptoms interfere with your daily functioning, ask your healthcare provider about their suggestions for alleviating your anxiety.

Natural remedies for anxiety—like routine exercise, mindfulness and meditation, and psychotherapy—can also help you manage anxiety related to Wellbutrin. If anxiety is extreme, your provider may consider changing to a different type of medication.

In some cases, a doctor may recommend both Wellbutrin and an SSRI or SNRI medication.

For acute episodes of anxiety or panic attacks related to Wellbutrin, you may also be prescribed a short-acting anti-anxiety medication like benzodiazepine or hydroxyzine (Visteril).

But because these drugs have a higher risk of side effects, and because benzodiazepines are habit-forming, they are not good long-term options. Your doctor may prefer to manage your anxiety with a different medication option instead.

It’s important to follow your provider’s instructions if you do take Wellbutrin. For example, alcohol should not be mixed with Wellbutrin because it can increase Wellbutrin’s side effects and make depression worse. 

Certain prescription medications or supplements may also interact with Wellbutrin, so be sure to consult with your healthcare provider for medical advice before starting anything new. 

When to Talk to a Healthcare Provider

If you’re overwhelmed by anxiety, talk to a healthcare professional to determine a diagnosis and proper course of treatment.

If you’re currently taking Wellbutrin for depression or anxiety, seek medical care if side effects become unmanageable.

If you experience serious adverse effects like suicidal thoughts or worsening depression, or if you believe that you or someone you know may harm themselves or others, call 9-1-1, a suicide crisis line like 988, or immediately visit the nearest emergency department.

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Alternatives to Wellbutrin 

There are plenty of evidence-based treatment options for anxiety disorders that won’t increase anxiety symptoms.

Selective serotonin reuptake inhibitor (SSRI) drugs are effective for treating generalized anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and eating disorders like anorexia and bulimia. Common SSRIs for anxiety include:

SSRI drugs may work better than Wellbutrin because of the specific neurotransmitters they deal with.

While Wellbutrin changes how the brain produces dopamine and norepinephrine, SSRIs shift how the brain uses and absorbs serotonin, a neurotransmitter related to mood regulation. 

Selective serotonin & norepinephrine inhibitors (SNRIs) may also be used for anxiety symptoms. Lifestyle measures like meditation, exercise, psychotherapy, and support groups may all help manage anxiety symptoms.

If you take Wellbutrin but you’re concerned about anxiety symptoms, discuss alternatives with your healthcare provider, a psychiatrist, or a K provider. 

How K Health Can Help

Think you might need a prescription for Wellbutrin (bupropion)?

K Health has clinicians standing by 24/7 to evaluate your symptoms and determine if Wellbutrin is right for you.

Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.

Frequently Asked Questions

How long does Wellbutrin take to work for anxiety?
Certain anxiety symptoms, such as those associated with depression or smoking cessation, may improve from Wellbutrin within one or two weeks of starting the prescription. However, full remission of symptoms may not take place for up to eight weeks. If you’re experiencing anxiety for more than a few days after starting Wellbutrin or increasing your dosage, speak with a prescriber who can help manage side effects or alter your course of treatment if needed.
What to pair with Wellbutrin for anxiety?
If your anxiety is becoming unmanageable, schedule an appointment with your prescriber or talk to a K provider to discuss the side effects and possible alternatives. No matter what you do, it’s important to avoid self-medicating with alcohol while taking Wellbutrin, since it can worsen both side effects and depression and anxiety symptoms.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.

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