What are the effects of Wellbutrin (Bupropion) on anxiety? Discover real user reviews, effectiveness, ease of use, and satisfaction levels in this detailed article.

Wellbutrin Anxiety Reviews: User Experiences and Insights

Wellbutrin, also known as Bupropion, is a widely-prescribed antidepressant medication that has been the subject of numerous reviews and discussions regarding its impact on anxiety. In this comprehensive analysis, we delve into the real-world experiences of individuals who have used Wellbutrin to manage their anxiety and associated conditions.

Effectiveness of Wellbutrin for Anxiety

One user shares their remarkable experience with Wellbutrin, stating, “This medication has worked SO WELL for me, that I wanted to share, in case my comments might help someone who is undecided about Wellbutrin.” They go on to explain that they have had severe depression for about 10 years and have tried other medications like Prozac and Effexor, but none have been as effective as Wellbutrin in helping them. They are currently taking 300mg XL per day and feel “so normal now” that they don’t even feel like they’re on medication, which they consider a sign that the treatment is working well.

Another user, who was prescribed Wellbutrin for a number of symptoms including increased appetite, low energy, and inability to focus, experienced a noticeable improvement in their mood after about a month of taking the medication. They stated, “I have already begun getting out of my deppressive state after years of trauma, so I didnt think I needed something that was mainly used as a mood booster. but…. After a month it was a noticeable change in my mood. I’ve never felt not deppressed, so this was great.”

Challenges with Wellbutrin and Anxiety

While many users have reported positive experiences with Wellbutrin for managing their anxiety, some have also faced challenges. One user shared that they had to stop taking Wellbutrin when they started experiencing suicidal thoughts, stating, “I finally stopped taking it when I started having suicidal thoughts.”

Another user, who was prescribed Wellbutrin mainly for their attention deficit disorder with hyperactivity (ADHD), expressed concerns about the potential for the medication to trigger their anxiety, saying, “i have anxiety/panic disorder so i was worried knowing this is a med people have said could trigger your anxiety, but my depression has been so bad that i decided to give it a go for any possible relief. it increased my resting heart rate, not.”

Interactions with Other Medications

Some users have reported experiencing interactions between Wellbutrin and other medications they were taking. One user shared, “After taking Wellbutrin, I found that my oxycontin would not last as long. I had to take my oxycontin earlier because I was going into withdrawals from taking the Wellbutrin.”

This highlights the importance of discussing any potential interactions with healthcare providers when starting or adjusting medication regimens, as individual responses can vary.

Factors Influencing Wellbutrin’s Effectiveness for Anxiety

The reviews and experiences shared indicate that the effectiveness of Wellbutrin for managing anxiety can be influenced by several factors, including:

• Underlying mental health conditions (e.g., depression, ADHD)
• Individual neurochemistry and response to the medication
• Dosage and duration of treatment
• Interactions with other medications
• Presence of comorbid physical health issues

Implications for Healthcare Providers and Patients

The variety of experiences shared in these reviews underscores the importance of healthcare providers working closely with patients to find the most appropriate and effective treatment approach for managing anxiety and related conditions. Open communication, close monitoring, and personalized adjustments to medication regimens may be necessary to achieve the desired outcomes.

For patients, these reviews highlight the need to be proactive in communicating any changes or concerns with their healthcare providers, as individual responses to Wellbutrin can vary significantly. Seeking support from healthcare professionals and being involved in the decision-making process can help ensure the most suitable treatment plan is implemented.

Conclusion

The reviews and experiences shared regarding Wellbutrin’s impact on anxiety provide valuable insights for both healthcare providers and patients. While some users have reported remarkable success in managing their anxiety with Wellbutrin, others have faced challenges or experienced interactions with other medications. Ultimately, a personalized approach that takes into account individual needs and responses is crucial for optimizing the effectiveness of Wellbutrin in managing anxiety and related conditions.

Effectiveness, Ease of Use, and Satisfaction

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168 People found this comment helpful

I normally never write on these things, but this medication has worked SO WELL for me, that I wanted to share, in case my comments might help someone who is undecided about Wellbutrin.

I have had severe depression for about 10 years. Had been on prozac and effexor before wellbutrin. They both worked, but not even close to how the wellbutrin is helping me! I’m taking 300mg XL per day.

I felt …

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14 People found this comment helpful

i am trying to loose weight to

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Condition: Binge Eating Disorder EffectivenessEase of UseSatisfaction

I have been taking Wellbutrin for about one month, at first I couldn’t sleep that lasted about one week, the doctor told me to buy a white noise maching and that helped. This medication helped me to stop binge eating, and my depression.

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I was prescribed wellbutrin for a number of symptoms such as increased appetite and weight gain, low energy, inability to focus, low libido, etc. It started to work for me around a month of taking it, but at about 6-7 weeks I fell into a deep depression, which I hadn’t experienced before taking this medication. I finally stopped taking it when I started having suicidal thoughts.

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I was prescribed this mainly for my ADD. I have already begun getting out of my deppressive state after years of trauma, so I didnt think I needed something that was mainly used as a mood booster. but….
After a month it was a noticeable change in my mood. I’ve never felt not deppressed, so this was great.

im on 300. Im regular build, 5’6 male .

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Wellbutrin is a miracle drug.

Before Wellbutrin, I would randomly feel a strong, sudden wave of darkness and emptiness, like a black hole was swallowing the life out of me from the inside. This would just hit me randomly. I could be alone chilling in my room, in the middle of a party I’m having a great time at, at school, at work, just anywhere at anytime. It was unpredictable AF. And it was super uncomfortable to be in that situation. That dark feeling immediately brought on suicidal desires. I didn’t necessarily want to feel like that, but I’ve chalked it up to that’s just what my brain chemistry naturally does. I didn’t want to kill myself, but everything in my brain opened that door more and more, welcoming more pain until it becomes so mentally painful I can actually feel a physical reaction in my body. My heart would literally feel like it was getting drained and dragged down into a dark lake by the biggest weight you can imagine.

So that describes the feeling that Wellbutrin has SAVED me from. After I started taking it, my life immensely changed for the better immediately.

Depression runs in my family and Wellbutrin works for all of us.

I’ve been taking 300mg XL every morning for over 4 years now. I feel so normal now that I don’t even feel like I’m on medication (which is how you know it’s working!)
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After taking Wellbutrin, I found that my oxycontin would not last as long. I had to take my oxycontin earlier because I was going into withdrawals from taking the Wellbutrin. I read that Wellbutrin will cause the oxycontin to not work as long but I can’t find where it says that anymore.

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my psychiatrist suggested giving this a try since it usually doesn’t give GI side effects (i’m dealing with some GI issues aside from this so we didn’t want to worsen that) and it doesn’t kill your sex drive (which was an issue i had with my previous meds), but i’ve only been on it for 3-4 days and we’ve already decided it’s best that i stop. i have anxiety/panic disorder so i was worried knowing this is a med people have said could trigger your anxiety, but my depression has been so bad that i decided to give it a go for any possible relief. it increased my resting heart rate, not so much that my heart was racing, but it was a noticeable change and i kept going back to the feeling and focusing on it which made me anxious. i noticed it also made my body a little twitchy too. after a few days of trying to push through that, i suddenly had this burst of restless and jittery energy that made me feel like i was going to start bouncing off the walls and going crazy. my thoughts were racing and i suddenly bursted into tears even though i didn’t feel sad. i nearly had a panic attack, but luckily i was able to hold it together. that whole experience freaked me out so i told my psychiatrist im done with it. we’re gonna try something else thankfully. i don’t think it’s fair for me to call this med bad. it just wasn’t right for me. i think if anxiety is a big issue for you, this might not be the best choice, but everyone’s different. good luck!Read More Read Less

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Prescribed XL 150 MG. I noticed after only a week – a decrease in depression and anxiety, and a little more energy. However – made me hungry (I actually gained some weight), did nothing for me for smoking, increased problems sleeping, sort of a slow-burning anger was building, and increased cold-like symptoms (coughing, allergies, bit of problem breathing). SIde-effects outweigh the benefits for me. The only thing I think that has worked for me -helped me overcome a couple of major depressive episodes) was Zoloft – but had to take 200 MG of this- which I think is max dose.Read More Read Less

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In the process of a divorce and my doctor was so patient listening to my broken heart. He prescribed This medication 150 mg but the anxiety and depression were to much to handle after a year. He increased the dose from 150 to 300 and I couldn’t have felt better. This pills has helped my through the years.

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Wellbutrin is the only medicine that gives me any relief from my depression. After trying Prozac and Lexapro for many years, found a new doctor that has me take Wellbutrin along with my Lexapro. Not sure why, but he said they work well together. Amazing results. I feel like I have my life back and I don’t find myself so pitiful. I’m healthy and happy and just wish someone had given me Wellbutrin earlier. Also – the side effects do go away… constipation, tremors and dreaming were pretty bad at first. Now, after two to three months, they are all gone. Keep trying with this med. it may not work for everyone, but it sure did for me. Read More Read Less

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Took initial dose (37.5mg) and within an hour I started vomiting. Vomiting lasted nearly 2 days. Doctor called it an allergic reaction and agreed that I discontinue taking. I only took the one dose.

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This medication has been a God sent! I started taking it for low energy levels which started impacting my work and my relationship because my energy was drained by 2pm every day and I’d be on the couch by 5pm. I’ve only been taking it a week now but the effect was immediate – Now I’m up at 7am and good until about 11pm. No other side effects other than a lack of appetite so I just have to remind myself to eat.

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After around 6 months use, my smoking almost stopped.

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I was fine on this medication along with cymbalta until covid I am out of control with anxiety my nerves system is shot I want to be off but my dr will not agree. My kids say I am out of my mind canâ??t sleep canâ??t sit still and my lip is quivering I am changing dr

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I recently added wellbutrin to zoloft, which I have taken for years. I feel better re: mood and energy. However, the side effects: constipation, edginess, confusion, anxiety, inability to concentrate are significant. I would like to know if the side effects lessen over time.

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Did relieve my depressive symptoms but I was then left with raging, uncontrollable anxiety. I’m not one for panic attacks but with Wellbutrin, I was very panicky. Furthermore, I experienced a bit of a brain fog. After the 6 weeks, my anxiety was worse than I had even experienced and I couldn’t hold a conversation without forgetting the topic after about a minute. This medication did not work for me, and completing the loading dose just furthered my anxiety and brain fog.

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I felt compelled to write a review for this medication because it literally changed my life. I spent most of my adult life experiencing severe bipolar depression and was hospitalized for suicide. After starting wellbutrin – about a month in, I just… got better. Whatever chemicals in my bran that were not functioning correctly, the wellbutrin was the answer for me. I combine this medication with Lamictal to stablize my mood as well as a fairly healthy lifestyle, which I think is another big factor. These medications work differently on everyone, but for me wellbutrin was a complete life saver. I feel like I came out of a fog and can finally live my life again. Read More Read Less

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After being in Lexapro for years, I felt as though it wasn�t doing anything anymore. My doctor switched me to Wellbutrin XL which made me almost manic/weepy. I also felt like I had �zaps� in my brain. I took it for 3 weeks then asked if he�d switch it to Wellbutrin SR after reading some reviews. Some people felt that the SR version worked better for them. I�m on my second day if the Wellbutrin SR. I feel more energized, but I�m worried after reading all of the side effects from everyone. I have the ringing in the ears( will this go away?) and have been weepy and short tempered. Should I keep taking it for a little longer to see if the side effects subside? I�m just confused on what to do. Read More Read Less

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Worked at first. I found relief in a week. I should have known that was impossible to work that quickly. Maybe it was the placebo effect that gave me the initial boost. Now, after about 3 months, I’m back to my “before” me at my worst. Very sad indeed. Back to that “eternal” chalkboard of still seeking something for relief. I don’t think relief on any drug is possible in the long term — just glimmers here and there. Best to be realistic and settle.

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As a young single mother, I suffered a traumatic car accident, I was prescribed everything under the sun including xanax which is the devil, I became addicted and then i went through a dry spell and didn’t trust any meds, antidepressant, or anxiety meds, i changed doctors and told him i can’t be living this way anymore and he finally introduced me to 150-300mg wellbutrin and I take klonopin for the anxiety, within a weeks time frame i feel happy and i have actually been getting my ass out of bed. And doing more around the house…i am so pleased. Remember not every medtication works for everyone but I am a huge fan of wellbutrin, if you name a drug I’ve probably tried it and had the worst experience. So I do say give it time and maybe eat with it in the mornings…take in the mornings only!! If you can’t sleep take melatonin or benadryl, as for me I have to take klonopin. Hope this helps! Read More Read Less

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I have ADHD that meds have not been able to treat successfully (I was diagnosed at 29). I also have anxiety and depression. My biggest symptom that was causing the most stress was my irritability. I would feel irrational and my mood was not great. I would be upset easily and critical with my young kids and husband. Felt trapped in a spiral that I knew was going to wreck my life. Thank goodness for Wellbutrin. A month after I first started it I remember one day feeling strange. A feeling I hadn’t felt in a long time. I realized that constant sense of nagging worry and nothing to live for was gone and I was feeling happy. When I tried to increase to 300 mg o had to try 3 times because at first I would get irrational and grumpy again and feel awful. Eventually I got up to 300mg and felt the most change. It’s been two years now and I now am on 150mg and doing good. I’ve tried to go off it before but I always get irritable and just aren’t as good as a mother or wife. I become so critical and never like anyone when I’m off, which is a horrid feeling.
Another unexpected side effect that I LOVE is that my **sex drive** increased. I was always once a week at most and didn’t really love sex. Now I enjoy it more and actually have a drive. In that way alone my relationship has become better with my husband. I’m sad that I need a medication and worry it won’t always work. It didn’t cure my ADHD or anxiety but it helped a little. Mainly helped my depression. I still have bad days but I’m thankful it has helped. Read More Read Less

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The Many Uses of Bupropion and Bupropion Sustained Release (SR) in Adults

Sir: Bupropion is an antidepressant originally approved by the U.S. Food and Drug Administration (FDA) in 1989 for the treatment of depression.¹ Its unique mechanism of action among antidepressants is thought to be due to reuptake of dopamine and norepinephrine.² In 1997, the FDA approved bupropion sustained release (SR) for the treatment of smoking cessation.³ Bupropion has been used to treat a number of conditions, and the following discussion will review those off-label uses.

It appears that bupropion may be an effective antidepressant across a wide spectrum of depressive conditions. Weihs et al.⁴ found bupropion to be a safe and effective agent in the treatment of depression in the elderly. In addition to having a favorable side effect profile, bupropion has been shown to have positive results in treating anxiety associated with depression compared with sertraline and fluoxetine.^5–7 The most common side effects of bupropion described in a series of studies include headache, dry mouth, and nausea when compared with placebo.⁸ Two important clinical issues noted in the studies were that sexual dysfunction was reported by less than 1% of patients and that a dose-associated weight loss was found in all 3 studies.⁸ Bupropion has also been associated with weight loss in overweight and obese women in a recently published study.⁹

Dysthymic disorder, a chronic low-grade depression, is often treated with antidepressants.¹⁰ In an open-label study of 21 adults diagnosed with dysthymia, 71.4% responded to bupropion SR treatment with no dropouts due to side effects.¹¹

Bipolar depression can be a debilitating phase of the illness with associated morbidity and increased risk of suicide.¹² Mood stabilizer monotherapy is insufficient for the majority of bipolar patients.¹³ In the Expert Consensus Guideline Series for the medication treatment of bipolar disorder, bupropion is the treatment of choice for mild-to-moderate depression.¹⁴ It is also a preferred agent in the treatment of severe melancholic and atypical depression associated with bipolar disorder.¹⁴ Bupropion was associated with lower rates of inducing mania than desipramine in a prospective, double-blind trial.¹⁵ It may also be associated with milder manic states than other antidepressants.¹⁶ Bupropion may also be a promising adjunct to lithium in rapid-cycling bipolar patients.¹⁷

Up to 46% of patients do not adequately respond to treatment with antidepressants.¹⁸ Clinicians are left with either switching or augmenting options. Bupropion appears to be a safe and effective agent when added to selective serotonin reuptake inhibitors (SSRIs).¹⁹ Mischoulon et al.²⁰ reported that bupropion was the most widely chosen augmentation agent in a survey of 801 clinicians in the United States and Canada.

Sexual dysfunction may occur in up to 75% of patients taking antidepressants.²¹ In head-to-head trials, bupropion SR has also been shown to have a significantly lower rate of sexual dysfunction than sertraline and fluoxetine.^22–24 Bupropion has been used successfully to treat antidepressant-induced sexual dysfunction in a number of studies.^25–30 Bupropion SR may also be a useful agent in treating orgasmic dysfunction in nondepressed patients.³¹ It has been reported to be a treatment option for women diagnosed with hypoactive sexual desire disorder.³²

Initial results of an open-label study involving bupropion in the treatment of social phobia appear to be promising.³³ Canive et al.³⁴ looked at bupropion’s efficacy in treating posttraumatic stress disorder (PTSD). They found bupropion decreased depressive symptoms, but no significant changes in symptoms of intrusion and avoidance were noted. Almai et al.,³⁵ in an open trial evaluating bupropion SR in the treatment of PTSD, noted that 89% of the patients completing the study reported a marked improvement in reexperiencing, avoidance, numbing, and hyperarousal symptoms.

Bupropion may offer a valuable treatment option in adults with attention-deficit/hyperactivity disorder (ADHD), which may occur in as many as 4.7% of adults.³⁶ As early as 1990 in an open-label trial, Wender and Reimherr³⁷ reported that bupropion treatment was beneficial in adults with ADHD. Wilens et al.³⁸ conducted a double-blind, placebo-controlled, randomized, parallel 6-week trial comparing bupropion SR with placebo in adults with ADHD. The results showed that bupropion SR was associated with significant changes in ADHD symptoms, with 76% reporting improvement compared with 37% taking placebo. Based on Clinical Global Impressions scale screens, 52% of patients taking bupropion reported being much improved compared with 11% treated with placebo. Kuperman et al.³⁹ in a randomized, double-blind, parallel study compared bupropion, methylphenidate, and placebo. The group treated with bupropion reported a 64% response rate based on the Clinical Global Impressions scale versus a 50% response rate in the methylphenidate group and a 25% response rate in the placebo-treated group. There are at least 2 other double-blind, placebo-controlled studies and 1 open-label study in adults demonstrating bupropion SR to be effective in reducing ADHD symptoms.^40–42

To date there is 1 double-blind, placebo-controlled crossover study evaluating the efficacy of bupropion in the treatment of neuropathic pain, which showed promising results with 73% of patients experiencing pain relief on bupropion SR.⁴³

In a case report, bupropion SR has been shown to be of value when combined with behavior modification in treating smokeless tobacco use.⁴⁴ Bupropion has been helpful in reducing cravings associated with cocaine use in an active-controlled study, an open-label trial, and a case report,^45–47 but showed no advantage in 2 other reports.^48,49 In another case report, bupropion SR therapy and participation in a 12-step program showed positive results in reducing cravings associated with methamphetamine use.⁵⁰

Bupropion appeared to be superior to placebo in a double-blind, controlled study of patients with bulimia.⁵¹ However, 4 patients suffered grand mal seizures during treatment, and it is recommended that bupropion not be used in patients with any history of seizures, anorexia nervosa, bulimia, or major head injury.¹ It is also recommended that when physicians are prescribing medications in an off-label use that informed consent be obtained acknowledging the off-label use.

Bupropion appears to have a number of uses in a variety of conditions, in addition to its FDA indications. It is recommended that physicians using bupropion in an off-label condition document the patient.

Wellbutrin for Anxiety: What You Need To Know

More than 30 percent of Americans will suffer from 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 struggling with 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 suffering from 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:

• Dizziness
• Nervousness
• Shakiness (tremor)
• Blurred vision 
• Irritability 
• Dry mouth 
• Edema (swelling)
• Excessive sweating
• Headaches
• Migraines
• Difficulty sleeping or insomnia 
• Constipation 
• Abnormal dreams
• Nausea
• Vomiting
• Tachycardia (fast heartbeat)
• Weight gain or weight loss
• Sedation

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 struggling with anxiety, talk to a healthcare professional to determine a diagnosis and proper course of treatment. You don’t need to suffer.

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 1-800-273-TALK, 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:

• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Celexa (citalopram)
• Paxil (paroxetine)
• Zoloft (sertraline) 
• Luvox (fluvoxamine)

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

You can start controlling your anxiety and get access to the treatment you need with K Health. Starting at $12/month get prescriptions for mental health medications plus unlimited provider visits through the K Health app. Start your free assessment here.

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.

4 Sources

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions,
and medical associations. We avoid using tertiary references.

Does Wellbutrin Help With Anxiety?

Anxiety is commonly treated with psychotherapy, but it also can involve the use of medication. 

One of the medications sometimes prescribed is bupropion—more specifically, the brand name version Wellbutrin®. To learn more about Wellbutrin and its effectiveness, keep reading.

What is Wellbutrin Used For?

As previously mentioned, Wellbutrin is the brand name version of bupropion. It’s an antidepressant sold in tablet form that works by increasing certain types of activity in the brain.  

It’s most commonly prescribed to treat depression or seasonal affective disorder, and along with its Wellbutrin moniker, it’s also sold under the brand names Wellbutrin SR® and Wellbutrin XL®.

Bupropion is also sometimes prescribed to help someone stop smoking. Research has found that bupropion can reduce tobacco cravings and withdrawal symptoms, making it easier for people to give up cigarettes.

Sometimes people who take Wellbutrin for depression experience anxiety as a side effect. Interestingly, the drug has also been found to help people who suffer from anxiety associated with depression. Your healthcare provider can help you monitor how the drug is working for you. 

How might this anxiety present itself? There are many ways it may show up. Examples include anxious or negative thoughts, social anxiety or anxiety attacks. 

The anxiety can be short term, but if it lasts longer than six months, it’s considered an anxiety disorder. This is the type of anxiety that benefits from treatment of some sort.

How Does Wellbutrin Work to Help Anxiety? 

Wellbutrin is in a class of drugs called aminoketones, and it affects the way your body produces certain neurotransmitters—specifically, dopamine and norepinephrine. 

Both of these are crucial to your mood. 

Dopamine regulates a variety of functions—most notably, sleep, pleasure, motivation and mood. 

Norepinephrine keeps your body alert, pumping blood through your system, keeping you awake, and more.

People with depression may have low levels of dopamine, which is why Wellbutrin is thought to help. 

For this reason, it’s also used for people who deal with anxiety as a result of depression.

It’s important to note that generic bupropion can be just as effective in treating depression and anxiety as the name brand—and it’s often most cost effective.

If you are interested in exploring taking bupropion for your anxiety, the first step is to talk to a healthcare professional and schedule an online psychiatry evaluation.

online counseling

the best way to try counseling

What Are Potential Wellbutrin Side Effects? 

Good news: Compared to many other antidepressants, bupropion is less likely to cause side effects like drowsiness, weight gain and sexual issues. 

Of course, like with any medication, there is a chance you may experience some minor adverse reactions. 

Potential bupropion side effects include: 

• Abnormal dreams

• Agitation

• Blurred vision

• Constipation

• Dizziness

• Dry mouth

• Edema (swelling) 

• Excessive sweating

• Headaches

• Insomnia

• Nausea

• Vomiting

If you experience any side effects, however minor, consult with your healthcare provider to discuss what’s right for you.

There are sometimes more severe side effects that can occur when taking bupropion. These include: 

• Mental health issues such as changes in mood, panic attacks, and worsened depression or anxiety.

• Hypertension. Bupropion can contribute to high blood pressure. If you already deal with blood pressure issues, be sure to tell your healthcare provider before taking bupropion.

• In rare instances, bupropion can cause risk of seizure. This occurs in less than 1% of people who take the medication. If you have a history of seizures, be sure to mention it to your healthcare professional.

Both generic bupropion and the brand name Wellbutrin (along with many other antidepressants) have what is called a “black box” safety warning from the FDA. 

This is the most serious type of warning and it lets users know that antidepressants can increase the risk of suicidal ideation and/or behavior in children, adolescents and young adults.

Research shows this risk can especially exist for people up to the age of 24.

Anxiety may feel overwhelming, but it is highly treatable. In addition to medication, there are a few other approaches you can take to deal with anxiety. Here are some common treatment options: 

Therapy

In addition to meds, psychotherapy can be an effective treatment for anxiety.  While one can explore any type of therapy to treat anxiety, cognitive behavioral therapy (CBT) and exposure therapy are common go-tos.

In CBT you work with a mental health professional to identify unhealthy or problematic thoughts and habits that may contribute to your anxiety.

Then you work on ways to change those negative thoughts and behaviors.

With exposure therapy you confront things that cause anxiety with the goal of making those things less worrisome. 

This type of therapy is best for phobias, post traumatic stress disorder and situational anxiety.

If you’d like to explore therapy as a way of dealing with your anxiety, find a mental health professional in your area or consider online counseling.

Anonymous Support Groups

Talking to people going through similar things can make you feel less alone. The benefit of going with an anonymous group? 

You don’t have to worry about feeling judged and may feel more comfortable sharing. 

Hearing how others deal with their anxiety won’t just give you peace of mind, you may pick up a few tips, too. 

Hims has anonymous online support groups you can join.

Lifestyle Tweaks

In addition to talking it out and medications, there are a number of research-backed life habits you can implement that may help ease anxiety. Common ones include: 

• Exercise: The Anxiety and Depression Association of America has found that breaking a sweat on a regular basis helps to boost your mood and ease anxiety and depression. Keep in mind, your workout doesn’t have to be intense to reap the psychological benefits—just taking a long walk or light jog regularly can help. 

• Healthy Eating: Research has shown that a diet packed with fruits, veggies, whole grains and lean protein may result in lower risk of developing anxiety. Oh, and think twice about drinking cup after cup of java. According to studies, excessive amounts of caffeine can worsen anxiety.

• Sleeping well: Sleep is important for a variety of reasons, not the least of which is that bad sleep is connected to anxiety. According to the Anxiety and Depression Association of America, people who deal with chronic sleep issues are at a high risk to develop an anxiety disorder. The goal: to get at least seven to nine hours of snooze time per night.

online psychiatry

it’s never been easier to talk to a psychiatry provider about treatments

The Big Question: Is Wellbutrin Good For Anxiety? 

No matter what, remember this: Anxiety doesn’t have to rule your life. Wellbutrin can help with anxiety, but check with a healthcare professional to see if it’s right for you.

Whether you take medication or partake in talk therapy or both, there are a variety of ways to deal. 

Anxiety might be common, but it’s possible to manage it so you can feel more balanced every day.

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

1. Facts & Statistics. Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/facts-statistics
2. Help With Anxiety Disorders. American Psychiatric Association. Retrieved from https://www.psychiatry.org/patients-families/anxiety-disorders
3. Bupropion (2018). MedlinePlus. Retrieved from https://medlineplus.gov/druginfo/meds/a695033.html
4. Britton, J. (2000, July). Bupropion: A New Treatment For Smokers. BMJ, 321(7253): 65-66. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1127748/#:~:text=The%20first%20of%20these%20studies,daily%2C%2022.9%25%20for%20those%20who
5. Berigan, T. (2002). The Many Uses of Bupropion and Bupropion Sustained Release (SR) in Adults. The Primary Care Companion to the Journal of Clinical Psychiatry. 4(1): 30-32. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314381/
6. Unwanted Intrusive Thoughts (2018). Anxiety and Depression Association of America. Retrieved from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/unwanted-intrusive-thoughts
7. Understanding Anxiety Disorders (2016). News In Health. Retrieved from https://newsinhealth.nih.gov/2016/03/understanding-anxiety-disorders
8. Stahl, S., Pradko, J., Haight, B., et al (2004). A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. The Primary Care Companion to the Journal of Clinical Psychiatry, 6(4):159-165. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514842/
9. Dopamine. National Library of Medicine. Retrieved from https://pubchem.ncbi.nlm.nih.gov/compound/Dopamine
10. Norepinephrine. Hormone Health Network. Retrieved from https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/norepinephrine
11. Belujon, P., Grace, A., (2017, December). Dopamine System Dysregulation in Major Depressive Disorders. International Journal of Neuropsychopharmacol, 20(12): 1036-1046. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716179/
12. Yasin, W., Ahmed, S., Gouthro, R., (2019, March). Does Bupropion Impact More than Mood? A Case Report and Review of the Literature. Cureus, 11(3): e4277. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529042/#:~:text=It%20is%20as%20effective%20as,%2C%20and%20sedation%20%5B2%5D
13. Wellbutrin Prescribing Information. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/018644s043lbl.pdf
14. Exercise for Stress and Anxiety. Anxiety and Depression Association of America. Retrieved from https://adaa.org/living-with-anxiety/managing-anxiety/exercise-stress-and-anxiety
15. Jacka, F., Pasco, J., Mykletun, A., et al. (2010, March). Association of Western and traditional diets with depression and anxiety in women. American Journal of Psychiatry, 167(3): 305-11. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20048020/
16. Addicott, M., (2014, September). Caffeine Use Disorder: A Review of the Evidence and Future Implications. HHS Public Access Author Manuscript, 1(3):186-192. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4115451/
17. Sleep Disorders. Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/sleep-disorders

Using Wellbutrin for Anxiety: Can it Help?

Wellbutrin is the brand name for bupropion, which is a medication commonly prescribed to treat depression, though it can also be prescribed for those with anxiety. 

Medications can have different effects on different people, which may leave you with some questions. 

For some, Wellbutrin may cause worsened anxiety symptoms, but for others, it can actually be a highly effective treatment. It all comes down to the fact that everyone’s body and brain chemistry is different. 

The FDA has approved bupropion for use in treating seasonal affective disorder as well as helping those trying to quit smoking. These usages that have been approved are referred to as “on-label” uses, but Wellbutrin has several off-label uses as well. 

These off-label uses include treating:

• Sexual dysfunction that has been caused by previous use of antidepressants
• Depression associated with bipolar disorder and obesity
• Weight gain linked to the previous use of psychiatric medications
• Symptoms of attention deficit hyperactivity disorder in adults and children
• Generalized anxiety disorder

If your doctor has recommended that you start treatment with Wellbutrin and you are looking to learn more, or if you are curious about the medication before heading into your consultation, we have you covered. 

Gaining a better understanding of psychiatric medications can help you make more informed decisions when it comes to your health and treatment plans. 

What is Wellbutrin and Why is it Usually Prescribed?

The exact way that Wellbutrin works in your body is not known, but it is commonly thought to have an impact on the mood-influencing chemicals in your body, specifically dopamine and norepinephrine. In this way, it differs from other common antidepressants because it does not impact serotonin levels the way that traditional antidepressants and SSRIs do.

The therapeutic effects of Wellbutrin generally start to become apparent after about 2 weeks of using the medication regularly, making it relatively fast-acting. Your doctor may be able to give you a more accurate window of time for when the effects will start taking place. 

Does Wellbutrin Itself Cause Anxiety?

Like most medications, Wellbutrin does have some potential side effects. 

One of these is anxiety, and others include restlessness, agitation, and insomnia. Generally speaking, any anxiety-related side effects will likely be at their worst right after treatment starts, or in the short time period following any dosage increases. 

The good news is that only about 2% of people end up stopping their usage of Wellbutrin as a result of these side effects, providing insight to how manageable these side effects can be. 

These side effects can also be a result of your Wellbutrin dosage being increased too quickly. If you do start experiencing any side effects, consulting your doctor can help you get to the bottom of it. 

Generally, using Wellbutrin in low doses, and only changing those doses very slowly, can help prevent side effects from occurring, or at least lessen the severity of any side effects.

Can Wellbutrin Really Help My Anxiety?

Even though anxiety is a potential side effect of Wellbutrin, it can still be an effective treatment for anxiety disorders, and it may even be able to help improve symptoms associated with panic disorder. 

Further research is still needed to determine whether or not Wellbutrin may be an appropriate second or third-line treatment for anxiety, but regardless, some have found it to be effective.

As mentioned earlier, the FDA has not yet approved the use of Wellbutrin for anxiety, but this does not mean that it can’t help you or isn’t worth a try. 

If other treatment methods or plans have not been working for you thus far, it may be worth asking your doctor about Wellbutrin and listening to what they have to say for your particular situation and health history. If they think it may be a good fit, they might prescribe it. 

What Other Side Effects Should I Be Aware Of?

Besides anxiety, Wellbutrin has several other potential side effects:

• Sleep disturbances
• Fast heart rate
• Nervousness
• Dizziness
• Headaches
• Tremors
• Nausea
• Constipation

These are the most common, generally mild side effects, and they do not differ much from the side effects of other common medications prescribed for mental health conditions. 

However, there are some rarer, more serious side effects as well. These include:

• New or worsening suicidal thoughts
• Manic episodes, especially in people who have bipolar disorder
• Paranoia, delusions, and hallucinations
• High blood pressure
• Certain eye problems, including pain, swelling, and redness of the eyes
• Severe allergic reactions

These side effects are much less common, and usually only occur in people who are taking high doses of Wellbutrin. 

Because of these side effects, there are many common misconceptions and myths surrounding Wellbutrin usage, which may be the source of some of your concerns and questions. Let’s take a look at a few. 

Common Misconceptions About Wellbutrin

One of the biggest misconceptions about Wellbutrin is that it can cause new anxiety, make existing anxiety worse, or will not help anxiety at all. Anxiety is a side effect of the medication, so these speculations aren’t impossible, but taking low doses of Wellbutrin can help prevent this from happening.  All common antidepressants have a risk of causing anxiety, so Wellbutrin is not much different in this regard.

Some people may also believe that Wellbutrin will not be effective in the treatment of anxiety in people who also have depression, but this is not necessarily the case. People who are specifically struggling with anxious depression may see great results from Wellbutrin, and those with generalized anxiety disorder may also benefit. 

The grey area occurs with people with depression and a completely separate anxiety disorder that is not GAD. This is why it is important to consult your doctor in order to choose the best treatment plan for your specific needs. 

One final myth associated with Wellbutrin is that it is not a good fit for people struggling with insomnia or other sleep disturbances. Wellbutrin does have insomnia as a potential side effect, but this is seen more so when someone first begins taking this medication. That said, insomnia generally does not persist as a result of Wellbutrin, but if it does, consulting your doctor can help you find a better solution for your anxiety. 

Summary

Wellbutrin is the brand name for the drug bupropion, and it is commonly prescribed to treat depression and seasonal affective disorder. 

Wellbutrin is sometimes used to help treat anxiety, but because anxiety is also a potential side effect, it may not be the best fit for everyone. Everyone’s body works differently, and what works for one person may not work for another. Therefore, it is always important to consult your doctor before starting a new medication so that they can help you take care of your specific needs and concerns. 

That said, Wellbutrin can be effective for anxiety, specifically in cases of anxious depression or generalized anxiety disorder. Using Wellbutrin for anxiety is currently an off-label usage, meaning the FDA has not yet approved it for this purpose, but this does not make it any less viable of an option. 

When it comes to the right treatment plan for your specific needs and concerns, it is important to consult a mental health professional who can help guide you in the right direction. 

YANA is a virtual mental health clinic that matches you with a doctor who can perform an assessment in order to help figure out what may be bothering you. Your doctor will give you a tailored plan for improving your symptoms and starting the path to a happier and healthier you. If medication is an option, your prescriptions will be discreetly delivered to your door at no additional cost. 

YANA’s online platform is both affordable and accessible, meaning you will spend less time and money trying to find the quality care that you need.

Anxiety can be exhausting both physically and mentally, and our doctors and mental health professionals are here to make getting mental healthcare easier, more affordable, and on your terms!

Sources:

https://www.medicalnewstoday.com/articles/does-wellbutrin-cause-anxiety

https://www.healthline.com/health/anxiety/wellbutrin-anxiety

https://www.psychiatrictimes.com/view/3-myths-about-bupropion

Bupropion (Oral Route) Proper Use

Proper Use

Drug information provided by: IBM Micromedex

Take this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Swallow the tablet whole. Do not break, crush, or chew it.

You may take this medicine with or without food. But if you have nausea, take the medicine with food.

A part of the extended-release tablet may pass into your stool. This is normal and is nothing to worry about.

Use of Zyban® tablets:

• 
  You may continue to smoke for about 1 week after you start the medicine.
• 
  Set a target date to quit smoking during your second week of treatment.
• 
  If you are still having trouble with quitting after using the medicine for at least 7 weeks, talk to your doctor.
• 
  If you use a nicotine product (eg, patch) together with Zyban®, do not smoke. Smoking may increase the chance for serious side effects.

If you have trouble sleeping (insomnia), do not take this medicine too close to bedtime.

If you use this medicine to prevent depression with seasonal affective disorder, take it during the autumn season before your symptoms start. Continue using the medicine through the winter season and until early spring.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• 
  For oral dosage form (extended-release tablets):
  • 
    For depression:
    • 
      Adults—
      • 
        Aplenzin®: At first, 174 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 522 mg per day.
      • 
        Forfivo XL®: 450 mg once a day.
      • 
        Wellbutrin XL®: At first, 150 mg once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 450 mg per day.

    • 
      Children—Use and dose must be determined by your doctor.

  • 
    For seasonal affective disorder:
    • 
      Adults—
      • 
        Aplenzin®: At first, 174 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 522 mg per day.
      • 
        Wellbutrin XL®: At first, 150 mg once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 300 mg once a day.

    • 
      Children—Use and dose must be determined by your doctor.

• 
  For oral dosage form (sustained-release tablets):
  • 
    For depression:
    • 
      Adults—At first, 150 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg two times per day, taken at least 8 hours apart.
    • 
      Children—Use and dose must be determined by your doctor.

  • 
    To quit smoking:
    • 
      Adults—At first, 150 milligrams (mg) once a day for the first 3 days. Your doctor may adjust your dose as needed. However, the dose is usually not more than 300 mg per day.
    • 
      Children—Use and dose must be determined by your doctor.

• 
  For oral dosage form (tablets):
  • 
    For depression:
    • 
      Adults—At first, 100 milligrams (mg) two times per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 150 mg three times per day, taken at least 6 hours apart.
    • 
      Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you are taking the Wellbutrin XL® extended-release tablet and you miss a dose, skip the missed dose and go back to your regular dosing schedule.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Portions of this document last updated: Sept. 01, 2021

Copyright © 2021 IBM Watson Health. All rights reserved. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.

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Best Antidepressant for Anxiety – Consumer Reports

Most respondents—78 percent—received medication for their depression or anxiety, reflecting the tremendous growth of the use of antidepressant drugs in the past 15 years. According to IMS Health, a group that monitors drug sales, U.S. doctors prescribed $9.9 billion worth of antidepressants in 2009, a 3 percent growth over the previous year. They’re the third most prescribed class of drugs in the country, after cholesterol-lowering drugs and codeine-based painkillers, thanks at least in part to years of aggressive marketing.

Drugmakers spent almost $300 million in 2009 on ads for two newer antidepressants alone: duloxetine (Cymbalta: “When you’re depressed, where do you want to go? Nowhere.”) and desvenlafaxine (Pristiq: “I feel like I have to wind myself up just to get out of bed.”).

Reflecting national trends, most recipients of medication in our survey got an SSRI (selective serotonin reuptake inhibitor) such as fluoxetine or sertraline; many others got an SNRI (serotonin and norepinephrine reuptake inhibitor) such as venlafaxine or duloxetine. The drugs alter the levels of certain brain chemicals, or neurotransmitters, that carry signals between nerve cells. The Food and Drug Administration has approved SSRIs and SNRIs as standard first-line treatments for depression and anxiety disorders.

Forty-seven percent of respondents got their prescription from a psychiatrist; the rest obtained it from their primary-care physician, whom they saw separately or as an adjunct to talk therapy with a mental-health professional. That’s consistent with national data that show primary-care doctors, not psychiatrists, prescribe the majority of SSRIs and SNRIs and have done so for at least the last five years.

One size doesn’t fit all

Some SSRIs and SNRIs are promoted for particular types of anxiety, such as social anxiety or obsessive-compulsive disorder. But clinical evidence shows that they work equally well for each major form of anxiety. And individuals don’t all react the same way to these drugs, so it can take some trial and error to find the one that works best for you. Among respondents who took medication for anxiety or depression, the median number of drugs tried was three. Respondents who tried three medications had slightly better outcomes than those who tried fewer or more, suggesting that trial and error is an important part of pharmaceutical treatment.

Expect some side effects

As with all drugs, antidepressants have side effects. But our findings suggest they can be a lot more common than what’s reported in the package inserts you get when you fill your prescription. For example, 31 percent of people we surveyed who took SSRIs and 36 percent of those who took SNRIs reported a decrease in sexual interest or ability. That’s more than double the rate reported in studies sponsored by drug companies, which can carefully choose their participants and tend to pick those least likely to experience adverse effects.

Interestingly, men reported more sexual side effects than women, while women complained more often about weight gain. It may be a true physiological difference, or women may simply be more bothered by weight gain and men by sexual difficulties.

The sexual side-effect rates from the current survey are lower than those we found in 2004, when up to 53 percent of respondents reported them. “It’s possible that health-care providers are either prescribing antidepressants that are less likely to cause these problems, such as bupropion (Wellbutrin and generic) or are adding another drug in as an antidote to help counteract the sexual side effects,” said Anita Clayton, M.D., a professor of psychiatry and obstetrics and gynecology at the University of Virginia.

For many respondents, side effects proved more than mere annoyances: Of those who’d stopped taking an antidepressant, 33 percent said they did so because of intolerable side effects. Still, the drugs helped a lot for about half of the people who took them and at least somewhat for another 30 percent. And people who took the drugs in conjunction with talk therapy fared especially well.

Use tranquilizers selectively

For the 58 percent of respondents who experienced anxiety, we also asked about benzodiazepines, an older class of anti-anxiety drugs that includes alprazolam (Xanax and generic) and lorazepam (Ativan and generic). About one-quarter had tried a benzodiazepine; of those, 57 percent said it helped “a lot.” The drugs can cause dizziness and drowsiness, though, and unlike SSRIs and SNRIs, their daily use can lead to dependence. Our medical consultants say they’re best for short-term “rescue” situations, such as quelling a panic attack or helping a fearful flyer board a plane.

What to do

Consumer Reports Best Buy Drugs, a public education project that generates drug recommendations based on safety, efficacy, and price, says that generic bupropion, citalopram, fluoxetine, and sertraline are among the best initial options to consider for depression. Ask your doctor whether you can start at the lowest dose possible. If the first drug hasn’t helped within six to eight weeks, talk with your doctor about increasing the dose or switching to a different drug. Don’t take bupropion if you have a history of seizures, since it carries a risk of seizures at high doses. Discuss with your doctor the potential side effects and how long you’ll probably need to take the drug (most respondents had been taking theirs for at least two years). Don’t stop taking an antidepressant suddenly, which could cause withdrawal symptoms.

90,000 in the Ministry of Health established whether the antidepressant bupropion can be equated with drugs – RT in Russian

The experts of the Ministry of Health recognized the antidepressant bupropion as an effective drug that does not have characteristic side effects. Since the spring of this year, despite the fact that the drug was not banned, criminal cases were initiated against the Russians who bought this drug on drug charges. However, experts have found that only those who have qualifications and deep knowledge in organic chemistry can get a narcotic substance from it.In addition, over the past 10 years in Russia, not a single case of using the drug to obtain a psychoactive effect has been identified.

The antidepressant bupropion, used to treat mental disorders, unexpectedly became outlawed in the spring of 2019, when law enforcement agencies opened several criminal cases at once over the purchase of a medicine. As the security officials themselves explained, examinations showed that bupropion is a derivative of the banned ephedrone – it has a formal similarity in the chemical formula.As a result, those who ordered pills in foreign pharmacies were charged with drug smuggling (229.1 of the Criminal Code of the Russian Federation), and if purchased through intermediaries in Russia, they were attracted under the article on drug trafficking (228 of the Criminal Code of the Russian Federation).

As reported by RT, after a request from State Duma Deputy Yaroslav Nilov to the Ministry of Health on the topic of criminal prosecution of citizens for the purchase of this antidepressant, the department turned to leading experts with questions about the narcogenic potential of an antidepressant and the effectiveness of its use for medical purposes.

So, the representatives of the department received the conclusions of three experts: the chief freelance psychiatrist of the Ministry of Health of Russia Zurab Kekelidze, the director of the Moscow Scientific and Practical Center for Narcology of the Moscow Department of Health Sergei Koporov and the chief freelance specialist in analytical and forensic toxicology of the Ministry of Health Boris Izotov.

RT peer reviews of bupropion are available.

Unpopular, but no side effects

The response of the Ministry of Health to RT’s request for the results of consultations with experts indicated that the drug bupropion, known under the trade names Velbutrin, Zyban, Voxra, Budeprion, Aplenzin ”, Is an atypical antidepressant used in medical practice in Europe and the United States since the 1980s for the treatment of anxiety and social phobia accompanying depression, attention deficit disorder, and seasonal affective disorders.

Chief freelance psychiatrist of the Ministry of Health Zurab Kekelidze notes that bupropion, which was previously officially sold in Russia, has not received widespread use, but in comparison with similar antidepressants it does not cause side effects characteristic of them.

“In addition, bupropion has proven to be effective in the treatment of nicotine addiction,” says the expert.

Narcogenic potential

According to Kekelidze’s conclusion, bupropion can be used to obtain a psychoactive effect.

Also on the topic

“Protect society from drug aggression”: the Ministry of Internal Affairs expressed their position on criminal cases for the purchase of antidepressants

The Ministry of Internal Affairs believes that it is not worth changing the legislation that allows citizens to be held accountable under “narcotic” articles …

“In this case, the route of administration changes from oral to intranasal, and the dosages are many times higher than therapeutic, which leads to an increased risk of seizures, since the use of bupropion can lower the threshold of seizure readiness of the brain,” the expert writes.

However, apparently, the likelihood of using the drug for non-medical purposes exists only in theory.

“According to the Moscow Scientific and Practical Center for Narcology of the Moscow Healthcare Department, over the past ten years, there have been no cases of abuse of bupropion in the narcological service of the constituent entities of the Russian Federation. In addition, no cases of bupropion were detected during chemical and toxicological studies in samples of biofluids of the examined citizens, ”says the conclusion of the director of the institution, Sergei Koporov.

With regard to the practical possibility of converting bupropion to the banned ephedrone, according to experts, it is possible, but extremely difficult.

“Obtaining ephedrone in this way requires deep knowledge in organic chemistry and relevant qualifications, therefore, ephedrone is most often obtained from ephedrine,” explains Boris Izotov, chief freelance specialist in analytical and forensic toxicology of the Ministry of Health.

When asked by RT about whether the Ministry of Health will take any action to “legalize” bupropion, taking into account the opinion of experts, the department did not answer.

Belyaeva’s case

One of the first cases of persecution of Russians for buying bupropion became known in April 2019. Then the Ministry of Internal Affairs opened a criminal case against a resident of Yekaterinburg, Daria Belyaeva, who suffers from schizotypal personality disorder.

Also on the topic

“It’s gotten worse, but it’s dangerous to order”: the State Duma is asked to deal with criminal cases on the purchase of antidepressants

The State Duma asks the Prosecutor General’s Office to find out whether the actions of law enforcement officers who initiate criminal proceedings against are legal…

Belyaeva became a defendant in a criminal case under Part 3 of Art. 229.1 of the Criminal Code of the Russian Federation after she ordered in Poland the antidepressant Elontril recommended by her doctor, which includes bupropion. The drug was not on the lists of substances prohibited for import, but during the examination it was found that it was theoretically possible to make drugs from tablets. The Customs Forensic Service concluded that the product could be considered an ephedrone derivative.

Now for the purchase of 30 tablets the girl faces up to 20 years in prison.

The media reported on a number of similar criminal cases, which are being investigated in several regions.

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Pharmacological properties
Bupropion is a selective inhibitor of the neuronal uptake of catecholamines (norepinephrine) c and dopharmaceutical minimal effect on the seizure of indolamines (serotonin) and the absence of inhibition of monoamine oxidase.

Pharmacokinetics
Absorption. After oral administration of bupropion tablets to healthy volunteers, the maximum plasma concentration was reached after 3 hours. Bupropion and its metabolites exhibit linear kinetics with prolonged administration at doses ranging from 150 mg to 300 mg per day. The absorption of bupropion is not significantly increased when consumed simultaneously with food. Distribution. Bupropion is widely distributed – its volume of distribution is approximately 2000 liters.Bupropion and hydroxybupropion bind moderately to plasma proteins (84% and 77%, respectively). The degree of binding to proteins of threohydrobupropion is about half that observed for bupropion. Metabolism. Bupropion is extensively metabolized in the human body. Three pharmacologically active metabolites have been identified in plasma: hydroxybupropion and its amino alcohol isomers – treohydrobupropion and erythrohydrobupropion. Elimination. Approximately 87% of bupropion is excreted in the urine (of which less than 10% is in the form of active metabolites), up to 10% is excreted in the feces.In an unchanged state, only 0.5% of bupropion is excreted. The average clearance after oral administration of bupropion is close to 200 L / h, and the average half-life of bupropion is approximately 20 hours. Patients with renal insufficiency. The effect of kidney disease on the pharmacokinetics of bupropion has not yet been studied. Elimination of the major metabolites of bupropion may be reduced with decreased renal function. Patients with hepatic impairment. The pharmacokinetics of bupropion and its active metabolites in patients with mild to moderate cirrhosis differs little from that in healthy volunteers.In patients with severe cirrhosis of the liver, the maximum concentration of bupropion and the area under the concentration-time curve are significantly increased, the mean half-life is also lengthened in comparison with healthy individuals. Elderly patients. Pharmacokinetic studies of the elderly have produced mixed results. Clinical experience has not established a difference in the tolerance of the drug between the elderly and young people, however, greater sensitivity to it in the elderly cannot be excluded.

Indications for use
Bupropion is indicated for the treatment of depressive conditions. If the patient responds positively to treatment, continued therapy with Bupropion is effective in preventing relapse and recurrence of depressive episodes in the future.

Route of administration and dosage
Bupropion tablets should be swallowed whole, without breaking or chewing. Adult use. Initial Treatment: The starting dose is 150 mg once daily.The full antidepressant effect of Bupropion, like other antidepressants, may not appear earlier than a few weeks after the start of treatment. Patients for whom the dose of 150 mg per day is insufficient may experience an improvement when the dose is increased to a maximum of 300 mg per day. The maximum single dose should not exceed 150 mg. Doses of Bupropion in excess of 150 mg per day should be taken in two divided doses at least 8 hours apart. Supportive care: Acute episodes of depression require antidepressant treatment for at least 6 months.It has been established that Bupropion at a dose of 300 mg per day is effective over a long (up to 1 year) period of treatment. Application in children and adolescents. The safety and efficacy of Bupropion in patients under 16 years of age has not been established. Use in patients with impaired liver function. In patients with liver disease, Bupropion should be used with caution. Given the increased variability of the pharmacokinetics of the drug in patients with mild to moderate liver cirrhosis, decisions must be made about long intervals between doses.In patients with severe liver cirrhosis, Bupropion should be used with extreme caution. In such patients, the dose should not exceed 150 mg every other day.

Side effects
General effect on the body: fever, chest pain, asthenia. The cardiovascular system; tachycardia, vasodilation, postural hypotension, increased blood pressure (in some cases significant), redness, loss of consciousness. Effect on the central nervous system: convulsions, insomnia, tremors, attention disorders, headache, dizziness, depression, disorientation, hallucinations, agitation.anxiety, irritability, aggressiveness, depersonalization. Endocrine and metabolic events: anorexia, weight loss. Gastrointestinal tract: dry mouth, gastrointestinal disorders that include nausea and vomiting, abdominal pain, constipation. Skin and hypersensitivity: rash, itching, sweating. Hypersensitivity reactions that range in severity from urticaria to vascular edema, dyspnea / bronchospasm, rarely anaphylactic shock. Arthralgia, myalgia, and fever have also been described in association with rashes and other symptoms of delayed hypersensitivity.These symptoms may mimic serum sickness. Erythema polymorphism and Stevens-Johnson syndrome are also described as rare side effects. Certain disorders: tinnitus, visual and taste disorders.

Contraindications
Bupropion is contraindicated in patients with hypersensitivity to bupropion or to any of the drug’s components. Bupropion is contraindicated in patients with vascular disorders. Bupropion tablets contain bupropion and should not be given to patients receiving any other drug that contains bupropion, as the incidence of seizures is dose-dependent.Bupropion is contraindicated in patients with a current or history of bulimia nervosa or anorexia nervosa, since this group of patients experienced a higher incidence of seizures when the rapid-release form of bupropion was administered. Concomitant use of Bupropion and monoamine oxidase inhibitors is contraindicated. At least 14 days should elapse between the cancellation of MAO inhibitors and the start of treatment with Bupropion.

Interaction with other drugs
In vitro studies show that bupropion is metabolized to its main active metabolite, hydroxybupropion, mainly by cytochrome P450 IIB6 (CYP2B6).Therefore, it is necessary to prescribe with caution Wellbutrin simultaneously with drugs that affect the isoenzyme CYP2B6 (for example, orphenadrine, cyclophosphamide, ifosfamide). Although bupropion is not metabolized by the CYP2D6 isoenzyme, in vitro studies of P450 in humans have shown that bupropion and hydroxybupropion are inhibitors of the CYP2D6 metabolic pathway. In human pharmacokinetic studies, administration of bupropion increased plasma levels of desipramine. This effect was observed for at least 7 days after the last dose of bupropion.The concomitant administration of Bupropion with other drugs that are metabolized by the CUR2G6 isoenzyme has not yet been studied. So, simultaneous use with drugs that are metabolized mainly by this isoenzyme (such as individual beta-blockers, antiarrhythmics, antipsychotics) should start with the minimum doses of the concomitant drug. If Bupropion is included in the treatment plan of a patient who is already receiving a drug that is metabolized by CYP2O6, the need to reduce the dose of this drug should be assessed, especially for drugs with a narrow therapeutic index.Since bupropion is extensively metabolized, concomitant administration of drugs that increase metabolism (eg, carbamazepine, phenobarbital, phenytoin) or inhibit metabolism may alter its clinical activity. Limited clinical data demonstrate a higher incidence of neuropsychiatric side effects in patients receiving bupropion concomitantly with levodopa or amantadine. The administration of Bupropion to patients receiving levodopa or amantadine should be administered with caution.Concomitant use of Bupropion and the Nicotine Transdermal System (NTS) may cause an increase in blood pressure.

Overdose
A single dose is described that is 10 times higher than the maximum therapeutic dose. In addition to the actions described in the Side Effects section, the overdose caused symptoms that included drowsiness and loss of consciousness. Treatment: in case of overdose, hospitalization is recommended. Ensure adequate airway patency, oxygenation and ventilation.Soon after overdose, gastric lavage may be helpful. The use of activated carbon is also recommended. The specific antidote for bupropion is unknown.

Application details
Special precautions The recommended dose of Bupropion should not be exceeded, as bupropion is characterized by a dose-dependent development of seizures. At doses that do not exceed the maximum recommended daily dose (150 mg Bupropion twice a day), the incidence of seizures is approximately 0.1% (1/1000).The risk of seizures associated with the use of Bupropion is closely correlated with the presence of risk factors. Therefore, Bupropion should be used with extreme caution in patients with one or more factors that contribute to increased seizure readiness. These factors include: • a history of head trauma; • tumors of the central nervous system; • history of seizures; • concomitant administration of other drugs that lower the seizure threshold. In addition, one should be careful in clinical cases associated with an increased risk of seizures.These include alcohol abuse, abrupt cessation of alcohol or sedatives, diabetes treated with hypoglycemic drugs and insulin, and the use of stimulants or anorexants. Bupropion should be discontinued and not re-prescribed to patients who have experienced seizures during treatment. Bupropion should be discontinued if the patient experiences symptoms of hypersensitivity or anaphylaxis during treatment (skin rash, itching, urticaria, chest pain, edema or dyspnea).Bupropion is extensively metabolized in the liver to active metabolites, which are subject to further metabolism. There was no statistically significant difference in the pharmacokinetics of bupropion in patients with mild to moderate liver cirrhosis compared with healthy volunteers, but the plasma levels of bupropion in individual patients were highly variable. Therefore, Bupropion should be used with caution in patients with liver pathology, reducing the frequency of dosing in patients with mild to moderate liver cirrhosis.Bupropion should be used with extreme caution in patients with severe cirrhosis. In these patients, it is necessary to reduce the frequency of dosing, since the peak concentrations of bupropion in them are significantly increased and accumulation of the drug occurs to a much greater extent than usual. All patients with liver disease should be carefully examined for possible side effects (eg, insomnia, dry mouth, seizures) that may indicate high levels of the drug or its metabolites.Bupropion and its metabolites are excreted primarily by the kidneys. Therefore, the treatment of patients with kidney damage should begin with reduced doses, since bupropion and its metabolites accumulate in such patients to a greater extent than usual. Careful monitoring of the patient is necessary, taking into account possible side effects (for example, insomnia, dry mouth, convulsions), which may indicate high levels of the drug or its metabolites. Clinical experience with bupropion has not shown any differences in tolerance in older people compared with other adult patients.However, a greater sensitivity to the drug in some elderly persons cannot be ruled out. Elderly patients are often characterized by decreased renal function, therefore, the dose must be reduced. As with other antidepressants, there is a risk that Bupropion may accelerate the manic phase in patients with manic-depressive psychosis during the depressive phase of the illness, and may also intensify patent psychoses in other susceptible patients. Pregnancy and lactation The safety of using Bupropion during pregnancy has not been established.Evaluation of studies on animals did not show direct or indirect harmful effects on the development of the embryo and fetus, the course of pregnancy, peri- and postnatal development. A reproductive study in rats showed no impairment of fertility. However, since reproductive studies in animals are not always those that can be applied in relation to humans, the appointment of Bupropion during pregnancy is permissible only in cases where the expected benefit is higher than the possible risk. Since bupropion and its metabolites are excreted in breast milk, it is recommended to stop breastfeeding while taking Bupropion.Influence on the ability to drive a car and other mechanisms. Like other drugs that affect the central nervous system, bupropion can interfere with the ability to perform tasks that require increased attention and coordination. Therefore, patients should be careful when driving and other mechanisms until they are convinced that Bupropion does not impair their function.

Terms of dispensing from pharmacies
The drug is dispensed by prescription.

Bupropion: Drug or Drug?

Psychiatrists refused to consider the antidepressant bupropion a narcotic, which led to at least two criminal cases opened in 2019.Why was it punished for his purchase – in the material “360”.

The Russian Society of Psychiatrists (ROP) has issued an opinion on the antidepressant bupropion, destroying the myth that it is a narcotic substance. The text states that bupropion does not cause euphoria, addiction syndrome and is not subject to massive abuse.

From the point of view of clinical pharmacology and narcology, bupropion cannot be considered a drug derivative only because of its structural chemical similarity to the illicit stimulant ephedrone.

In addition to bupropion, the experts in the conclusion drew attention to the imperfection of the Russian anti-drug legislation, which makes it possible to consider the drug available on the market in the public domain as a drug derivative.

Bupropion will bring to court

The ROP prepared an opinion in response to a request from a lawyer of one of the accused in a criminal case to buy bupropion. It is based on research and recommendations from European and American healthcare institutions.

In 2019 alone, at least two criminal cases were opened on drug smuggling due to the purchase of bupropion. The defendant in the first case was Daria Belyaeva from Yekaterinburg. She ordered a bupropion-based antidepressant from Poland since she was diagnosed with schizotypal personality disorder back in 2012. Then she spent a month in a neuropsychiatric dispensary, but after treatment the diagnosis was not withdrawn and how many drugs were prescribed: antidepressants, antipsychotics and anxiolytics. These medications did not help, so in 2019, the girl read about bupropion, an atypical antidepressant that affects dopamine levels.When leaving the post office, where Belyaeva took the parcel, she was detained by customs officers.

The second case is related to the employees of the Viagra Guru online store. They bought smoking control pills in India that contained bupropion. The outlet was created in 2017. She did not have a license to sell drugs. The store ordered them from foreign manufacturers in small batches under the guise of private individuals.

As a result, the founder of “Viagra guru” and his mother, who worked with him, were detained.Both were charged with drug smuggling on an especially large scale.

The remedy for the total

Bupropion was invented in 1966. Now it is produced under different brands: Wellbutrin, Zyban and Elontril. The drug is used to treat depression, anxiety, sexual dysfunction, attention deficit hyperactivity disorder, obesity, and nicotine addiction.

In 2016, bupropion became the 28th most popular antidepressant drug in the United States. He has been appointed over 20 million times.In the same year, the drug was included in the state register of medicines in Russia and was sold in pharmacies.

Psychiatrist Alexander Fedorovich in an interview with “360” supported the league of psychiatrists and noted that if a substance is included in the class of antidepressants, then it is not considered narcotic under any circumstances. It is not euphoric or physically addictive.

This is not a drug, it is a medical preparation for which there are very narrow indications and which is included in the pharmacopoeia.Used exclusively for treatment, not for pleasure

Alexander Fedorovich.

Now bupropion can be bought not only abroad, but also on Russian online drug booking services, as well as on forums and specialized groups in social networks.

GlaxoSmithKline antidepressant Paxil – “Resistant attitude to stress is provided, relieves anxiety”

For many years now I have been taking antidepressants from time to time, someone will say that I am a weakling, but I feel more comfortable living this way, because without them life is a nightmare.Who knows what real, soul-tearing anxiety is, he will understand me.

There was a period of taking the drug “Paxil”, it is a drug from the group of selective serotonin reuptake inhibitors. The doctor prescribed an initial dosage of 20 mg for me, dividing it into two doses 1/2 in the morning and 1/2 in the evening.

After taking the first dose of the drug, all emotions were completely kicked out of me, there was such bliss, indifference and calmness, which I had not experienced for a long time. But this only lasted for a few days, as then I began to suffer from side effects such as sweating, insomnia, tremors, muscle contraction and increased anxiety.During the period of getting used to the drug, I took additional tranquilizers to relieve anxiety.

After a month of taking it, I began to feel how anxiety began to let go of me and it just became easier to breathe, there was confidence in myself and the hope that sooner or later all this will pass and I will be cured.

I drank the drug at a dosage of 30 mg for half a year, it brought me into remission, the anxiety went away completely, the depression simply evaporated, but the two side effects did not go away. This is sweating and severe drowsiness.I slept literally at every step, wherever possible, in the evening when I came home from work I had enough strength just to take a shower and have dinner … and then sleep !!! In the morning I barely tore myself off the pillow.

Of course, I could not endure this for a long time, the doctor canceled the drug for me and transferred it to another, which not only has a sedative, but an activating effect. Knowing that the Paxil withdrawal syndrome was quite pronounced, when switching to another medicine I took additional tranquilizers, so I did not feel any obvious vegetative attacks.

In general, the preparation is excellent, but unfortunately it did not suit me perfectly. In theory, all side effects should go away after 2-3 months of administration completely, when the body adapts to the drug. By the way, I did not gain weight from the drug, as I was in the same weight, and remained.

Bupropion for attention deficit hyperactivity disorder (ADHD) in adults

Review Question

We reviewed the evidence regarding the effects of bupropion in adults with ADHD.We also looked at adverse effects (side effects that result from taking this medication).

Relevance

ADHD is a brain disorder that results in inattention, impulsivity, and / or overactive activity that interferes with normal functioning or development. Some people with ADHD have problems with only one aspect of behavior, while others have problems in combination. Bupropion is a medication used to treat depression and smoking cessation, but it is also used to treat ADHD.People with ADHD are usually prescribed stimulant medications such as methylphenidate and amphetamines. However, not everyone responds well to these medications. Some people cannot tolerate stimulants due to the side effects. Others may have medical contraindications for taking stimulants, such as mental or tic disorders. Other people may not want to use stimulants as they are controlled substances. Therefore, sometimes non-stimulants such as bupropion are used instead.Its effectiveness in treating ADHD remains unclear.

Search date

Evidence is current to February 2017.

Characteristics of research

We included six randomized controlled trials (RCTs), studies in which participants are randomly assigned to one of two or more treatment groups. Five studies were conducted in the United States and a sixth in Iran. The study involved 438 people with ADHD.All studies evaluated long-acting bupropion, a slow-release dosage form that can be taken just once a day. This simple dosage is suitable for people with ADHD, as illness may make them forget to take their medication.

The duration of the studies ranged from six to 10 weeks. All participants were diagnosed with ADHD and often had other mental health problems. In one study, all participants had ADHD and dependence on opioids (drugs that relieve pain).

Sources of research funding

Four studies were funded by industry and two others were funded by public funds. In one public-funded study, the lead author was paid by the industry (not buproprion manufacturers) for research activities.

Key Findings

Bupropion may lead to small improvement in ADHD as well as to reduce the severity of symptoms associated with ADHD.There were no more adverse effects with this drug than with a placebo. Bupropion may be an alternative treatment for those adults with ADHD who cannot or will not take stimulants.

Quality of evidence

The quality of the evidence in this review was low due to the small number of studies; five of the six studies were small and all inappropriate. The effects of bupropion on various aspects of daily functioning have not been studied.In addition, no studies have evaluated the long-term effects of this medication. Further research is needed to assess whether bupropion is effective in certain subgroups of ADHD or in people with additional disorders / disorders.

“Many people are already in prison” Why a Russian woman faces 20 years in prison for a pack of antidepressants: Society: Russia: Lenta.ru

A resident of Yekaterinburg, Daria Belyaeva, is suspected of drug smuggling due to the purchase of a Polish antidepressant on the Internet.The girl herself suffers from a mental disorder, and the active substance of the drug – bupropion – is not indicated in the list of narcotic drugs, psychotropic substances and their precursors, it is not in the list of potent and poisonous substances. In Russia, the license for it was revoked in 2016, but it is not prohibited – it simply cannot be bought in pharmacies. However, the Russian woman faces from 10 to 20 years in prison. At the request of Lenta.ru, the artist and psychoactivist Sasha Starost talked with Belyaeva and talked about why such situations can become a system.

“I have been ill since adolescence, but I came to a psychiatrist only seven years ago, already with derealization and depersonalization, terrible anxiety, jumping mood and severe apathy. Diagnoses were constantly changing, but in 2015 they settled on schizotypal disorder. Now we are treating symptoms in the form of depression, derealization-depersonalization, a jumping emotional state and, of course, apathy, ”says 24-year-old Daria.

She is a psychiatric patient with a diagnosis of schizotypal personality disorder since 2012, and since that time she has been constantly taking a combination of drugs, including antidepressants, antipsychotics and tranquilizers.As often happens with schizotypals, her depression was not relieved by standard antidepressants that work as selective serotonin reuptake inhibitors, so she consulted with her doctor and decided to buy the original European drug Elontril, which could eliminate dopamine receptor malfunction.

On April 23, the public PSY.WEB on VKontakte published the news that a criminal case was opened against her, which could threaten her for up to 20 years. She is accused of drug smuggling on a large scale for purchasing an atypical antidepressant with the active substance bupropion on the international pharmacological portal Euromedex.She was detained by customs officers right at the post office, where she came to receive the parcel.

Photo: Kirill Kukhmar / TASS

Law enforcement agencies claim that the drug is a derivative of the illegal drug ephedrone and “is used by drug addicts to obtain a euphoric effect.”

In the international classifier of diseases, schizotypal disorder is classified as a personality disorder and is defined when the symptoms do not correspond in strength to the classic schizophrenic manifestations, but have a common nature with other schizo-spectrum disorders.Like other disorders in this cluster, it is characterized by features of thinking, speech, behavior and affect – that is, mood.

While the average layman is likely completely unfamiliar with the medical definition, the disorder has a long and confusing history. More recently, this condition was denoted by the vague term “sluggish schizophrenia”, which, however, is still done in some government agencies to this day.

The so-called “schizophrenic defect”, which is manifested by a gradual degradation of the cognitive and volitional sphere in schizotypal disorder, does not arise, but this does not mean at all that fluctuations of affect or apathetic states are not peculiar to it.

rehabilitation requires the most individual approach. The selection of the right medications is akin to fortune-telling on tarot cards, and the same symptoms, depending on the diagnosis, medical history and patient’s life, can manifest themselves in completely different ways and, accordingly, succumb or resist standard therapy.

“Depression in the circle of depressive, bipolar or schizo-disorders in most cases will require a completely different approach – that is why people suffering from such disorders go through many ways to cure, and this is not uncommon,” says psychiatrist and activist Viktor Lebedev, creator of the public “Delo Pinel “.

According to him, serotonin reuptake inhibitors, or classical antidepressants such as Sertraline, Fluoxetine, Paroxetine, are the first line drugs, according to modern guidelines for the treatment of depression and depressive conditions.This means that patients should start therapy with them if there are no direct contraindications.

“They are really effective, and in many cases they do it. Thanks to the action of this group of antidepressants, the amount of serotonin, one of the neurotransmitters, which, among other things, is responsible for mood and balanced brain function, increases. But not everything is so simple, and first-line drugs do not always work, and in this case we switch to second-line drugs, for example, tricyclic and non-tricyclic antidepressants, ”he says.

Bupropion, also known as Welbutrin, Elontril or Zyban, is just a second-line drug, and its fate in Russia is no less complicated than the fate of Dasha’s diagnosis.

This drug is recommended for the treatment of depression, but it also has another side quality: in the West, it is periodically used in the treatment of nicotine addiction. The peculiarity of Bupropion is that, unlike classical antidepressants, it affects not only the serotonin system, but also the dopamine system, and therefore works especially productively in apathetic states.This is Dasha’s case.

“According to the guidelines, it is not a starting drug, it should be used exactly when first-line antidepressants do not work,” says Lebedev.

Bupropion has advantages, he says. If classical antidepressants mainly contribute to the accumulation of serotonin in the synaptic cleft, in the place where one neuron transmits a signal to another, then this drug can increase the content of both norepinephrine and dopamine, another neurotransmitter.Due to this, it has a stimulating effect, but only in the medical sense of the word. That is, it allows you to cope with the apathetic component of depression, when a person has severe drowsiness, lethargy, and decreased tone. “Sometimes this becomes the main problem of our patients, and despite the adequately selected dose of SSRIs, these symptoms cannot be removed. Bupropion does an excellent job with them, ”says the psychiatrist.

Apathy is difficult to treat and is particularly common in the spectrum of schizo disorders.Extreme manifestations of apathy and violations of the volitional sphere can elementarily lead to disability and complete loss from society.

Until 2016, the drug was on the free market in Russia, and then its license was revoked. However, this had nothing to do with drug side effects: drug manufacturers simply stopped importing it into our country, and the need for registration disappeared by itself.

Bupropion is still recommended by doctors, is listed in the standards of medical care and is easily googled, including in combination with the word “buy”.

The Rosminzdrav website in the State Register of Medicines indicates that Bupropion is not on the list of illegal drugs and is not a precursor of any known drug.

According to Lebedev, there are no studies that would prove that the drug is addictive or is a narcotic substance.

“This is a completely safe medication, at least not more dangerous than other antidepressants, or tranquilizers, which are sold relatively freely in our country, and, by the way, are very addictive,” says the psychiatrist.

Yes, and the Euromedex website is not at all a secret opium brothel from the depths of the darknet: hundreds of people order original European drugs and their generics on the website.

The problem is how drug control and accounting is organized in modern Russia: drug control has been fighting synthetic drugs, salts and spice for several years now, which have gained enormous popularity in Russia. Smoking blends, which until 2009 were openly sold as incense in esoteric stores, turned out to be a powerful drug that causes severe addiction.

Spice and salt made their way to the Olympus of drug use in no time and became one of the most popular street drugs. As soon as they came to the attention of law enforcement agencies, a process began that eventually made Daria’s situation possible.

Drug manufacturers created new formulas, and the drug police consistently banned them. To combat the constantly adjusting drug market, in 2012 the concept of “derivative” was created.

It is this derivative of the stimulating drug ephedrone that is now called Bupropion.The difference between a derivative and a precursor or a drug itself is that a precursor is something you can make a drug from if you want and have a home laboratory.

A derivative is a substance that is obtained by modifying the components of the original formula. In the drug market, a change in the formula is used in order to bring the drug back into the legal zone, making it invisible. Nevertheless, even minor changes in the formula of a substance affect its quality and effect.

On the one hand, this explains the unpredictability of salts and spices, on the other hand, the impossibility of getting narcotic intoxication from an antidepressant.

Photo: press service of the Ural Customs Directorate

Each formula can have up to a trillion derivatives, and in Russia all of them are prosecuted. This means that not only ephedrone itself, but also any other substances that may be obtained by changing its formula, are recognized as a drug within the country.For the acquisition or distribution of these substances, any of us can go to jail.

According to Arseniy Levinson, an expert at the Institute of Human Rights and a consultant at the Hand-help portal, such a situation is unacceptable. According to him, a mechanism was created in which the list simply states that the narcotic substance and all its derivatives are prohibited.

“This is a completely wrong regulation that we have been criticizing since 2012. Not a single layman would guess to read the formula of a substance and understand that when hydrogen atoms are replaced, something happens to it, and it turns into a drug, therefore it cannot be acquired.This is not an easy task, even for professionals. This approach creates legal uncertainty in which a person is not aware of the consequences of his actions, and, accordingly, cannot commit a crime, because the crime is committed intentionally. The average citizen does not have enough knowledge to draw conclusions about a substance, ”he says.

Levinson adds that scores of people are already imprisoned for believing they were dealing with legal substances by acquiring drug derivatives.

“The police justified their actions by the fact that their hands were tied and they were unable to cope with the changing drug market. But this is not the case, all buyers of synthetic drug derivatives were attracted quite calmly. The current legislation allows millions of chemical compounds to be considered derivatives. Once we asked for the derivatives of one of the substances indicated in the list, and we were told that it was impossible to do this, because the result would be a number with 12 zeros. Each of these formulas can lead to criminal liability, and it is not known who they will come to with such an accusation next time, ”the expert sums up.

In 2015, the state decided to create a register of derivatives, the head of the drug police was appointed in charge of it.

But this initiative has not received any completion. The register has been created, but it has not been maintained or updated for four years. Probably because it is technically impossible.

Drug control generally does not favor ordinary consumers, making them its main targets. Every fourth prisoner in Russia is imprisoned under Article 228, and the overwhelming majority of them are drug addicts, not traffic organizers.Human rights organizations have repeatedly drawn attention to the fact that the bodies act in a completely formal way, sometimes simply closing cases for accountability.

But Daria’s case still remains unique and causes particular concern. As far as it was possible to find out, drugs had never been declared as derivatives before.

Human rights activist Levinson also does not remember such stories, but he can definitely answer the question about the legality of such a practice.

“The conclusion of a customs specialist recognized that the drug Elontril with the active ingredient” bupropion “is a derivative of the drug ephedrone.However, drugs cannot be recognized as drug derivatives. According to paragraph 6 of the Note to the List of Narcotic Drugs, approved by Government Decree No. 681 of 1996, derivatives may include substances with a certain modified chemical formula, “which are not included in independent positions in the state register of drugs or in this list”, – emphasizes he.

Levinson adds that if we look at this norm formally, without taking into account other provisions of the Criminal Code, the Administrative Offenses Code, the basics of anti-drug legislation, legislation on the circulation of drugs and health protection, we can conclude that a drug excluded from the state register may be recognized as a derivative of a narcotic drug, but this is not the case: a drug, even if it is not registered in Russia, cannot be a derivative of a narcotic drug.In relation to medicines, the legislation provides for the specifics of circulation. And anti-drug legislation can only be applied to narcotic (psychotropic) drugs. Therefore, the investigation must establish whether the seized tablets are a drug and whether it is a narcotic drug.

Materials on the topic

00:01 – January 16, 2019

According to paragraphs 8 and 9 of Article 4 of Federal Law No. 61 of 2010 “On the Circulation of Medicines”, only those that can be classified as narcotic (psychotropic) medicines contain substances included in the list of narcotic drugs.Meanwhile, Bupropion is not included in the list of drugs, but belongs to derivatives. This means that the seized medicinal product cannot be the subject of contraband, that is, a narcotic medicinal product illegally transported across the customs border.

Levinson notes that controlling all psychoactive substances as drugs is an unproductive way, and already now there are mechanisms that regulate the circulation of such drugs. The tranquilizers and other sedatives mentioned by Viktor Lebedev, for example, are sold by prescription in Russia.

Fortunately, it is not easy to get a sentence for phenazepam so far. But it is not known how long this will last.

The only offense actually committed by Daria Belyaeva is the initiation of the import of unregistered medicinal products into Russia. This is an administrative article that is punishable by a fine.

According to Levinson, the case of Daria Belyaeva should be terminated for lack of corpus delicti and intent, and the accused should be assisted in rehabilitation and compensation for the damage caused.If this does not happen, the police will have the opportunity to manipulate the concept of a derivative in the most unpredictable way.

This situation will automatically affect the most vulnerable groups of Russian citizens – patients with chronic mental and somatic disorders.

Where drugs potentially intersect with drug derivatives, a space of absolute powerlessness is created, born of the double stigma of drug use and mental illness.The need to protect their rights will automatically put many patients in a situation of compulsory disclosure of the diagnosis, which, among other difficulties, will have a direct impact on their standard of living and social adaptation.

The social stigma of the mentally ill is a part of the reality of modern Russia, with which I, as an activist and patient with schizoaffective disorder, are very familiar. And the prospect of adding to it the stigma of a prisoner causes nothing but alarm.

is it only an anxiolytic?

contribution to the antidepressant, anxiolytic and procognitive activity of buspirone

(T.Stern et al., 2015).

In addition, buspirone also has weak 5-HT2A- and 5-HT2C-blocking properties

(Ki = 1300 and 1100 nM, respectively). This is approximately 60 times less than its affinity for

5-HT1A receptors (M. Fava, 2007). It is considered unlikely that these receptor properties of

, due to the rather low affinity of buspirone for these receptors, make any contribution to the

general pharmacological activity of buspirone (A. Hamik et al., 1990; C. Loane, M. Politis,

2012). However, some authors give higher values ​​for buspirone

of affinity for 5-HT2A and 5-HT2C receptors – Ki = 138 and 489.7 nM, respectively (D.Bonhaus

et al., 1997). With such affinity values, if they are correct, these receptor properties

buspirone may also contribute to some extent to its general antidepressant,

anxiolytic and procognitive activity and the ability to reduce extrapyramidal

antipsychotic syndrome and sexual side effects from antidepressant

analogies with the corresponding receptor properties of atypical antipsychotics (S.Stahl,

2013; T.Stern et al., 2015).

One of the main active metabolites of buspirone, 1- (2-pyrimidinyl) -piperazine,

circulating in the blood in quantities higher than buspirone itself, is a potent

antagonist of presynaptic inhibitory a2-adrenergic receptors, similar to

mirtazapine or

, with an affinity of KD = 40 nM (G. Tunnicliff, 1991; K. Zuideveld et al., 2002;

M. Yu. Drobizhev et al., 2014). Due to the blockade effect of 1- (2-pyrimidinyl) -piperazine

presynaptic inhibitory a2-adrenergic receptors theoretically should increase

release of neurotransmitters, such as serotonin, dopamine, norepinephrine, into the synaptic

cleft.Probably, it is this presynaptic a2-adrenergic blocking effect

1- (2-pyrimidinyl) -piperazine that mediates the already mentioned increase

concentrations of dopamine and noradrenaline in the central nervous system

experimental animals under the influence of Buspirone (G. Tunnicliff, 1991; .Fava, 2007).

It is also likely that the presynaptic a2-adrenergic blocking properties

1- (2-pyrimidinyl) -piperazine make a significant contribution to the total antidepressant,

anxiolytic and procognitive activity of buspirone (M.Fava, 2007).

Buspirone itself also has a weak affinity for a1-adrenergic receptors (Ki = 1000 nM) and another

weaker affinity for a2-adrenergic receptors and b-adrenergic receptors – Ki = 6000 and 8800 nM

, respectively (A. Hamik et al. , 1990; T.Stern et al., 2015). The clinical significance of this

fact is unknown. However, it is possible that this property makes a small contribution to the ability of

buspirone to somewhat lower blood pressure and heart rate.