What is Wellbutrin?
Wellbutrin is the brand name for the antidepressant drug bupropion. The U.S. Food and Drug Administration (FDA) approved Wellbutrin in the United States for treating depression in 1985. They approved its use to help people stop smoking in 1997.
Off-label use of Wellbutrin
Doctors often use medications “off-label” when there’s scientific evidence to show that a medication might help with a certain condition, even though the medication isn’t currently approved by the FDA for that particular use.
Wellbutrin isn’t approved by the FDA to treat attention deficit hyperactivity disorder (ADHD). But some doctors prescribe Wellbutrin off-label to treat ADHD.
Wellbutrin has shown promising benefits in adults with ADHD during clinical trials, but more research is needed. Wellbutrin typically isn’t recommended for children since its safety and effectiveness hasn’t been established.
Stimulant medications, like Adderall and Ritalin, are the most widely accepted and tested treatments for ADHD in both children and adults. But stimulant medications have a high potential for misuse, especially in teens and adults.
For some people, stimulants aren’t as effective for treating ADHD. Studies have shown that up to 20 percent of people treated for ADHD don’t respond to stimulants. For this reason, researchers have been looking for alternative, nonstimulant options for adults with ADHD.
Your doctor may consider using Wellbutrin to treat your ADHD if:
- you can’t tolerate stimulants because of side effects
- stimulants haven’t been effective in managing your ADHD symptoms
- you have a medical condition, such as a mental health disorder or tic disorder, for which taking stimulants isn’t advised
- you have a substance use disorder
- your ADHD is complicated by other mental disorders, like depression
- you have an addiction to nicotine
There have been a small number of studies conducted to evaluate Wellbutrin in treating ADHD. Scientists are interested in Wellbutrin because of the way it’s thought to work.
Wellbutrin acts on chemicals in the brain called dopamine and norepinephrine, in a way similar to how stimulants are believed to work.
There have been several small, randomized clinical trials completed to test how well Wellbutrin works to treat ADHD. All of these studies were done in adults.
In these trials, which included a total of more than 400 people, long-acting forms of Wellbutrin resulted in clinically significant improvements in the symptoms of ADHD. It was also shown to be safe compared to a placebo.
Adult dosage (ages 18–64 years)
For depression and smoking cessation, Wellbutrin is typically taken in a 100-milligram (mg) dose three times daily (300 mg total). A doctor might start you at a lower dose and slowly increase the dose over time.
The maximum dose is 450 mg per day, taken in divided doses of no more than 150 mg each.
The sustained release formulation of Wellbutrin (Wellbutrin SR) may be taken in a dose of 150 mg once or twice daily. The extended release version of Wellbutrin (Wellbutrin XL) is usually taken as a single 300-mg pill once in the morning.
In clinical trials that assessed Wellbutrin for ADHD, the dosage ranged from 150 mg up to 450 mg daily.
Child dosage (ages 0–17 years)
Wellbutrin hasn’t been shown to be safe and effective for use in people younger than 18 years old. There’s no FDA-approved dosage for children.
Wellbutrin’s product label contains a black box warning from the FDA due to a potential increased risk of suicidal thinking and behavior. This risk is seen in children, teens, and young adults less than 24 years old.
Anyone treated with Wellbutrin should be monitored for suicidal thoughts, behavior, and attempted suicide.
You should also call a doctor or seek emergency care if any of the following occurs after taking Wellbutrin:
- fast or pounding heartbeat
- rash or hives
- trouble breathing
Wellbutrin shouldn’t be used by anyone with a history of seizures or eating disorders, or by people diagnosed with bipolar disorder.
Don’t take Wellbutrin with the following medications:
- other drugs containing bupropion, such as Zyban
- monoamine oxidase inhibitors (MAOIs), like phenelzine (Nardil)
Wellbutrin can interact with several other drugs. Talk to your doctor or pharmacist before taking Wellbutrin if you take any other medications.
The most commonly used medications for ADHD are in a class of compounds known as stimulants. These include:
- methylphenidate (Ritalin, Concerta)
- amphetamine-dextroamphetamine (Adderall)
- dextroamphetamine (Dexedrine)
- lisdexamfetamine (Vyvanse)
There are three nonstimulant drugs approved by the FDA to treat ADHD in adults:
- atomoxetine (Strattera)
- guanfacine (Intuniv)
- clonidine (Kapvay)
Nonstimulants might be less effective than stimulants, but they’re also considered less addictive.
Behavioral therapy, like cognitive behavioral therapy, may also help with ADHD. Cognitive behavioral therapy focuses on creating healthier behavioral patterns and changing a person’s way of thinking.
Wellbutrin has shown promise in small clinical trials for treating ADHD in adults.
If your doctor prescribes Wellbutrin for managing your ADHD symptoms, the prescription will be for off-label use. Your doctor will likely have a good reason for recommending Wellbutrin in lieu of an FDA-approved ADHD medication.
Always take care to go over any medication you’re prescribed with your doctor and pharmacist.