Like other medications for ADHD such as Bupropion, Wellbutrin affects the brain’s neurotransmitters. Specifically, it prevents the brain from reuptake or reabsorbing dopamine and norepinephrine after the nerve cells release them. Medications that act like this are called Norepinephrine Dopamine Reuptake Inhibitors or NDRIs.
Reuptake describes how the body controls the duration of a nerve signal. When a substance blocks reuptake, it increases the active concentration of norepinephrine and dopamine in the brain. In the case of these substances, more is better; when more neurotransmitters are active, they can keep sending messages to other nerves.
How People Use Wellbutrin for ADHD
There are several reasons why someone might get a prescription of Wellbutrin for attention deficit hyperactivity disorder. Primarily, it helps people who do not experience a reduction of ADHD symptoms from their medication. Sometimes, people need reuptake blockers like Wellbutrin to enhance the action of norepinephrine and dopamine in the brain.
Alternatively, a patient who takes stimulants could experience adverse side effects from their medication. Wellbutrin could have a different action than these stimulants, which might mean fewer side effects on the patient. Also, most patients have at least one comorbid condition. There are many people with ADHD who also deal with depression and anxiety. An antidepressant, like Wellbutrin, can help minimize these symptoms.
Finally, stimulant medications are not ideal for people with underlying medical or psychiatric conditions. Sleep or tic disorders, heart conditions, a history of addiction, and mood disorders preclude patients from safely taking stimulant medication.
Forms and Dose of Wellbutrin for ADHD
This medicine has three variants: Wellbutrin, Wellbutrin SR or sustained-release, and Wellbutrin XL or extended-release. A patient takes Wellbutrin SR twice a day, and its effects last for 12 hours. Meanwhile, a patient only needs one daily dose of Wellbutrin XL since its effects last 24 hours.
Specialists prescribe Wellbutrin for ADHD in the extended-release or XL form. The patient can take it with or without food, and they can safely combine it with another ADHD medication. For adults, the starting dose is typically 150 milligrams. Patients can gradually increase it up to 450 milligrams every day. Usually, Wellbutrin doses are taken once in the morning and once at night, but the specific dose depends on the individual and the medication’s effectiveness on them.
What to Remember About Taking Wellbutrin for ADHD
Wellbutrin’s full benefits may take approximately three to seven days to appear. It could also take prescribers and patients several weeks to find the best dose. Once they have adjusted the dose, it might take another four to six weeks before the patient reaps the medication’s full benefits. Even while the prescriber determines the dose, the patient could see signs of the medication working. Some things to watch for are an improved mood, better sleep, and increased appetite.
Note that once a person is on Wellbutrin, they should not discontinue it without a physician’s assistance. If a patient wants to stop taking Wellbutrin, they should discuss it first with their physician. They might experience side effects like irritability if they abruptly stop taking Wellbutrin. Also, keep in mind that pregnant or breastfeeding women should not take Wellbutrin. Patients who are planning to be pregnant or are pregnant should discuss their medication options with their clinician.
Wellbutrin has a black box warning about a risk of suicidal thoughts or action in children, teens, and young adults. Patients, specialists, and caregivers should note that there is no FDA-approved dosage of Wellbutrin for children or people 18 and below. Caregivers should know to watch for changes in their loved one like attempted suicide or suicidal thoughts and behavior while taking Wellbutrin.
How Wellbutrin Works
Wellbutrin is a norepinephrine and dopamine reuptake inhibitor. It keeps neurotransmitters like norepinephrine and dopamine available for a longer time to the brain’s neurons. As a result, you see improved concentration and focus in the patient and reduced symptoms of ADHD.
Also, Wellbutrin does not influence serotonin. As such, it does not work like other antidepressants. For instance, SSRIs affect serotonin, while tricyclic antidepressants or TCAs increase norepinephrine and serotonin levels. They also block acetylcholine, which leads to side effects.
Wellbutrin for Anxiety
There is limited data on Wellbutrin’s capacity to treat anxiety disorders. In one older pilot study, researchers found Bupropion XL to be comparable to Escitalopram. The latter is an SSRI, another type of antidepressant, which specialists use in treating people with GAD or generalized anxiety disorder. Though this suggests that Wellbutrin could be a second- or third-line treatment option for GAD, these findings are not conclusive.
There is also evidence of Bupropion being effective against panic disorder. In a case study, researchers found that a daily dose of 150 milligrams of Bupropion improves patients’ panic and anxiety symptoms.
There is also anecdotal evidence supporting the use of Bupropion in addition to other medications for panic disorder. Like the GAD pilot study, though, there needs to be further research in determining Bupropion’s effectiveness against panic disorder.
Wellbutrin’s Side Effects
Like other types of medication, a person taking Wellbutrin could experience side effects. Some of these include dizziness, blurry vision, low appetite, headaches, and nausea or vomiting. Other side effects include agitation or increased anxiety, dry mouth, sweating, muscle twitching or restlessness, constipation, and difficulties in sleeping.
Wellbutrin Withdrawal
People typically do not experience withdrawal symptoms when they cease taking Wellbutrin. Those who do experience only mild to moderate symptoms. Wellbutrin works differently than other antidepressants since it affects noradrenaline and dopamine, which are both neurotransmitters. If you are not withdrawing from an SSRI, you are unlikely to experience serotonin-related symptoms.
Furthermore, there are only very few published cases of Wellbutrin withdrawal. The most common symptom is irritability; experts say patients quitting Wellbutrin could resemble patients quitting nicotine, which means hostile and aggressive behavior.
The Difference Between XL and SR
Usually, specialists prescribe Wellbutrin XL for ADHD to ensure that the medication stays effective throughout the day. The XL variant also reduces the possibility of side effects. Typically, a daily dose for someone 12 years old and above is anywhere between three to six milligrams per kilogram of body weight.
Wellbutrin, like other antidepressants, takes approximately a week before patients will notice benefits, and it takes four to six weeks for it to exhibit its full effects. As such, it will take more than a month before the prescriber might find the therapeutic dose fit for a patient.
Wellbutrin XL and Wellbutrin SR are time-controlled release formulations, meaning the drug is released in the body over several hours. As such, there is consistency in the concentration of the drug in the bloodstream. People might prefer the XL version because there is less opportunity to miss a dose, ensuring better patient compliance. This situation is particularly attractive to parents of younger patients.
Conclusion
There are various types of ADHD medication available today. These drugs address the symptoms of this condition in different ways. One way to treat ADHD is by taking Norepinephrine Dopamine Reuptake Inhibitors or NDRIs. NDRIs have mild side effects, but certain drugs like Wellbutrin have black box warnings for patients under 18 years old. Parents, caregivers, and prescribers have to monitor the patient’s situation closely and be sensitive to mood changes or suicidal ideation while on Wellbutrin.
Sources
https://pubmed.ncbi.nlm.nih.gov/18362870/
https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.23.2.jnpe47
