Wellbutrin® for anxiety: What’s the link?

Wellbutrin® is one of the most commonly prescribed antidepressants available today. It’s typically used to treat symptoms of depression, but you may have heard about people using it for anxiety, sometimes with mixed results. That’s because Wellbutrin feels more stimulating than most antidepressants, and that boost in energy can ease anxiety in some people but leave others feeling restless or jittery. Which camp you fall into usually depends on the type of anxiety you have and whether it’s tied to depressive symptoms.

What is Wellbutrin and what is it used for?

Wellbutrin is the brand name for bupropion, a prescription antidepressant. It’s FDA-approved to treat major depressive disorder (MDD) and seasonal affective disorder (SAD), helping with symptoms like persistent low mood, low energy, and losing interest in things you used to enjoy. Wellbutrin works differently from many antidepressants and may be more likely to increase energy, focus, and alertness in some people. 

Bupropion is also marketed under the brand name Zyban®, and is prescribed specifically to help people quit smoking.

While Wellbutrin is only approved for SAD and MDD, doctors also prescribe it off-label for anxiety if they think it’s the right call for a specific patient’s situation. 

Does Wellbutrin help with anxiety?

Wellbutrin isn’t usually one of the first medications doctors reach for when treating anxiety. Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are usually the first stop because they’re better studied for anxiety disorders and tend to ease symptoms more reliably.

Wellbutrin can have a stimulating effect because it acts on dopamine and norepinephrine, chemicals that influence focus, motivation, and energy levels. This can make some people feel more alert and energized, while others feel more jittery and on edge. 

Whether Wellbutrin could help depends on what your anxiety feels like and which symptoms you have. 

• If the anxiety feels depression-like with low energy, mental fog, fatigue, or low motivation, Wellbutrin may help.
• If the anxiety is causing restlessness, insomnia, a racing heart, or constant worrying, Wellbutrin may intensify those symptoms. 

Can Wellbutrin cause anxiety?

Wellbutrin can sometimes trigger anxiety or make existing symptoms feel worse, especially in the first few weeks or after dose increases. For a lot of people, mild symptoms like jitters fade as the body adjusts. But if you think Wellbutrin is making your anxiety worse, check in with your doctor and let them know. 

Since Wellbutrin can affect anxiety in different ways for different people, it helps to know which symptoms are annoying-but-normal and which ones need immediate medical attention.

Mild but manageable

You might feel a little more wired than usual, have a harder time winding down at night, or feel more amped up in the morning, but you can still get through your day.

What to do: Let your doctor know what you’re noticing. Sometimes a lower dose, increasing the dose more slowly, or taking Wellbutrin earlier in the day can help.

Getting worse, not better

If your anxiety is more intense than it was before you started Wellbutrin, you’re feeling more restless by the day, sleep is getting worse instead of better, or it’s starting to affect your ability to work or focus, that may mean Wellbutrin isn’t the best choice for you right now. 

What to do: Don’t try to tough it out. Talk to your doctor about whether Wellbutrin is the right fit.

Urgent symptoms

If you’re experiencing panic attacks, intense agitation, going days without sleep, unusual impulsiveness, suicidal thoughts, or a feeling that something is seriously wrong, this is urgent.

What to do: Get medical help right away, either from your doctor or the nearest emergency room. 

Wellbutrin and anxiety disorders: what to know

Wellbutrin’s relationship to anxiety isn’t always straightforward. When deciding whether Wellbutrin is the right fit for you, your doctor isn’t just looking at the anxiety. They’ll also look at what other symptoms you’re dealing with, how you’ve responded to other medications, and whether low energy or motivation is part of what’s going on.

Why would a doctor prescribe Wellbutrin for anxiety?

Prescribing Wellbutrin for anxiety can seem counterintuitive since it can have an energizing effect. But when anxiety comes alongside the kind of symptoms Wellbutrin treats well (like low energy, low motivation, or depression), doctors may prescribe it off-label. 

Doctors may also consider Wellbutrin when other antidepressants have caused difficult side effects, like sexual dysfunction or emotional blunting. 

When Wellbutrin may be more likely to help with anxiety

Wellbutrin may be more likely to help when anxiety is happening alongside symptoms that overlap with depression. These symptoms include:

• Low energy
• Fatigue
• Low motivation
• Mental fog
• Emotional heaviness
• Feeling shut down
  

Because Wellbutrin tends to boost energy and alertness, some people feel less weighed down and better able to function day to day. When that happens, the anxiety tied to feeling stuck or running on empty may ease up, too.

When anxiety is the primary or only issue

When anxiety is the main or only issue, Wellbutrin isn’t usually the first medication doctors prescribe. That’s partly because the research on bupropion as a standalone treatment for anxiety disorders is limited, and what does exist is mixed.

This doesn’t mean Wellbutrin is off the table, but that doctors tend to start with SSRIs and SNRIs because they have stronger evidence for conditions like generalized anxiety disorder and panic disorder.

What to know before taking Wellbutrin for anxiety

Before starting Wellbutrin, it helps to know what to expect in terms of dosing, potential side effects, and whether it’s safe for you.

Wellbutrin dosage for depression and anxiety

Wellbutrin comes in three forms at different doses for depression:

• Immediate release (Wellbutrin IR): 75 mg and 100 mg
• 12-hour sustained-release (Wellbutrin SR): 100 mg, 150 mg, and 200 mg
• 24-hour extended-release (Wellbutrin XL): 150 mg and 300 mg
  

For depression, most people start at a lower dose and increase gradually based on how they respond. Daily totals generally range from 150 mg to 450 mg, depending on the form. Your doctor will settle on a target dose based on which form you’re taking, how well you’re tolerating it, and whether your symptoms are improving.

Wellbutrin is FDA-approved for depression and SAD, but because Wellbutrin isn’t FDA-approved specifically for anxiety, there’s no official recommended dose. 

Wellbutrin contraindications

Wellbutrin isn’t the right fit for everyone. As is the case with any medication, there are certain health conditions, medications, or withdrawal situations that raise the risk of side effects. That’s why it’s important to have an open, honest conversation with your doctor about your medical history. This way, they can help find the right medication that helps you feel more like yourself while being mindful of any other conditions present. 

Wellbutrin is generally not recommended for people who:

• Have a seizure disorder, since Wellbutrin can increase the risk of seizures if used at a higher dosage. 
• Have a current or past diagnosis of bulimia or anorexia nervosa, which are linked to a higher seizure risk with this medication.
• Are going through withdrawal from alcohol or certain drugs. Suddenly stopping benzodiazepines (like Xanax or Ativan), barbiturates, antiepileptic drugs, or alcohol can raise seizure risk, and adding Wellbutrin makes it higher. 
• Take an MAOI (a type of antidepressant), have taken one in the past 14 days, or are being treated with linezolid or IV methylene blue. These can cause dangerous interactions when combined with Wellbutrin.
• Are allergic to bupropion or any ingredient in Wellbutrin.
  

If any of these apply to you, or if you’re not sure, bring it up with your doctor. 

Alternatives to Wellbutrin for anxiety

If Wellbutrin isn’t helping with your anxiety, your doctor can prescribe other options that might be a better fit. The most common starting points are other types of antidepressants that are FDA-approved for anxiety disorders.

Medications commonly used long-term for ongoing anxiety treatment:

• SSRIs, such as sertraline (Zoloft®), escitalopram (Lexapro®), or paroxetine (Paxil®): These are often the first medications doctors prescribe for when treating anxiety long-term. They’re widely used for generalized anxiety disorder, panic disorder, and social anxiety disorder.
• SNRIs, such as venlafaxine (Effexor XR®) or duloxetine (Cymbalta®): These work similarly to SSRIs and may be a good option if an SSRI doesn’t work well for you or causes side effects that are hard to manage.
  

Medications your doctor may add or use in specific situations:

• Buspirone: An anti-anxiety medication sometimes prescribed for generalized anxiety disorder. It’s taken daily, and unlike some other anxiety medications, it doesn’t carry a risk of dependence.
• Hydroxyzine: An antihistamine that can help with anxiety symptoms on a short-term basis. It can cause drowsiness, so it’s typically used for temporary relief rather than ongoing treatment.
• Benzodiazepines, such as lorazepam (Ativan®) or clonazepam (Klonopin®): These can help with intense, short-term anxiety, but they’re usually not recommended for long-term use because of the risk of tolerance, dependence, and withdrawal.

Ready to take the next step in your mental health journey?

Wellbutrin isn’t the right fit for every type of anxiety, especially when anxiety is the main struggle. But if it also comes with depression, low energy, or low motivation, Wellbutrin can make a big difference in helping you feel more like yourself and improving your quality of life.