From the Research
Prescribing Wellbutrin (bupropion) and Adderall (amphetamine and dextroamphetamine) together should be done with caution, as the most recent and highest quality study suggests that bupropion can be an effective alternative to stimulants for adult ADHD, but its combination with Adderall may increase the risk of side effects 1. When considering this combination, it is essential to weigh the potential benefits against the risks, particularly the increased risk of seizures, as bupropion lowers the seizure threshold, and this risk may be compounded by Adderall. Key considerations include:
- Starting with lower doses of each medication, such as 150mg daily of Wellbutrin and 5-10mg daily of Adderall, with gradual titration based on response and tolerability.
- Regular monitoring of vital signs, mental health status, and potential side effects, with follow-up appointments recommended every 2-4 weeks initially.
- Careful evaluation of patients with cardiovascular conditions, seizure disorders, eating disorders, or substance use disorders before starting this combination.
- Awareness of the potential for increased blood pressure, heart rate, and anxiety, insomnia, or agitation, as both medications can affect dopamine and norepinephrine neurotransmitter systems. The combination of Wellbutrin and Adderall may be considered for treatment-resistant depression or when a patient has both depression and ADHD, as Wellbutrin addresses depressive symptoms while Adderall targets attention and focus issues, as supported by studies such as 2, which highlights the novel effects of bupropion in ADHD treatment. However, it is crucial to prioritize the patient's safety and well-being, and to carefully consider the potential risks and benefits of this combination, as the overall quality of evidence is still rated as low, and more research is needed to reach more definite conclusions 1.