From the Guidelines
Wellbutrin (bupropion) can be used to help with ADHD symptoms, particularly in patients who have not responded well to stimulants or have co-occurring depression, as it increases levels of dopamine and norepinephrine in the brain, improving attention, focus, and impulse control 1.
Key Points to Consider
- Typical dosing for ADHD ranges from 150-450 mg daily, often starting at a lower dose and gradually increasing, with the extended-release formulation usually preferred, taken once daily in the morning 1.
- Improvement may take 1-4 weeks to become noticeable, and common side effects include insomnia, headache, dry mouth, and nausea 1.
- Wellbutrin carries a lower risk of appetite suppression and growth issues compared to stimulants, making it potentially suitable for certain patients, especially those with concerns about these side effects 1.
- However, it's crucial to note that stimulant medications like methylphenidate or amphetamine derivatives remain the first-line treatments for ADHD due to their higher efficacy, as supported by a recent meta-analysis proposing methylphenidate for children and adolescents and amphetamines for adults as the preferred therapy 1.
Considerations for Treatment
- The decision to use Wellbutrin for ADHD should be based on individual patient needs and circumstances, considering the presence of co-occurring conditions such as depression, and the potential benefits and risks of treatment 1.
- It's also important to weigh the risks of untreated or inadequately treated ADHD, which can lead to significant impairments in functioning and worse mental health outcomes, against the potential benefits of medication 1.
From the Research
Wellbutrin and ADHD Symptoms
- Wellbutrin, also known as bupropion, is an antidepressant that has been used off-label to treat Attention Deficit Hyperactivity Disorder (ADHD) symptoms 2.
- A 2017 study found low-quality evidence that bupropion decreased the severity of ADHD symptoms and moderately increased the proportion of participants achieving a significant clinical improvement in ADHD symptoms 2.
- The study also found that the tolerability of bupropion was similar to that of placebo, suggesting that it may be a viable alternative to stimulants for adults with ADHD 2.
Comparison to Other Treatments
- Other studies have investigated the use of combination pharmacotherapy for adult ADHD, including the use of stimulants and non-stimulants such as atomoxetine 3, 4.
- A 2019 study compared the efficacy of methylphenidate and atomoxetine on emotional and behavioral problems in youths with ADHD, finding that both treatments were effective in improving a wide range of emotional/behavioral problems 5.
- However, the use of stimulants and atomoxetine in adults with comorbid ADHD and bipolar disorder may be problematic and requires careful evaluation 6.