CAN WELLBUTRIN TREAT ANXIETY?

QUESTION:  "Doctor, I need something for my anxiety but I'm concerned about my libido being affected. Might Wellbutrin be helpful for me?"

Wellbutrin, also known as bupropion, has been prescribed for many years to treat depression and to help people stop smoking. Because of its stimulating qualities, people sometimes wonder if it might also help with anxiety. The short answer is that it is not usually chosen as the first option when anxiety is the main problem. Doctors are more likely to use medications such as SSRIs or SNRIs for conditions like generalized anxiety or panic disorder. In fact, Wellbutrin can sometimes make a person feel more restless or keyed up, particularly at the beginning of treatment or when the dose is increased. That being said, there are cases where people who suffer from both depression and anxiety notice that their anxiety lessens when their mood improves. In that indirect way, Wellbutrin can play a role in reducing anxious feelings, though it is not considered a front-line therapy for that purpose.

One area where Wellbutrin often stands out is in its effect on sexual function. Many antidepressants, especially SSRIs, are notorious for causing sexual side effects such as decreased libido or difficulty reaching climax. Wellbutrin is different. Because it works on norepinephrine and dopamine rather than serotonin, it does not usually cause these problems. In fact, some people notice the opposite. Their interest in sex either stays steady or even improves. For this reason, physicians sometimes prescribe Wellbutrin to offset the sexual side effects that can appear when someone is already taking another antidepressant.

Another trait that sets Wellbutrin apart is its energizing quality. People who describe themselves as weighed down, fatigued, or struggling with motivation often find that their energy improves once they begin the medication. Some say it helps them feel more alert, more focused, and more capable of tackling daily responsibilities. For individuals with depression that leaves them drained and listless, this stimulating effect can be especially welcome. At the same time, it can backfire for those who are already prone to nervousness or insomnia. The extra energy may come across not as calm productivity but as jitters, racing thoughts, or difficulty settling down at night.

Taken together, these qualities explain why Wellbutrin is sometimes a good fit and sometimes not. It is not the go-to medication when anxiety is the sole concern, since it can heighten the very symptoms a person is trying to escape. Yet it can be highly effective for depression, particularly if the individual struggles with low energy or has been discouraged by the sexual side effects of other antidepressants. It occupies a unique place in the landscape of treatment. For some, it brings relief and vitality, while for others it may stir up restlessness.

​As with any medication, its usefulness depends on the person, the balance of symptoms, and the guidance of a thoughtful physician.