Wellbutrin for ADHD and Anxiety

[firedoor]

How effective is Wellbutrin in treating ADHD and GAD?

There is evidence for Wellbutrin in treating ADHD:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2416755/

http://www.biopsychiatry.com/bupometh.htm

Additionally, I believe it is recommended as a 4th line treatment for ADHD per APA practice guidelines.

Also, Wellbutrin seems to have a reputation of being anxiogenic, perhaps unfairly so. In fact, a small study suggested Wellbutrin comparable to Lexapro in treating GAD.

http://www.ncbi.nlm.nih.gov/pubmed/18362870

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[billypilgrim37]

My experience has been that Wellbutrin worsens panic attacks but is helpful for GAD. And real panic disorder, not the "my husband yells at me so I have a panic attack" panic attacks. I don't know how evidence-based that is.

 

[whopper]

Many patients I've seen in outpatient treatment have had an anxiety disorder secondary to ADHD left untreated, or their ADHD was misdiagnosed as an anxiety disorder.

Many of the symptoms are the same:, poor concentration, a feeling that the mind is "blank" is a DSM criteria for GAD, but heck, if a patient came in complaining of that, I'd bet you several psychiatrists are going to think ADHD first. I've seen several people with ADHD feel anxious because they have poor control over things they want better controlled, and some have DSM symptoms of an anxiety disorder such as poor sleep (related to not being able to calm their minds at rest), living in fear of having to do another task where their ADHD will get in the way, etc, but when treated only with an ADHD med such as Adderall, all the anxiety sx go away.

It could be that in the studies mentioned, the person may have been misdiagnosed or had both disorders at once, hence the results are contaminated. This is just speculation on my part.

(On a parallel, I've often wondered if the data where schizoaffective disorder has better outcomes than schizophrenia are contaminated by people with MDD w/ psychotic features or bipolar w/ psychotic features.)

Wellbutrin does have NRI benefits, and that in theory should provide anxiety benefits, but this could be countered by dopamine, that often can excite the PNS and possibly exacerbate anxiety.

If someone has a true anxiety disorder that is separate from ADHD, Wellbutrin, IMHO, would be a better treatment than a stimulant because stimulants activate the PNS much more so than Wellbutrin. There are, of course, several other treatment options. Effexor, for example, has been found to treat ADHD in studies. (An NRI is supposed to benefit ADHD, that's how Strattera works). One could try that med if the person had a true anxiety disorder and ADHD among several other choices.

 

[9point75]

Buproprion is a completely underused drug relegated to the add-on-to-an-ssri role. It works in MDD. And it will work in GAD. It will work in Panic too. Serotonin modulation is not the panacea it was sold to us as. I'd posit that any mind altering drug with regular scheduled f/u appointments with a good psychiatrist and few side effects will improve almost any condition listed in satan's bible... I mean the DSM