Can Wellbutrin Reduce Panicking? (+3 Effective Drug Classes)

This article explores Wellbutrin’s potential use in managing panic attacks and anxiety symptoms. It will examine the existing research and evidence regarding Wellbutrin’s impact on panic attacks and compare its effectiveness to other approved medications for anxiety disorders. Additionally, the article will discuss other medications that are approved for treating panic attacks and anxiety.

Can Wellbutrin reduce panicking?

Wellbutrin may reduce panic attacks in some people. However, It is not approved for this indication.

Bupropion has various off-label uses (like anti-depressant-induced sexual dysfunction, attention-deficit hyperactivity disorder (ADHD), weight loss, and depression associated with bipolar disorder), but helping with panic attacks isn’t one of them. There is some evidence to suggest that it may help in reducing the frequency and severity of panic attacks.

It primarily works by inhibiting the reuptake of norepinephrine and dopamine. Anxiety disorders and panic attacks, on the other hand, involve an imbalance of various other neurotransmitters, notably serotonin, gamma-aminobutyric acid (GABA), and glutamate. Therefore, the mechanism of action of Wellbutrin may not directly target anxiety and panic attacks.

However, anxiety and panicking often co-occur with depression, and in some cases, addressing the depressive symptoms with Wellbutrin can indirectly improve anxiety symptoms. This is because depression and anxiety frequently share overlapping symptomatology, such as restlessness, irritability, and difficulty concentrating.

It is also important to note that anxiety may often present as a side effect of bupropion, so it is not recommended to consider using Wellbutrin for anxiety symptoms. Additionally, alternative treatments for anxiety, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed and may be more suitable options for addressing anxiety symptoms.

What does research suggest?

One study suggests that bupropion SR could be effective in treating panic disorder, as it showed significant improvement in various measures of the disorder including the Panic Disorder Severity Scale, frequency of panic attacks, and presence of anticipatory anxiety.. However, further controlled investigations are needed to confirm its efficacy in this condition [1]. 

A case report of a 47-year-old man with panic disorder showed that initial treatment with bupropion 150 mg daily had a notable response. Increasing the dosage to 300 mg daily due to recurring anxiety symptoms resulted in only a partial response and undesirable side effects. Researchers suggest that bupropion may be effective at a lower dosage of 150 mg daily [2].

The report also highlighted overall improvement in panic- and anxiety-related symptoms, including reduced or eliminated panic attacks, avoidance behavior, and anticipatory anxiety. Bupropion was also found to improve psychosocial functioning and quality of life, important goals in managing panic disorder [2].

Upon comparing anxiety levels between individuals taking SSRIs and bupropion, the bupropion group was found to have higher levels. However, in propensity-matched comparisons, no significant differences were seen over 12 weeks [3]. Similarly, studies comparing bupropion’s anxiolytic effect to escitalopram and sertraline found similar effectiveness in treating generalized anxiety disorder [4] [5].

According to the FDA, bupropion can cause side effects like restlessness, agitation, anxiety, and insomnia in some patients. These symptoms may require additional treatment, and about 2% of patients had to stop taking bupropion because of the severity of these side effects [6].

What other drugs are approved for panic attack treatment?

Wellbutrin may have shown effectiveness in treating panic attacks, but it is not approved for this indication. Several drugs, including other antidepressants, have been approved by the FDA for the treatment of panic attacks and anxiety disorders. Here are a few commonly prescribed drugs along with their approved doses for treating panic attacks and anxiety: 

Selective Serotonin Reuptake Inhibitors (SSRIs):

This class of medications, such as sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), and escitalopram (Lexapro), are frequently prescribed as first-line treatments for panic attacks and anxiety disorders. Recommended daily doses for these medications typically range from 25-200 mg for sertraline, 10-60 mg for fluoxetine, 10-40 mg for citalopram, and 10-20 mg for escitalopram. 

Benzodiazepines

Benzodiazepines, like alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin), provide rapid relief from anxiety symptoms. Due to their potential for dependence and abuse, they are generally prescribed for short-term use or during acute episodes.

Dosing varies depending on the specific benzodiazepine and the severity of symptoms, with recommended daily doses ranging from 0.25-1.5 mg for alprazolam, 1-10 mg for lorazepam, and 0.5-2 mg for clonazepam. 

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Medications in this class, such as venlafaxine (Effexor) and duloxetine (Cymbalta), also play a role in managing panic attacks and anxiety disorders. Typical daily doses for venlafaxine range from 75-225 mg, while duloxetine doses range from 30-120 mg.

Conclusion

In summary, while Wellbutrin may provide some benefit in reducing panic attacks in some individuals, it is not approved for this specific use. Studies suggest that bupropion may improve symptoms of panic disorder, but more controlled investigations are needed to confirm its efficacy in this regard.

Bupropion has also shown improvements in panic- and anxiety-related symptoms, including the reduction of panic attacks and improved psychosocial functioning. However, it is important to note that bupropion may also cause anxiety as a side effect.

Alternative treatments, such as SSRIs and SNRIs, are commonly prescribed for anxiety disorders and may be more suitable options. It is crucial to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to individual needs.

References