What to pair with Wellbutrin for anxiety — a primer

Wellbutrin (bupropion) is commonly used to treat different forms of depression. But did you know it can help relieve symptoms of anxiety when you combine it with other medications and approaches? Read on to learn more about what to pair with Wellbutrin for anxiety and why. 

If you’re struggling to find relief from anxiety, don’t wait to get information about treatment options, including Wellbutrin and other antidepressants. Find a provider for anxiety treatment on Klarity Health today and find the best approach for treating your symptoms. 

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When Wellbutrin for anxiety isn’t enough

Wellbutrin is a norepinephrine-dopamine reuptake inhibitor (NDRI). In 1985, the U.S. Food and Drug Administration (FDA) approved it for the treatment of major depressive disorder (MDD) in adults and seasonal affective disorder (SAD). The FDA also approved Wellbutrin to help with smoking cessation.

Sometimes, providers prescribe Wellbutrin off-label to treat other conditions like attention-deficit/hyperactivity disorder (ADHD), episodes of depression in people living with bipolar disorder, and sexual dysfunction related to antidepressant use. Wellbutrin for OCD (obsessive-compulsive disorder) is also common. 

Providers also prescribe Wellbutrin for anxiety off-label, including for generalized anxiety disorder (GAD) and panic disorder. When it comes to reducing anxiety, research shows that Wellbutrin is comparable to other antidepressants, specifically those that affect serotonin levels.

Your anxiety treatment plan depends on the type of anxiety you have, your symptoms, and the severity. For some, Wellbutrin alone may be enough. Others may benefit by adding or switching medications or trying therapy.  

You may not respond to Wellbutrin if your dosage is too low, you’ve been misdiagnosed and have a condition Wellbutrin doesn’t treat, or because of individual differences in how your brain works. Getting an accurate diagnosis is the first step.

If Wellbutrin alone isn’t enough, you may need another option. Your provider may suggest pairing it with a different antidepressant to boost the benefits and improve your anxiety. They may also recommend trying a different antidepressant alone or other medications like benzodiazepines or antipsychotics.

Medication can help manage anxiety symptoms. But it doesn’t address other issues, like thoughts and feelings, daily stressors, or your ability to cope with anxiety. Your provider may suggest including therapy as part of your care plan. Research supports therapy and Wellbutrin as an effective treatment. 

What medications to pair with Wellbutrin for anxiety

Calming down your anxiety can require the right combination of treatment options for your symptoms and needs. 

Wellbutrin and Zoloft

Your provider may suggest pairing Wellbutrin with Zoloft (sertraline) for anxiety. Both are antidepressants, but they work differently.

Wellbutrin works by increasing 2 neurotransmitters-norepinephrine and dopamine. Norepinephrine is vital in regulating mood, arousal, and your fight-or-flight system. Dopamine helps regulate mood, sleep, memory, concentration, and motivation.

Zoloft prevents serotonin reuptake in your brain, meaning it makes serotonin more available to help regulate your mood, sleep, and appetite.

When you take Wellbutrin and Zoloft, you address a broader spectrum of neurotransmitters. Targeting dopamine, norepinephrine, and serotonin can lead to improved mood and energy, better sleep, and relief from anxiety symptoms. For many people, pairing Wellbutrin and Zoloft improves their outcome.

Antidepressants take time to work. You may start noticing improvements within 2 to 4 weeks, but it can take up to 2 months for you to feel the full benefits.

As the medications build up in your system, you may experience side effects. Wellbutrin side effects are insomnia, headache, nausea, dry mouth, and constipation. Common Zoloft side effects are similar and also include drowsiness, appetite changes, diarrhea, and sexual dysfunction.

Side effects may be temporary and subside as your body adjusts to the medication. Follow your provider’s instructions when taking Wellbutrin and Zoloft. Follow-up appointments are a good time to share any side effects and how you’re doing on the medications. 

Wellbutrin and SSRIs other than Zoloft

Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that work by increasing serotonin. Because Wellbutrin increases dopamine and norepinephrine, combining it with an SSRI gives you a broader range of neurotransmitter regulation by addressing 3 neurotransmitters. 

Common SSRIs, other than Zoloft, include Lexapro (escitalopram), and Prozac (fluoxetine). For conditions like GAD, research shows that SSRIs like Zoloft, Lexapro, and Prozac are first-line treatments that are well-tolerated and effective for short and long-term use. Adding one to your Wellbutrin regimen may help reduce anxiety symptoms.

Issues with sexual functioning, like decreased libido or ejaculation failure, can be a side effect of SSRIs. Because Wellbutrin helps treat sexual dysfunction, providers may prescribe this combination of medications for people who experience sexual side effects. 

Wellbutrin and SNRIs

For the same reason that taking an SSRI with Wellbutrin may be beneficial, so is pairing Wellbutrin with a serotonin-norepinephrine reuptake inhibitor (SNRI). The 2 together target a broader range of neurotransmitters. 

Wellbutrin combined with SNRIs like Cymbalta (duloxetine) and Effexor (venlafaxine) can regulate dopamine, norepinephrine, and serotonin and alleviate anxiety. That’s because too much norepinephrine can lead to anxiety, restlessness, and hyperarousal. And low levels of dopamine can contribute to hyperarousal, restlessness, and avoidance, which is common in people with anxiety. 

The side effects of SNRIs are similar to those of SSRIs. Also, like SSRIs, SNRIs can cause side effects related to sexual dysfunction. Wellbutrin helps manage those symptoms. 

Read more about SSRIs vs SNRIs. 

Wellbutrin and Xanax and other benzodiazepines

Your provider may suggest Xanax (alprazolam) or other benzodiazepines when considering what to pair with Wellbutrin for anxiety. Benzodiazepines are an FDA-approved medication for GAD, social phobia, panic disorder, insomnia, and seizures. 

Xanax, Klonopin (clonazepam), and Ativan (lorazepam) are commonly prescribed benzodiazepines. They target gamma-aminobutyric acid (GABA) receptors in your brain. GABA reduces anxiety by calming your central nervous system. Together, Wellbutrin and benzodiazepines target dopamine, norepinephrine, and GABA, 

An upside is that benzodiazepines can work quickly and are effective to reduce anxiety. But they can intensify the effects of opioid medications and alcohol. Mixing benzodiazepines and opioids or alcohol leads to serious side effects like slowed heart rate and breathing. Your provider may recommend avoiding alcohol and other medications. Because benzodiazepines can lead to dependence, they’re typically used short-term or on an as-needed basis to treat anxiety. 

What not to take with Wellbutrin

Now you know what your provider might suggest pairing with Wellbutrin for anxiety. Here’s  what not to mix with it and why.

While some medications help alleviate symptoms of anxiety, taking Wellbutrin with certain medications or substances can lead to serious and potentially life-threatening side effects. 

Your provider will likely recommend avoiding alcohol, stimulants, opioids, the psychotropic medications listed above, and others to reduce those risks. 

Alternatives to Wellbutrin for anxiety

If Wellbutrin doesn’t effectively work for your anxiety, whether your provider adds another medication or not, you have even more options. 

Xanax alone can manage anxiety. It works well because of its rapid onset and effect on the central nervous system (CNS). But, some anxiety meds can be addictive, like benzodiazepines. So, your provider may prescribe it only short-term for anxiety or panic attacks. 

BuSpar (buspirone) is a non-benzodiazepine medication. It’s approved for the treatment of GAD and targets serotonin. Unlike benzodiazepines, Buspar doesn’t come with the risk of dependence. This makes it a long-term option for the treatment of anxiety.  Read more about BuSpar for anxiety.

Another medication that works well as a standalone for anxiety is Zoloft. It’s well-tolerated and has fewer side effects than other antidepressants like Paxil (paroxetine) and Prozac for anxiety. You can also take Zoloft long-term for anxiety. 

Abilify and Seroquel (quetiapine) are antipsychotics used for anxiety. They affect dopamine and serotonin and can be helpful if you also experience insomnia or agitation. 

SSRIs like Paxil, Prozac, Celexa (citalopram), and Lexapro (escitalopram) are other popular options for anxiety. They increase serotonin levels, which regulate mood and reduce anxiety. Like Zoloft, they may take some time to build up in your system before you start to see results. 

SNRIs like Cymbalta (duloxetine) and Remeron (mirtazapine) target both serotonin and norepinephrine. They can be effective for treating anxiety, especially if you also have depression. 

Therapies to pair with Wellbutrin for anxiety

You can use medication, therapy, or a combination of both to treat anxiety. For many people, research shows that a combination of medication and therapy is the most effective approach. 

Medication addresses brain chemistry. Therapy helps with anxiety by identifying and challenging unhelpful thoughts, increasing coping strategies, and tackling other stressors that trigger your anxiety. Pairing Wellbutrin with therapy as part of an anxiety treatment plan may be ideal for many people. You may try standard forms of therapy or holistic therapy for mental health.

Wellbutrin and cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is an evidence-based approach to treating anxiety. CBT teaches you about the connection between your thoughts, feelings, and behaviors. You learn to recognize and challenge unhelpful thoughts that contribute to or increase anxiety. CBT techniques help you create balanced thoughts and use coping skills. Making CBT and Wellbutrin part of your treatment plan means you can develop cognitive and emotional tools while balancing neurotransmitter levels. 

Wellbutrin and mindfulness-based cognitive therapy

Mindfulness-based cognitive therapy (MBCT) is a well-researched approach to reducing stress and anxiety. It combines features of CBT and mindfulness training. MBCT increases your sense of awareness of your thoughts, feelings, and emotions without judgment. Like CBT, you also learn to recognize and challenge anxious thoughts. Taking Wellbutrin while developing cognitive and mindfulness skills can reduce feelings of worry and rumination and help you feel better overall. 

Wellbutrin and exposure therapy for anxiety

Exposure therapy is a type of CBT used to treat anxiety disorders. People with panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, phobias, obsessive-compulsive disorder (OCD), and GAD can benefit from exposure therapy. 

In exposure therapy, you and your provider identify situations or objects you fear or that trigger anxiety and develop relaxation strategies. By gradually exposing yourself to these situations in a safe way, you learn to cope with distress and reduce avoidance. 

Combining Wellbutrin with exposure therapy can help you cope with anxiety-inducing situations.  

Read more about exposure therapy for OCD.

Lifestyle changes to pair with Wellbutrin for anxiety

Lifestyle changes can help you manage anxiety. Research shows that moving your body, sleeping consistently, staying socially connected, eating nutritious meals, and adding relaxation techniques to your day can enhance the benefits of therapy and medication. 

Movement improves mood and reduces stress hormones like cortisol. Maintaining a consistent sleep schedule also regulates your mood. If you have consistent sleep trouble or insomnia, consider insomnia treatment. 

Keeping our social connections strong alleviates anxiety by increasing feelings of belonging. Healthy meals give your body the nutrients it needs to keep you feeling your best. 

If you have anxiety, you may notice that you constantly worry about the future. The need to avoid or mitigate something negative that might happen keeps you preoccupied and can make anxiety worse. Relaxation techniques like deep breathing, grounding exercises, meditation, and yoga focus your attention on the present moment, alleviating worry and fear. 

Key takeaways

• Wellbutrin alone may not be enough to treat your anxiety. Taking Wellbutrin with other antidepressants or medications may give you better results. 
• Medications that can be paired with Wellburtin include antidepressants, benzodiazepines, and some antipsychotic medications. 
• Therapy, alone or in combination with medication, can be effective for treating anxiety. CBT, MBCT, and exposure therapy are well-studied approaches that help change thought patterns, increase awareness and acceptance, and reduce anxiety in distressing situations. 
• Lifestyle changes like moving your body, eating nutritious meals, keeping a consistent sleep schedule, and using stress management techniques are holistic methods that help keep anxiety at bay. 

Get help for anxiety fast

You don’t have to suffer with anxiety. Talk to a caring licensed, board-certified provider in as little as 24 hours about what you can add to Wellbutrin or try instead for your anxiety symptoms.* Find a healthcare provider on Klarity Health today for a treatment plan.