Wellbutrin for OCD: uses, effectiveness, and side effects

If you live with obsessive-compulsive disorder (OCD), you want relief from its relentless obsessions and compulsions. If you’re like roughly half of people with OCD, you may also have depression. The good news, OCD is treatable with medication and therapy. And while Wellbutrin for OCD isn’t a first-line treatment option, it can help reduce depression symptoms and may offer some relief for OCD symptoms.

In this article, we cover everything you need to know about Wellbutrin for OCD, including its uses, effectiveness, and side effects.

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How is OCD treated with Wellbutrin?

Wellbutrin (bupropion) is an antidepressant in a class of drugs called norepinephrine-dopamine reuptake inhibitors (NDRIs). It’s U.S. Food and Drug Administration (FDA)-approved to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). It’s not FDA-approved for, or often used as, a first-line treatment for OCD, which means it isn’t typically used as a first choice to treat someone with OCD. 

Antidepressants approved to treat, and more commonly are used, for OCD include Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), and Luvox (fluvoxamine), which are selective serotonin reuptake inhibitors (SSRIs). Anafranil (clomipramine), a tricyclic antidepressant (TCA), is also used for and approved to treat OCD. Lexapro (escitalopram), an SSRI, is sometimes used off-label (for a use it’s not FDA-approved to treat) for OCD as well.

Studies have shown that Wellbutrin itself isn’t generally effective for OCD. If your mental health provider recommends Wellbutrin for your OCD, it’s likely because you’ve exhausted other treatment options and/or need help with co-existing depression, anxiety, or antidepressant-related sexual dysfunction.

• Up to 50% of people with OCD also have depression. Wellbutrin may help decrease depression symptoms and make life with OCD easier to cope with. 
• Wellbutrin is sometimes used off-label for anxiety, so it may help reduce OCD-related anxiety as well.
• Wellbutrin is used off-label to help antidepressant-related sexual dysfunction. If you’re taking an SSRI for OCD and experience sexual dysfunction, your provider may prescribe Wellbutrin to help.

Does Wellbutrin help with OCD?

Research shows that overall Wellbutrin isn’t an effective treatment for OCD. It’s not recognized as an effective treatment for OCD by any professional association. The American Psychiatric Association (APA) doesn’t recommend Wellbutrin for treating OCD symptoms. The Centre for Addiction and Mental Health (CAMH) states that “there is clear evidence that Wellbutrin does not work in OCD.” 

A small study published in the Journal of Clinical Psychiatry found that Wellbutrin may make OCD symptoms worse, but may help a few people. Around one-third of study participants experienced some improvement in OCD symptoms on Wellbutrin, but two-thirds experienced worsening OCD symptoms. 

Patient comments on drugs.com support that Wellbutrin may make OCD worse but help with co-existing challenges.

• “…this drug sent me into a deep spiral. It made my response to intrusive thoughts worse….”
• “…this medicine just was horrible for me… [having] thoughts of death like OCD fixated on death.”
• “I am now 3–4 weeks in and I don’t have much anxiety BUT I feel like I developed OCD….”
• “Although it does not directly help OCD, the medication helps me manage anxiety related to the disorder.”

While Wellbutrin is usually only used to address OCD-related depression or sexual dysfunction, some people with OCD say that Wellbutrin helps them. For example, on one Reddit, a user states: “I had great results with [Wellbutrin] after having a terrible time with SSRIs…My life has improved considerably more [now] that the weight of depression has been lifted.” Note that this person mentions that they also have ADHD and depression and only mild OCD symptoms.

How long does Wellbutrin take to work for OCD? 

For depression, Wellbutrin takes  4 to 6 weeks to start having noticeable effects. It likely takes as long to start working if you’re taking it for comorbid depression (alongside OCD) or antidepressant-related sexual dysfunction. And because research shows that Wellbutrin isn’t generally effective for OCD,  you may not see benefits for OCD symptoms regardless of how long you take it.

What’s the best Wellbutrin dose for OCD? 

There’s no approved or recommended dosage for Wellbutrin for OCD. When taken for depression, the usual dosage for adults is between 200 and 300 milligrams a day. 

The starting dose is 100 or 150 milligrams per day depending on which form of Wellbutrin you take. Your provider will start you on a smaller dose and increase your dosage gradually to lower the risk of side effects. 

The typical maintenance dose is 300 milligrams a day taken as two 150-milligram doses at least 8 hours apart. The maximum safe dosage of Wellbutrin is 400 milligrams a day, taken as two 200-milligram doses at least 8 hours apart. 

Starting and maintenance doses may be adjusted if you have other health conditions, such as kidney or liver problems. 

What is Wellbutrin?

Wellbutrin is a brand-name medication for the active ingredient bupropion, a type of psychiatric medication that’s classified as an antidepressant; specifically, it’s a norepinephrine and dopamine reuptake inhibitor (NDRI). Wellbutrin is approved by the FDA to treat:

• Depression (major depressive disorder)
• Seasonal affective disorder (SAD)

A medication with the same active ingredient bupropion, named Zyban, is FDA-approved to help people stop smoking.

Wellbutrin is sometimes used off-label to treat antidepressant-related sexual dysfunction, attention-deficit hyperactivity disorder (ADHD), obesity, and bipolar depression. Off-label means that medical providers sometimes prescribe Wellbutrin for these conditions, but it’s not FDA-approved to treat them.

Wellbutrin works by affecting 2 important neurotransmitters that affect mood and motivation in the brain, norepinephrine and dopamine. It works well for people with depression because depression can cause imbalances in these brain chemicals. 

Wellbutrin dosages and formulas

Wellbutrin is available in sustained-release (SR) and extended-release (XL) formulations as an oral tablet. Wellbutrin SR comes in 100-, 150-, and 200-milligram tablets. Wellbutrin XL comes in 150- and 300-milligram tablets. 

What side effects does Wellbutrin have? 

Although Wellbutrin is considered safe, all medications come with the risk of side effects. Knowing what side effects you might have on Wellbutrin, and how long they could last, can help you understand what to expect and stick to your treatment plan.

Common side effects of Wellbutrin

Common side effects are experienced by at least 1% of people who take Wellbutrin. If you experience any of these, tell your medical provider. Don’t stop taking Wellbutrin without first consulting your provider.

The most common side effects with either Wellbutrin SR or Wellbutrin XL include:

• Headache
• Dry mouth
• Nausea
• Trouble sleeping
• Dizziness
• Sore throat
• Stuffy nose
• Constipation
• Feeling anxious
• Joint pain

Serious side effects of Wellbutrin

Wellbutrin can cause serious side effects. While more serious, these side effects are less common and typically only happen in less than 1% of people taking a medication. If you notice any of these side effects, call your healthcare provider or 911 right away.

• Suicidal thoughts and behaviors — Wellbutrin has a boxed warning for suicidal thoughts and behaviors. A boxed warning is the FDA’s strongest safety warning for a medication.
• Seizures, particularly at higher doses.
• Hypertension or high blood pressure.
• Mania or hypomania.
• Psychosis and other neuropsychiatric reactions, such as delusions, hallucinations, psychosis, trouble concentrating, paranoia, and confusion.
• Angle-closure glaucoma, particularly in people with anatomically narrow angles who don’t have a patent iridectomy.
• Hypersensitivity reactions (allergic reactions).

Some people have allergic reactions to Wellbutrin that can cause anaphylaxis, a severe, life-threatening allergic reaction. If you take Wellbutrin and develop hives, chest pain, shortness of breath, or swelling in parts of your body, stop taking Wellbutrin and get immediate medical help.

What to know when considering Wellbutrin

Like other antidepressant medications, Wellbutrin comes with a boxed warning that it can increase the risk of suicidal thoughts in children, teens, and young adults. If you’re under the age of 24, monitor your thoughts and feelings consistently while taking Wellbutrin. If you feel more suicidal, even temporarily, let your healthcare provider know right away.

In addition, it’s important to be aware that Zyban, a smoking cessation drug that has the same active ingredient as Wellbutrin, has caused serious adverse effects including severe depression, psychosis, hallucinations, aggression, and more. 

What to avoid when taking Wellbutrin

Wellbutrin can have dangerous interactions with other medications and substances. It’s important to be completely honest with your healthcare provider about the medications you take.

• Don’t take monoamine oxidase inhibitors (MAOIs), which are another type of antidepressant medication, within 14 days of taking Wellbutrin. If you’ve taken MAOIs in the past, tell your provider. Examples of MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), and tranylcypromine (parnate).
• Avoid taking illicit drugs, especially those that increase your risk of seizures, like cocaine, while on Wellbutrin.
• Some people experience negative effects when drinking alcohol while on Wellbutrin. If you take Wellbutrin, limit or avoid alcohol use.
• Don’t take more Wellbutrin than your prescribed dose. Taking more Wellbutrin than you’re prescribed can lead to overdose and seizure.
• Don’t take other bupropion medications, like Zyban for smoking cessation, if you’re taking Wellbutrin.

Ask your provider any questions you have about what you can and can’t do while taking Wellbutrin.

Who shouldn’t take Wellbutrin?

Wellbutrin shouldn’t be taken, or should only be taken with caution and provider supervision, by:

• People with epilepsy or another seizure disorder
• People with a past or current history of anorexia or bulimia
• People using or withdrawing from alcohol, benzodiazepines, barbiturates, and antiepileptic drugs
• People who’ve had a severe head injury
• People with metabolic disorders, including hypoglycemia
• People who use illicit drugs, especially stimulants
• Anyone at risk for a seizure

In addition, all antidepressants come with the risk of triggering bipolar mania/hypomania. If you have a history of bipolar disorder or psychosis, be honest about this with your healthcare provider. 

Stopping Wellbutrin can cause withdrawal-like symptoms

Although Wellbutrin isn’t considered addictive, stopping it suddenly can cause withdrawal-like symptoms, including:

• Aches and pains
• Irritability and anxiety
• Headaches
• Insomnia

In addition, stopping abruptly can cause previous mental health symptoms, like depression, to return. Never stop taking prescribed medication without consulting your healthcare provider.

How much does Wellbutrin cost?

According to drugs.com, Wellbutrin SR costs between $473 and $933 depending on the dose for 60 tablets. Wellbutrin XL costs from $2,100 and $2,700 for a 30-day supply, depending on the dose. These are retail prices, and many insurance plans cover the cost. In addition, generic Wellbutrin, bupropion, is available for a much lower cost, starting at around only $17 for a 30-day supply.

Efficacy of Wellbutrin compared to other OCD treatments 

When compared to other OCD medications, Wellbutrin is not as effective. The most effective therapeutic treatment for OCD is a type of cognitive-behavioral therapy called exposure and response prevention (ERP). 

Wellbutrin vs SSRIs for OCD

SSRIs are the class of antidepressant medications proven most effective for OCD. Several SSRIs, including Prozac, Luvox, Paxil, and Zoloft, are FDA-approved for the treatment of OCD. Another SSRI, Lexapro, is sometimes used off-label for OCD as well.

Your provider will suggest an SSRI or other treatment for you based on our unique needs and health history.  

Wellbutrin vs SNRIs for OCD

A few different serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants have evidence promoting their effectiveness for OCD. Research has found that Cymbalta (duloxetine) and Effexor (venlafaxine), both SNRIs, may be as effective for OCD as SSRI medications. Neither is approved by the FDA to treat OCD.

Wellbutrin vs TCAs for OCD

One tricyclic antidepressant (TCA) medication, Anafranil, is FDA-approved to treat OCD. Most comparison trials have failed to find significant differences between the effectiveness of Anafranil and SSRIs in treating OCD. Anafranil tends to cause more side effects and be less well tolerated than SSRIs however.

Wellbutrin vs behavioral therapy for OCD

The gold standard in OCD treatment is exposure and response prevention (ERP). It’s shown to be effective for up to 80% of people who live with OCD. For most people with OCD, ERP therapy is more effective than medication, although a combination of medication and ERP works well for many.

How to get a prescription for Wellbutrin

The first step to getting a prescription for any medication, including Wellbutrin, is to get an OCD assessment and diagnosis from a qualified mental health provider. You can get an assessment online or in-person from a provider on Klarity Health. After your initial assessment session, your provider will create a personalized treatment plan for OCD that may include medication, therapy, or a combination of both.

Key takeaway 

Wellbutrin isn’t as effective for treating OCD as other medications and is generally not considered a first-line treatment. There are more effective options for OCD, including other antidepressants. Wellbutrin can be helpful with treating OCD-related depression and the sexual side effects that result from some OCD and antidepressant medications. In rare cases, your healthcare provider may prescribe you Wellbutrin for OCD if other first-line treatments haven’t worked.

The best person to help you find the right treatment option for your OCD symptoms is a qualified mental health provider. 

Find a provider for a Wellbutrin for OCD or other prescription

OCD is treatable. On Klarity Health, you can connect with a mental health provider today who can offer effective medication management or therapy for OCD. Book an appointment today and see someone within 48 hours.