Is Bupropion Making You Anxious? The Science and What to Do Next

If you've started bupropion and noticed you're feeling more anxious, restless, or on edge, you're not imagining things. Anxiety can be a side effect of bupropion for some people. The key question is whether what you're experiencing is temporary and manageable—or something that needs medical attention.

Let's break down what the science says, why this can happen, and what your next steps should be.

---

What Is Bupropion?

Bupropion is a prescription medication commonly used to treat:

• Major depressive disorder
• Seasonal affective disorder
• Smoking cessation (to help people quit)

Unlike many antidepressants, bupropion does not primarily affect serotonin. Instead, it works on two brain chemicals:

• Dopamine
• Norepinephrine

These chemicals are linked to motivation, energy, and alertness. That's why bupropion is often described as more "activating" compared to other antidepressants.

For many people, that boost in energy is helpful. For others, it can feel like nervousness or anxiety.

---

Can Bupropion Cause Anxiety?

Yes, it can.

Clinical data show that anxiety, agitation, restlessness, and insomnia are known side effects of bupropion. These effects are usually:

• Most noticeable in the first few weeks
• Dose-related (higher doses may increase the risk)
• More common in people already prone to anxiety

However, it's important to note:

• Some people actually experience less anxiety once their depression improves.
• Others may find anxiety worsens temporarily before stabilizing.
• A smaller group may find bupropion simply isn't a good fit.

---

Why Might Bupropion Increase Anxiety?

The answer lies in how the medication works.

Bupropion increases levels of norepinephrine, which is part of your body's "fight-or-flight" system. This system controls:

• Heart rate
• Alertness
• Focus
• Physical arousal

If that system becomes overstimulated, you might notice:

• Feeling jittery
• Racing thoughts
• Increased heart rate
• Trouble sleeping
• Feeling "keyed up" or tense

In people with underlying anxiety disorders—like generalized anxiety disorder or panic disorder—this activation can feel uncomfortable.

---

What Anxiety From Bupropion Feels Like

Anxiety related to bupropion may include:

• Restlessness or pacing
• Irritability
• Difficulty falling asleep
• Feeling overstimulated
• Increased sweating
• Mild tremor
• Racing heart

More rarely, people may experience:

• Panic attacks
• Severe agitation
• Mood changes
• Suicidal thoughts (particularly in younger individuals)

If you are experiencing severe symptoms, thoughts of harming yourself, chest pain, or extreme agitation, seek medical care immediately.

---

Is It Temporary?

Often, yes.

Many side effects from bupropion improve within:

• 1 to 4 weeks after starting
• Or after a dose adjustment

Your brain needs time to adjust to changes in dopamine and norepinephrine levels.

If anxiety is:

• Mild
• Improving over time
• Not interfering with daily functioning

Your doctor may recommend continuing and monitoring.

But if it's worsening or interfering with your life, it may not be the right medication for you.

---

Who Is More Likely to Feel Anxious on Bupropion?

You may be at higher risk if you:

• Already have an anxiety disorder
• Are sensitive to stimulants (like caffeine)
• Take high doses
• Increased your dose quickly
• Have a history of panic attacks
• Are experiencing significant life stress

Bupropion is generally not considered a first-line treatment for primary anxiety disorders. In some cases, doctors may combine it with another medication to balance effects.

---

What You Can Do Next

If you suspect bupropion is increasing your anxiety, don't stop it suddenly without medical advice. Instead, consider the following steps:

1. Track Your Symptoms

Write down:

• When symptoms started
• Severity (mild, moderate, severe)
• Time of day they occur
• Any recent dose changes

This information helps your doctor decide what to do.

---

2. Consider a Symptom Check

If you're unsure whether what you're experiencing is medication-related anxiety or something else, Ubie's Free AI-powered Anxiety Symptom Checker can help you identify and understand your symptoms in just a few minutes—giving you clarity before your next doctor's appointment.

---

3. Review Your Dose With Your Doctor

Possible adjustments may include:

• Lowering the dose
• Switching from immediate-release to extended-release
• Slowing down dose increases
• Changing the time of day you take it
• Switching medications

Never adjust your dose on your own.

---

4. Reduce Other Stimulants

While taking bupropion, you may be more sensitive to:

• Caffeine
• Energy drinks
• Nicotine
• Decongestants (like pseudoephedrine)

Reducing these can significantly improve jitteriness.

---

5. Improve Sleep Hygiene

Since insomnia can worsen anxiety:

• Take bupropion in the morning (if advised by your doctor)
• Avoid screens before bed
• Keep a consistent sleep schedule
• Limit caffeine after noon

---

When to Call a Doctor Immediately

Seek urgent care if you experience:

• Suicidal thoughts
• Severe agitation
• Hallucinations
• Chest pain
• Seizures
• Extreme mood changes
• Signs of allergic reaction (rash, swelling, difficulty breathing)

These are rare but serious and require prompt evaluation.

Always speak to a doctor about anything that could be life‑threatening or serious.

---

Should You Stop Bupropion?

Do not stop abruptly unless instructed by a healthcare provider.

Sudden discontinuation can lead to:

• Mood changes
• Irritability
• Worsening depression
• Physical discomfort

Your doctor may recommend tapering gradually if discontinuation is necessary.

---

The Bigger Picture: Is It Anxiety or Activation?

Sometimes what feels like anxiety is actually:

• Increased energy after depression
• Restored motivation
• Heightened emotional awareness

Depression can numb emotions. When treatment begins working, emotions—including stress—can feel stronger before stabilizing.

A careful evaluation with your doctor can help determine whether:

• The medication is working
• The dose needs adjusting
• A different medication would be better

---

What the Evidence Suggests

Research and prescribing data show:

• Anxiety is a recognized side effect of bupropion.
• It is generally mild to moderate.
• It often improves over time.
• It is dose-related.
• Not everyone experiences it.

For many people, the benefits of improved mood and energy outweigh temporary side effects. For others, a different antidepressant may be more suitable—especially if anxiety is the primary concern.

Treatment is not one-size-fits-all.

---

The Bottom Line

Yes, bupropion can make some people feel anxious. This is usually due to its activating effect on dopamine and norepinephrine. For many, this side effect improves within a few weeks. For others, it may require dose adjustments or a medication change.

Here's what matters most:

• Monitor your symptoms.
• Don't stop medication suddenly.
• Reduce other stimulants.
• Speak openly with your doctor.
• Seek urgent care for severe symptoms.

If you're experiencing new or worsening feelings of anxiousness and want to better understand what you're going through, try Ubie's Free AI-powered Anxiety Symptom Checker to get personalized insights based on your specific symptoms.

Most importantly, talk with your healthcare provider. Medication decisions should always be made with medical guidance—especially if symptoms feel severe, sudden, or overwhelming.

With the right support and adjustments, you can find a treatment plan that helps your mood without leaving you feeling on edge.