Bupropion XL 450mg and Anxiety Association

Clinical Guidance

• The American College of Physicians recommends taking the second daily dose of bupropion before 3 PM to minimize insomnia risk, which can indirectly exacerbate anxiety, in patients taking bupropion XL 450mg 1, 2
• Bupropion is characterized as an "activating" antidepressant that should not be used in agitated patients, according to the American Academy of Family Physicians 1
• The American Academy of Family Physicians notes bupropion is appropriate for anxiety occurring as part of depressive syndrome, particularly when apathy and fatigue are prominent, in patients taking bupropion XL 450mg 2

Patient Monitoring

• Patients should be monitored intensively during titration of bupropion XL 450mg, watching for emergence or worsening of anxiety, particularly in the first 4-8 weeks, and blood pressure and heart rate should be checked, as tachycardia could be misinterpreted as anxiety or exacerbate anxiety symptoms 3
• Screen for contraindications, including current agitation, uncontrolled hypertension, seizure disorders, or eating disorders, before prescribing bupropion XL 450mg 1, 2