Dopamine/Norepinephrine Reuptake Inhibitor
“ALERT: US Boxed Warning
Suicidality and antidepressant drugs:
Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term trials. These trials did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in subjects aged 65 and older.
In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for the emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber. Bupropion is not approved for use in pediatric patients.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Wellbutrin/Bupropion appears to enhance norepinephrine and dopamine activity and does not inhibit monoamine oxidase or the reuptake of serotonin like other antidepressants. Selective serotonin reuptake inhibitors (SSRIs) can interfere with different aspects of sexual functioning, including desire, arousal, and orgasm. Treatment options include either switching to a different antidepressant or augmenting therapy with bupropion which can counter the effects of SSRI-induced sexual dysfunction.
Indications For Use
Bupropion is officially indicated for major depressive disorder, smoking cessation, and seasonal affective disorder depending on which dosage form is used. It is also prescribed off-label for ADHD and in combination for SSRI-induced sexual dysfunction.
Do not use in patients with hypersensitivity to bupropion; seizure disorders; current or prior diagnosis of severe anorexia nervosa and/or bulimia (due to risk of seizures).
Do not use in conjunction with monoamine oxidase inhibitors
Use with caution in patients with risk factors predisposing them to seizures such as head trauma, brain tumor, concurrent medications which lower the seizure threshold, abrupt withdrawal from alcohol, benzodiazepines or barbiturates, abuse of stimulant drugs.
SSRI-induced sexual dysfunction, augmentation (off-label use)
12-hour extended release (sustained release): 150mg once daily for the first 3 days then increased dose to 150mg twice daily based on response and tolerability.
Points To Consider
Causes fewer sexual side effects than other antidepressants; has been shown to improve libido and sex drive for some people
Can be combined with other antidepressants to counteract their sexual side effects
Can increase risk of suicidal thoughts and behavior
Like other antidepressants, does not work for everyone
How to Take Bupropion, Wellbutrin XL/SR: Do not split the tablet; take the entire tablet and swallow whole. If you are taking only one dose per day, take it in the morning. If you take two doses per day, take once in the morning and one in the afternoon, at least 8 hours apart. Avoid taking at bedtime to prevent insomnia. Take with food if you have any problems with nausea or an upset stomach.
You Need to Avoid Bupropion, Wellbutrin XL/SR: Do not use it if you have an eating disorder such as bulimia or anorexia nervosa due to the inherently higher risk of seizures.
Contact Your Doctor if You Ever Experience: Stop taking this medication and contact your doctor if you experience a rash (particularly in combination with facial swelling, breathing difficulties, or flu-like symptoms); severe agitation, anxiety or excitation, major sleep disturbance, or unusual mood change, muscle twitching or convulsions.
Well tolerated, most side effects are transient and mild to moderate in nature. The most common side effects include:
Cardiovascular: Tachycardia (<11%)
Central Nervous System: Insomnia (11% to 40%), headache (25% to 34%), agitation (2% to 32%), dizziness (6% to 22%)
Dermatologic: Diaphoresis (5% to 22%)
Endocrine and Metabolic: Weight loss (14% to 23%)
Gastrointestinal: Xerostomia (10% to 28%), constipation (8% to 26%), nausea and vomiting (23%), nausea (1% to 18%)
Neuromuscular and Skeletal: Tremor (1% to 21%)
Ophthalmic: Blurred vision (3% to 15%)
Respiratory: Nasopharyngitis (13%), pharyngitis (3% to 13%), rhinitis (12%)
Frequently Asked Questions
Do you take Bupropion, Wellbutrin XL/SR with food or on an empty stomach?
You can take Wellbutrin/Bupropion with an empty stomach or with food. However, if you experience nausea or an upset stomach you can take it with food.
Can you drink alcohol when you are on Bupropion, Wellbutrin XL/SR?
You should limit or completely avoid alcohol consumption when taking Wellbutrin/Bupropion because it may increase your chances of having a seizure while on this medication.
What if you miss a dose?
If you miss taking a dose by less than 4 hours, take it as soon as you remember. If your dose is more than 4 hours late, then skip it altogether and continue with your regular schedule.
How quickly will you experience an improvement?
If you are taking this medication for depression, it may take at least a week before you notice any improvement and a full response can take up to 4 to 6 weeks.