What is Bupropion (Wellbutrin)?
Bupropion hydrochloride is a noradrenergic/dopaminergic ANTIDEPRESSANT. It is available in 3 oral formulations, Wellbutrin IR (given three times a day), Wellbutrin XL (once a day), and Wellbutrin SR (twice a day). They restrain norepinephrine and dopamine reuptake.
Major Depressive Disorder (MDD) is a common psychiatric disorder. In a given year, 6.6 percent of the adult population in the United States experiences severe depression episodes. For depression, bupropion (Wellbutrin) is used as first-line monotherapy. Bupropion (Wellbutrin) is also used as “add-on therapy” with other antidepressants in a substantial percentage of cases. It has minimal side effects linked to sexual dysfunction and sedation. Bupropion (Wellbutrin) cessation has not been connected to any withdrawal symptoms.
As a smoking cessation medication, bupropion (Wellbutrin) is also sold as Zyban. The FDA (Food and Drug Administration) has allowed Contrave, a combination of bupropion and naltrexone, for weight loss. Bupropion (Wellbutrin) is the only medication recommended by the FDA as the only treatment for Seasonal Affective Disorder (SAD).
To increase the chances of therapeutic success, depressed individuals must receive proper treatment.
How Does Wellbutrin Works?
An imbalance in the number of neurotransmitters released causes depression. Reuptake is a process in which nerves recycle neurotransmitters that have been released.
Bupropion (Wellbutrin) works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine. As a result, more dopamine, serotonin, and norepinephrine are released, allowing information to be transmitted to other nerves. This is how Wellbutrin works in the brain to keep your mood in check.
What Bupropion (Wellbutrin) is Used For?
The FDA approves bupropion (Wellbutrin) to treat Major Depressive Disorder (MDD) and Seasonal Affective Disorder (SAD). SAD is more prevalent in the fall and winter months. Bupropion (Wellbutrin) is used to treat Attention-deficit/hyperactivity disorder (ADHD), Bipolar Disorder, Post-traumatic Stress Disorder (PTSD), Social Anxiety Disorder, and nerve pain as an off-label medicine (non-FDA approved).
How Long Does It Take For Bupropion (Wellbutrin) To Work?
In the first 1-2 weeks after starting Bupropion (Wellbutrin), the patient may notice some improvement in symptoms. The full effect of medication or complete remission of depressive symptoms may take at least 6-8 weeks.
To avert a relapse of symptoms, MDD requires a longer treatment course, usually at least 6-12 months after reaching baseline. The treatment for SAD and smoking cessation therapy will differ from person to person depending on their response. Based on your input, healthcare advisors will recommend a dose and subsequent therapy.
What Is The Recommended Dosage For Bupropion (Wellbutrin)?
- Immediate-release Bupropion (Wellbutrin IR) is available in 75-, 100-, and 150-mg tablets.
- Sustained-release Bupropion (Wellbutrin SR) is available in 100-, 150-, 200-, and 300-mg tablets.
- Extended-release Bupropion (Wellbutrin XL) is available in 150- and 300-mg strengths.
Budeprion XL 300-mg tablets, one of the extended-release generic variants, were found not to be therapeutically similar to Wellbutrin XL 300 mg and were taken off the market.
Immediate-release Bupropion (Wellbutrin IR):
- In a healthy adult, 75 mg of immediate-release Bupropion (Wellbutrin IR) should be taken twice a day to start.
- Experts can increase the dosage up to 100 mg three times a day on the fourth day of treatment.
- 300 mg is the suggested maintenance dose.
- Psychiatrists should divide the maximum daily dose of 450 mg into three doses of 150 mg each.
- A single dose of immediate-release Bupropion (Wellbutrin IR) should never be over 150 mg, and the total daily dose should never be over 450 mg.
Sustained-release Bupropion (Wellbutrin SR):
- The recommended starting dose for sustained-release tablets is 150 mg twice daily.
- The target dose is 150 mg twice daily, and the maximum dose is 200 mg twice daily.
- The maximum dose of sustained-release Bupropion (Wellbutrin SR) in a single administration should never exceed 300 mg. Depending on body weight, doses of up to 450 mg can occasionally be utilized.
Extended-release Bupropion (Wellbutrin XL):
- Extended-release tablets (Wellbutrin XL) provide a starting dose of 150 mg per day.
- A target dose of 300 mg per day, and a maximum dose of 450 mg per day.
- The extended-release tablets are prescribed once a day.
- When it is used as smoking cessation therapy, bupropion (Zyban) is normally started at 150 mg once a day for three days, then increased to 150 mg twice a day for seven to twelve weeks if the patient tolerates the first dose.
What side effects will I get from Bupropion (Wellbutrin)?
- The most common side effects comprise headache, sleeplessness, dry mouth, tremor, and nausea.
- Nervousness, turmoil, and irritability are potential side effects.
- Bupropion should not be given to patients who have severe anxiety or panic attacks. Bupropion (Wellbutrin) can elicit psychotic manifestations such as hallucinations, delusions, and catatonia, as well as delirium, owing to its potentiating effects on dopaminergic neurotransmission.
- However, some people may have dry mouth, constipation, and weight loss because of the medication.
- Some doctors are hesitant to prescribe Bupropion (Wellbutrin) because of the risk of seizures.
- The risk of seizure is dosage-dependent. Studies suggest that the incidence of seizures with sustained-release bupropion at doses of 300 mg or less per day is 0.05 percent. With daily doses of 400 mg, the risk of seizures rises to roughly 0.1 percent.
- Some individuals experience cognitive deterioration, most notably struggle to identify words properly.
- If you have bipolar disorder, you should be cautious about using Wellbutrin because it might cause Wellbutrin-induced mania.
Concerns Regarding Bupropion (Wellbutrin) Under Pregnancy:
- Bupropion use by pregnant women does not appear to be linked to an increased risk of birth abnormalities. Bupropion (Wellbutrin) is secreted in breast milk.
- Thus, its usage in nursing mothers should depend on the patient’s clinical conditions and the clinician’s opinion.
Bupropion (Wellbutrin) Overdose:
- Seizures occur in around one-third of overdose cases, and they are dose dependent. Uncontrollable convulsions, sinus bradycardia, and cardiac collapse are the potential causes of casualties.
- Seizures, sinus tachycardia, hypertension, gastrointestinal complications, hallucinations, and turmoil are the most prevalent poisoning symptoms.
- Almost all convulsions are abrupt and self-contained. Bupropion (Wellbutrin) is safer in overdose cases than other antidepressants, except for SSRIs.
Which Drugs Interact With Bupropion (Wellbutrin):
- Bupropion (Wellbutrin) should be used with caution in individuals who are taking medications that lower the seizure threshold. Prochlorperazine, chlorpromazine, and other phenothiazine-class antipsychotics are examples of such medicines.
- Patients should not take Bupropion (Wellbutrin) in combination with monoamine oxidase inhibitors (MAOI) since it may contribute to a hypertensive emergency. Before starting bupropion treatment, wait at least 14 days after you’ve stopped taking an MAOI.
- By reducing the blood concentration of Bupropion (Wellbutrin), carbamazepine may diminish the effect of bupropion.
What if I Miss Dose of Bupropion (Wellbutrin):
- Take the remaining Bupropion (Wellbutrin IR and SR) doses as soon as you realize that a dose was missed. If it has been longer than 6 hours from the dosage time, skip and take the next dose as scheduled.
- Never take an additional dose of Bupropion to compensate for missed doses. Just take the usual dose the next day.
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