What is this medication?
Dopamine/Norepinephrine Reuptake Inhibitor
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.
“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 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.”
How does this medication 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.
How should I take this medication?
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.
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.
What should I watch for while using this medication?
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 on 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.
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 inherent 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.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
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%)
Note this is not a complete list of side effects, only common ones
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