In addition, there are a number of generic bupropion HCl products for the immediate-, sustained-, and extended-release formulations. Instruct patients to discontinue and not restart WELLBUTRIN if they experience a seizure while on treatment. Advise patients that the excessive use or abrupt discontinuation of alcohol, benzodiazepines, antiepileptic drugs, or sedatives/hypnotics can increase the risk of seizure. Bupropion and its metabolites (erythrohydrobupropion, threohydrobupropion, hydroxybupropion) are CYP2D6 inhibitors. Therefore, coadministration of WELLBUTRIN with drugs that are metabolized by CYP2D6 can increase the exposures of drugs that are substrates of CYP2D6.
- If this dose isn’t working for you, your doctor may recommend another dose increase, up to 200 mg twice per day.
- Swallow the sustained-release and extended-release tablets whole; do not split, chew, or crush them.
- The risk of adverse reactions may be greater in patients with impaired renal function.
- No increased risk for cardiovascular malformations overall has been observed after bupropion exposure during the first trimester.
- Dr. Dion Metzger is a board certified psychiatrist and senior clinical advisor with passions within women’s health, building mental health awareness in communities of color and working with young adults.
A single-dose pharmacokinetic trial demonstrated that the disposition of bupropion and its metabolites in elderly subjects was similar to that of younger subjects. The pooled analyses of placebo-controlled trials in children and adolescents with MDD, obsessive compulsive disorder (OCD), or other psychiatric disorders included a total of 24 short-term trials of 9 antidepressant drugs in over 4,400 subjects. The pooled analyses of placebo-controlled trials in adults with MDD or other psychiatric disorders included a total of 295 short-term trials (median duration of 2 months) of 11 antidepressant drugs in over 77,000 subjects. There was considerable variation in risk of suicidality among drugs, but a tendency toward an increase in the younger subjects for almost all drugs studied. There were differences in absolute risk of suicidality across the different indications, with the highest incidence in MDD. The risk differences (drug vs. placebo), however, were relatively stable within age strata and across indications.
Seizure Risk – Important Information
Depression or other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a particularly high risk of having suicidal thoughts or actions. Pooled analysis of bupropion pharmacokinetic data from 90 healthy male and 90 healthy female volunteers revealed no sex-related differences in the peak plasma concentrations of bupropion.
Is Your Medication Making You Tired?
- Dose will depend on the condition being treated and symptom severity, among other things.
- The FDA has also approved a medication called Contrave, which is a combination of bupropion and naltrexone, for weight loss.
- Instruct patients to contact a healthcare professional if such reactions occur.
- It’s important that your doctor slowly decreases your dose of this medication over time.
If you’re considering taking it, it’s important to learn what it is, how it works, pros and cons, side effects, dosage information, and more. Stop taking WELLBUTRIN and call your healthcare provider right away if you, your family, or caregiver notice any of these symptoms. Work with your healthcare provider to decide whether you should continue to take WELLBUTRIN.
Do Not Take Bupropion If:
Administer the 100-mg tablet 4 times daily to not exceed the limit of 150 mg in a single dose. The recommended starting dose is 200 mg/day, given as 100 mg twice daily. After 3 days of dosing, the dose may be increased to 300 mg/day, given as 100 mg 3 times daily, with at least 6 hours between successive doses.
Bupropion works to regulate chemicals in your brain called norepinephrine and dopamine.
What Drugs, Substances, or Supplements Interact with Wellbutrin?
If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Stop taking bupropion and call your healthcare provider right away if you have any of the following symptoms. Bupropion is used for the management of major depression (major depressive disorder) and seasonal affective disorder (depression that occurs primarily during the fall and winter). Before taking WELLBUTRIN, tell your healthcare provider if you have ever had depression or other mental health problems. You should also tell your healthcare provider about any symptoms you had during other times you tried to quit smoking, with or without bupropion.
However, higher doses (which could not be tested because of the risk of seizure) might be modestly attractive to those who abuse CNS stimulant drugs. Of the approximately 6,000 subjects who participated in clinical trials with bupropion sustained-release tablets (depression and smoking cessation trials), 275 were aged ≥65 years and 47 were aged ≥75 years. In addition, several hundred subjects aged ≥65 years participated in clinical trials using the immediate-release formulation of bupropion (depression trials). No overall differences in safety or effectiveness were observed between these subjects and younger subjects.
In rodents, it has been shown to increase locomotor activity, elicit a mild stereotyped behavior response, and increase rates of responding in several schedule-controlled behavior paradigms. In primate models assessing the positive-reinforcing effects of psychoactive drugs, bupropion was self-administered intravenously. In rats, bupropion produced amphetamine-like and cocaine-like discriminative stimulus effects in drug discrimination paradigms used to characterize the subjective effects of psychoactive drugs. Bupropion, levodopa, and amantadine have dopamine agonist effects.
Bupropion has been FDA approved to treat major depression and seasonal affective disorder, and as an aid to stop smoking. It is sometimes used off label to treat anxiety and ADHD, and for weight loss. Wellbutrin is the brand name for bupropion and the active ingredient in Wellbutrin is bupropion hydrochloride (bupropion HCl).
Bupropion may be particularly helpful for people experiencing depression with fatigue, poor concentration, or lack of enjoyment in activities5,16,17. Wellbutrin increases dopamine and norepinephrine levels in the brain by preventing reabsorption. When levels of these neurotransmitters stay elevated, they can effectively reduce or relieve symptoms of depression. There is much research that supports the efficacy of Wellbutrin in treating major depressive disorder (MDD). One meta-analysis found that the drug was effective in reducing depression scores in 24 out of 27 trials. New or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depression, or suicidal thoughts or actions.
The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of bupropion in the elderly. However, elderly patients may be more sensitive to the effects of this medicine and are more likely to have age-related kidney or liver problems, which may require caution and an adjustment in the dose for patients receiving bupropion. Bupropion is used to treat major depressive disorder (MDD) and to prevent seasonal affective disorder (SAD), which is sometimes called autumn-winter seasonal depression.
How is bupropion supplied (dosage forms)?
Bupropion comes as a tablet and a sustained-release or extended-release (long-acting) tablet to take by mouth. The regular tablet (Wellbutrin) is usually taken three times a day, with doses at least 6 hours apart, or four times a day, with doses at least 4 hours apart. The sustained-release tablet (Wellbutrin SR, Zyban) is usually taken twice a day, with doses at least 8 hours apart.
While not systematically studied, these drugs may induce the metabolism of bupropion. Citalopram did not affect the pharmacokinetics of bupropion and its three metabolites. Bupropion and its metabolites exhibit linear kinetics following chronic wellbutrin uses, dosage, side effects administration of 300 to 450 mg/day. The absolute bioavailability of WELLBUTRIN in humans has not been determined because an intravenous formulation for human use is not available.