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Wellbutrin Patient Tips

Medically reviewed on Sep 25, 2017 by C. Fookes, BPharm.

How it works

  • Wellbutrin is a brand (trade) name of bupropion, used for the treatment of depression.
  • Experts are not exactly sure how Wellbutrin works as an antidepressant but they do know that it affects the reuptake of both dopamine and norepinephrine, two neurotransmitters.
  • Wellbutrin belongs to the class of medicines known as aminoketone antidepressant and is chemically unrelated to any other type of antidepressant.

Upsides

  • Wellbutrin may be used to relieve the symptoms of depression in Major Depressive Disorder (MDD) and Seasonal Affective Disorder (SAD).
  • Less likely to cause weight gain than some other antidepressants.
  • Wellbutrin is available as a generic under the name bupropion.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • A headache, dry mouth, blurred vision, nausea, constipation, dizziness, tinnitus, insomnia and sedation, fast heart rate, rash and increased sweating can occur. May trigger angle-closure glaucoma.
  • Severe neuropsychiatric symptoms, including agitation, anxiety, delusions, hallucinations, panic disorder, paranoia, and psychosis have been reported with Wellbutrin use. These have occurred in people with and without preexisting psychiatric disease. People should be monitored for the appearance of neuropsychiatric symptoms. Most cases resolved on discontinuation of Wellbutrin; however, a few persisted.
  • Should not be used in people with bipolar disorder as can precipitate a manic or mixed episode.
  • As with other antidepressants, Wellbutrin may increase the risk of suicidal thoughts or behavior. The risk is greatest for children and young adults under the age of 24. Monitor for worsening mood.
  • May increase the risk of seizures. The risk is greater with higher dosages and faster titration speeds. Slow, upwards dosage titration is recommended to the minimum effective dose.
  • May increase blood pressure. Blood pressure should be taken on treatment initiation and monitored periodically.
  • More likely than other antidepressants to cause weight loss; however, may cause weight gain in some people.
  • May cause allergic reactions in some people with symptoms such as itchiness, facial swelling, and hives (urticaria). Stop treatment immediately and seek medical help.
  • May cause a discontinuation syndrome if abruptly stopped or interrupted (symptoms include nausea, vomiting, diarrhea, headaches, dizziness, sweating, chills, tremors, vivid dreams, and insomnia).
  • May interact with several drugs including tamoxifen, other antidepressants, HIV anti-virals, some drugs used to treat heart conditions, increase bleeding risk, or increase serotonin levels (such as Tramadol, other antidepressants, St John's wort). Symptoms of serotonin syndrome include mental status changes (such as agitation, hallucinations, coma, delirium), fast heart rate, dizziness, flushing, muscle tremor or rigidity and stomach symptoms (such as nausea, vomiting, and diarrhea).
  • May cause false-positive results on urine screening tests for amphetamines.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Wellbutrin is effective in the treatment of depression; however, approximately 10% of people who take it discontinue it because of side effects (such as confusion, agitation, nausea, and vomiting).

Tips

  • Can be taken with or without food.
  • Take Wellbutrin in equally divided doses 3 or 4 times a day. Separate doses by at least 6 hours to minimize the risk of seizure; however, avoid taking the last dose of the day after 5pm to minimize the risk of insomnia
  • Swallow extended-release or slow-release formulations whole; do not crush, divide or chew.
  • Caregivers should be alert for changes in behavior including agitation, hallucinations, confusion, depressed mood, and talk of suicide; seek urgent medical advice if changes are apparent.
  • May cause sedation or impair concentration and affect your ability to drive or perform hazardous tasks. Avoid alcohol.
  • See your doctor urgently if you develop any eye pain, visual problems or swelling or redness in or around one eye while taking Wellbutrin.
  • Stop taking Wellbutrin and seek urgent medical help if any symptoms suggestive of an allergic reaction occur (such as difficulty breathing, chest pain, mouth sores, itchiness, body rash, facial swelling).
  • Most episodes of depression require treatment for several months even after the acute episode has resolved. Ask your doctor to reevaluate your treatment, and need for continued treatment, periodically.
  • Do not stop Wellbutrin abruptly unless on a doctor's advice or safety concern. Taper off slowly under medical supervision.
  • Please be aware that Wellbutrin and Zyban (used to help stop smoking) contain the same active ingredient (bupropion) and SHOULD NOT be taken together.
  • Zyban contains the same active ingredient as Wellbutrin, which is bupropion, and the two should never be used together.
  • When used to treat Seasonal Affective Disorder (SAD), Wellbutrin should be initiated in the autumn before the onset of depressive symptoms, continued throughout the winter season, and tapered off in early spring.
  • Do not stop Wellbutrin suddenly unless on a doctor's advice or if an allergic reaction occurs. If you need to discontinue bupropion, your doctor will advise you how to do so slowly.
  • Minimize or avoid consumption of alcohol as your tolerance to it may be diminished while taking bupropion, and it may also increase the risk of neuropsychiatric adverse events.
  • Talk to your doctor or pharmacist before you take any other medication with Wellbutrin, including that bought over-the-counter.

Response and Effectiveness

  • Improvements in sleep, energy, or appetite may be apparent within the first 1-2 weeks; improvements in depressed mood or motivation may take several weeks longer.
  • Takes up to eight weeks of regular dosing for plasma levels to become stable in the blood.

References

Wellbutrin (bupropion) [Package Insert] Revised: 04/2016 GlaxoSmithKline LLC https://www.drugs.com/pro/wellbutrin.html

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Wellbutrin only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of this information. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Drugs.com. Revision Date: 2017-09-25 00:40:28

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