Wellbutrin Uses & Side Effects

Wellbutrin is a brand-name drug that contains bupropion hydrochloride as the active ingredient. You may have known of Wellbutrin for its use in treating depression. However, besides depression, Wellbutrin is also used for other mental health conditions discussed below; and interestingly, different formulations of Wellbutrin are used for different indications. Please continue reading to learn about the uses and side effects of Wellbutrin.

What is Wellbutrin? How does it work?

Wellbutrin (bupropion) belongs to a group of antidepressants called norepinephrine-dopamine reuptake inhibitors (NDRIs), one of the atypical antidepressants. The exact mechanism of Wellbutrin is unknown; however, it is believed that Wellbutrin works by inhibiting the neurons (brain cells) from reabsorbing norepinephrine and dopamine after they have been released into the brain. These two neurotransmitters, norepinephrine and dopamine, are natural brain chemicals that help regulate mood, motivation, and certain brain responses affecting other body functions. Over time, Wellbutrin builds up a steady level of these neurotransmitters in the body which help reduce symptoms of a depressed mood while promoting the general sense of well-being.

One key thing to keep in mind is that the increase in levels of these brain chemicals does not occur overnight. This is why all antidepressants take about 6 to 8 weeks to show improvement in mood and motivation. However, it doesn’t mean you will have to wait that long to find out if this is the right medication for you. The first sign that Wellbutrin is working would take place between the first and second week when you would notice an improvement in appetite and sleep. You should let your provider know how you feel by week 4, including any improvement in mood or any side effects that do not get better over time.

What’s the difference between Wellbutrin IR, Wellbutrin SR, and Wellbutrin XL?

Wellbutrin is available in different formulations, including immediate-release (IR), sustained-release (SR), and extended-release (XL) oral tablets. All Wellbutrin formulations contain bupropion; however, they are not interchangeable as each formulation is approved for different uses. These brand-name drugs are also available as low-cost generics.

The generic Wellbutrin is available in all 3 formulations, immediate-release (IR), sustained-release (SR), and extended-release (XL) oral tablets. Whereas the brand name Wellbutrin is only available as a sustained-release (SR) and extended-release (XL). Zyban is another brand name for Wellbutrin that was used for smoking cessation; however, Zyban has been discontinued in the U.S.

Compared to Wellbutrin XL, Wellbutrin SR is absorbed a bit faster and takes approximately 3 hours to reach a steady-state level in your body, whereas Wellbutrin XL can take up to 5 hours. Another difference between these two formulations is that Wellbutrin SR is dosed twice daily, while Wellbutrin XL only requires once daily dosing. This is a huge advantage for people who have trouble remembering to take their medications.

Wellbutrin SR is used to treat depression and help quit smoking. The SR form is available as 100 mg, 150 mg, and 200 mg oral tablets and is usually taken twice daily. For depression, the usual dose is 150 mg once daily in the morning; after 3 days, based on tolerability, the dose can be increased to 150 mg twice daily at least 8 hours apart. The maximum daily dose is 400 mg. For smoking cessation, the dosing regimen is the same as for treating depression; however, the length of therapy is about 7-12 weeks, starting 1 to 2 weeks before the quit date.

Wellbutrin XL is released more slowly into the body for up to 24 hours; that’s why this medication only needs to be taken once a day. It is used to treat major depressive disorder and seasonal affective disorder, a type of depression that usually occurs in the fall and winter months when the days are shorter with less daylight. Wellbutrin XL is available as 150 mg and 300 mg tablets and, as mentioned, is taken once a day. Your doctor may start you on a dose of 150 mg once daily in the morning and may increase it to 300 mg once daily after 4 days.

Is Wellbutrin used to treat bipolar disorder?

Wellbutrin is not approved by the Food and Drug Administration (FDA) to treat bipolar disorder. Prescribers may use Wellbutrin to treat bipolar disorder as an off-label use for this mental health condition. Keep in mind that Wellbutrin is not the first-line treatment for patients with bipolar disorder. Your doctor will tell you the specific instructions, including which strength and how often to take this medication if you are prescribed Wellbutrin for bipolar disorder.

How to take Wellbutrin?

Dosing

Take the immediate-release (IR)tablet of Wellbutrin 3 times a day as prescribed, the sustained-release (SR) tablet twice a day, and the extended-release (XL) tablet once a day. The doses of Wellbutrin SR should be at least 8 hours apart, while the doses of Wellbutrin XL should be at least 24 hours apart. Do not split, crush, or chew the sustained-release tablets. Store Wellbutrin at room temperature in a cool, dry place away from moisture and heat.

Timing of Doses

Take your medicine at approximately the same times every day. You can take this medication with or without food. Avoid taking bupropion close to bedtime if you have trouble sleeping.

Missed Dose

In case you miss a dose, take Wellbutrin as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Do not take extra medicine to make up for a missed dose.

Duration of Wellbutrin Treatment

Your healthcare professional will likely start you on a lower dose of Wellbutrin and increase the dose gradually. It can take several weeks or even months to get the full benefit of the medicine. Do not stop taking Wellbutrin without talking to your doctor for medical advice; you should not stop taking this medication suddenly. Talk to your doctor or pharmacist about how to properly taper this medication. Quitting Wellbutrin cold turkey can cause antidepressant discontinuation syndrome, which is present with nausea, vomiting, anxiety, agitation, and sleeping problems. If you are taking Wellbutrin for seasonal affective disorder, your healthcare provider will probably start you on the medicine in the early fall and stop it in the spring.

What are the major side effects of Wellbutrin?

Antidepressant medications like Wellbutrin can cause possible side effects such as drowsiness, dizziness, headache, nausea, dry mouth, trouble sleeping, anxiety, stomach pain, vomiting, constipation, loss of appetite, weight loss, changes in taste, ringing in the ears, muscle or joint pain, and excessive sweating.

Call your healthcare provider for medical advice about side effects if they are severe or if you have new or worsening symptoms after starting Wellbutrin. Also, it is important to inform your doctor of any new or worsening mental health symptoms, such as aggressiveness, agitation, hostility, or if you feel impulsive, hyperactive, or have increased thoughts of hurting yourself or others.

Does Wellbutrin have serious side effects?

Rarely, Wellbutrin can have serious side effects. Call your doctor or pharmacist immediately or seek emergency medical care if you develop:

Fast or irregular heartbeats
Confusion, unusual behavioral changes
Seizures
Hallucinations (seeing or hearing things that are not there)
Hypomania or mania, psychosis, and delusions

Get emergency medical help if you have the following signs and symptoms:

Severe skin reaction with a purple skin rash, skin pain, hives, blisters, and itching (allergic reaction)
Difficulty breathing or swallowing
Chest pain
Swelling of the face, lips, throat, tongue, hands, lower legs, ankles, and feet
Fever
Hoarseness
Severe headache, chest pain, and shortness of breath

What are the risks of taking Wellbutrin?

Some of the risks of taking Wellbutrin are as follows:

Allergic reactions

Some people are allergic to Wellbutrin. Tell your healthcare provider if you have ever had an allergic reaction to bupropion, any of the active or inactive ingredients in bupropion tablets, or any other medications. Your pharmacist can give you a list of ingredients.

Drug interactions

Wellbutrin can interact with other medications and cause possible side effects. Give your doctor or pharmacist a complete list of your medications. Tell them if you have taken a group of drugs called monoamine oxidase inhibitors (MAOIs) within the last 14 days.

Overdose

Taking too much Wellbutrin can lead to seizures, muscle stiffness, hallucinations, rapid and uneven heartbeat, and loss of consciousness. Make sure you don’t take more than one product containing bupropion at the same time. Call 911 and seek emergency medical care or call the National Poison Control Center at 1-800-222-1222 in case of an overdose.

Medical conditions

Wellbutrin may not be right for everyone. Tell your doctor if you have a medical history of a seizure disorder, eating disorder, high blood pressure, heart attack, heart disease, diabetes, liver disease, kidney disease, glaucoma, head injury, brain or spine tumor, depression, bipolar disorder or other mental health conditions, or if you drink alcohol regularly. Also, tell your healthcare provider if you are pregnant or nursing an infant with breast milk or if you become pregnant while on Wellbutrin.

Precautions

Wellbutrin can make you drowsy and dizzy. Do not drive or do anything that requires your full focus until you know how this medicine affects you.
Avoid drinking alcohol because alcohol can increase your risk of side effects from Wellbutrin.
Talk to your doctor about checking your blood pressure while on Wellbutrin. This medicine can increase your blood pressure.
Taking Wellbutrin is associated with an increased risk of angle-closure glaucoma. Tell your doctor immediately if you develop eye pain, swelling, redness, or vision changes while taking bupropion.
Patients taking bupropion, especially young adults, can develop changes in behavior and mood, including suicidal ideation. This can occur when you first start treatment, several weeks later, and even after you stop taking Wellbutrin. Tell your doctor if you have a history of depression, bipolar disorder, schizophrenia, or any other mental illness. Seek immediate medical attention if you develop suicidal thoughts, new or worsening depression, anxiety, panic attacks, confusion, restlessness, agitation, abnormal excitement, hallucinations, paranoia, or any other unusual or sudden changes in behavior. Your family members should know how to seek medical attention if you cannot do so yourself.