Wellbutrin

The active ingredient in Wellbutrin is bupropion. Bupropion is a norepinephrine–dopamine reuptake inhibitor (NDRI) and a nicotinic receptor antagonist.

It mainly increases the amount of two key neurotransmitters in the brain: dopamine and norepinephrine. This increase in neurotransmitter levels helps with mood regulation and can effectively alleviate symptoms of depression and seasonal affective disorder (SAD). Bupropion and its metabolites do not significantly impact serotonin reuptake or interact with serotonin receptors, which sets it apart in the class of antidepressants.

Additionally, bupropion's ability to block nicotine receptors contributes to its effectiveness in smoking cessation therapies. By reducing nicotine cravings and the severity of withdrawal symptoms, it supports individuals in their efforts to quit smoking.

Follow all directions given by your doctor and read all documents provided, including the full prescribing information, FDA-approved product labeling, Instructions for Use, and Medication Guide before using Wellbutrin. However, the following is a synopsis of the general guidelines for the use of Wellbutrin:

• A dose of bupropion is typically taken once or twice daily, depending on the formulation (e.g., immediate-release, sustained-release tablets, or extended-release tablets).
• Take Wellbutrin at the same time each day.
• Wellbutrin can be taken with or without food. If it upsets your stomach, try taking it with food.
• Swallow the tablet whole. Do not crush, chew, or break it.
• If you miss a dose, take it as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Do not take extra medicine to make up for the missed dose.
• Regularly attend follow-up appointments with your healthcare provider.
• Monitor for side effects and report any unusual changes, worsening, or severe reactions.
• Do not stop taking Wellbutrin suddenly without consulting your doctor, as it may cause withdrawal symptoms.

The most common side effects of Wellbutrin seen in clinical trials include:

• Headache
• Nausea
• Dry mouth
• Trouble sleeping
• Sore throat
• Constipation
• Increased sweating
• Weight loss or weight gain

Some individuals may experience serious side effects while using Wellbutrin. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Increased risk of seizures
• High blood pressure or increased heart rate
• Suicidal thoughts and changes in mood or behavior
• Serious allergic reaction
• Serious skin reactions
• Manic episodes
• Vision problems or worsening angle-closure glaucoma
• Get help right away if you experience eye pain or blurred vision

These are not all of the possible side effects of Wellbutrin. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Wellbutrin, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• Seizure disorders
• An eating disorder, such as bulimia or anorexia nervosa
• Suddenly stopped taking seizure medications, sedatives, or alcohol
• Ever had a head injury, seizures, or tumor in your central nervous system (brain or spinal cord)
• Narrow-angle glaucoma
• Heart disease, heart attack, or high blood pressure
• Diabetes
• Depression, bipolar disorder, or other mental illness
• A history of drinking alcohol or substance dependence
• Including benzodiazepines
• Kidney disease
• Liver disease (especially cirrhosis)

Boxed warnings

Wellbutrin carries a boxed warning. Read the prescribing information for the full information. The boxed warning includes the following:

• If you are using bupropion for smoking cessation, watch out for serious neuropsychiatric events, including suicidal ideation, depression, suicide attempts, and completed suicide.
• You should be observed for mood changes. You should stop taking bupropion and contact a healthcare provider immediately if you or a caregiver observes hostility, agitation, depressed mood, developed suicidal ideation or suicidal behavior, or general changes in behavior or thinking that are not typical for you.
• Note that bupropion under the name Wellbutrin is not approved for smoking cessation. Instead, bupropion under the brand name Zyban is approved for this.
• Suicidal thoughts and antidepressant drugs
• Antidepressants increase the risk of suicidal thinking in adolescents, children, and young adults in short-term studies of major depressive disorder (MDD)

• Seizure disorder

• Patients taking Zyban sustained-release tablets, Wellbutrin XL, and Wellbutrin SR, or any medication that contains bupropion; other brand names include Aplenzin, Budeprion, and Forfivo

• Current or prior diagnosis of anorexia nervosa or bulimia

• Concurrent administration of Wellbutrin and a monoamine oxidase (MAO) inhibitor. 14 days should elapse between taking these medications.

• Patients who have a known allergy to bupropion or any of the other ingredients in Wellbutrin.

• Patients currently undergoing an abrupt discontinuation of alcohol or sedatives.

Wellbutrin typically starts to show some effects within 1 to 2 weeks, particularly improvements in energy and focus. However, it may take 4 to 6 weeks to experience the full antidepressant effects. As with most medications for depression, it’s important to stay in touch with your doctor while starting treatment with Wellbutrin.

When Wellbutrin is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking, including:

• Monoamine oxidase inhibitors (MAOIs)
• Examples: linezolid, methylene blue, isocarboxazid, phenelzine
• Other antidepressants
• Antipsychotics such as thioridazine
• Theophylline
• CYP2B6 inducers and inhibitors such as clotrimazole, carbamazepine, rifampicin, ritonavir, efavirenz, St John's wort, clopidogrel, and phenobarbital
• Certain urine drug tests for amphetamines

Wellbutrin comes in tablet form, in the strengths: 75mg, 100 mg, 150 mg, 200 mg, and 300mg depending on if you are using Wellbutrin SR, ER, or XL.

• Store at room temperature, away from moisture and heat.
• Keep out of reach of children and pets.

Wellbutrin is manufactured by GlaxoSmithKline (GSK).

There are lower-cost generics available for the brand name Wellbutrin.

To stop using Wellbutrin, it's important to consult with your healthcare provider for a safe discontinuation plan. Stopping abruptly may cause withdrawal symptoms, or a return of symptoms. Your doctor will likely recommend gradually tapering your dose to reduce these risks and monitor your progress during the process.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you. Currently, it is unknown if Wellbutrin can harm an unborn baby. Some data suggest it might affect the development of your unborn baby's heart. However, other studies didn't find any risk of heart problems with Wellbutrin.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you. Wellbutrin passes through milk, but it is unknown if Wellbutrin can harm your newborn baby.