Almost 16.1 million adults in the United States are affected by depression, but many have improved their condition with the help of prescription medication. Wellbutrin, also known by its generic name bupropion, is a norepinephrine and dopamine reuptake inhibitor (NDRI) antidepressant that's one of the most commonly prescribed antidepressants in the North America.
How It Works
Bupropion is used to treat major depression and seasonal affective disorder (SAD). It is also used to help with smoking cessation.
Bupropion increases the levels of dopamine and norepinephrine neurotransmitters in the brain. An imbalance of these chemicals can affect mood and may cause depression. The active ingredient in Wellbutrin is bupropion hydrochloride, which helps to create a chemical balance in the brain to lift your mood. It also blocks nicotine receptors and decreases cravings for cigarettes.
Types
Bupropion is available in three different formulations. All three forms of the treatment contain the same amount of bupropion hydrochloride. The only difference is the rate in which the medicine is absorbed.
Wellbutrin IR
IR stands for "immediate release." This form of the medication is usually taken two or three times a day with 4 to 6 hours between doses.
Wellbutrin SR
SR stands for "sustained release." It is released into the body at a slower rate than the immediate release. This medication is generally taken twice a day. Dosing for this medicine ranges from 100 mg twice daily up to 200 mg twice daily.
Wellbutrin XL
XL stands for "extended release." It is released slowly over a 24 hour period and is usually taken once a day. Dosing for this medicine ranges from 150 mg to 450 mg daily.
Conditions Wellbutrin Treats
Bupropion is effective in not only relieving depression symptoms but also helps to decrease nicotine cravings.
Depression
Depression affects your mood, thoughts, and your interest in daily activities. These symptoms must be present for at least two weeks to be diagnosed with depression. The treatment is a generally well-tolerated and is as effective in treating depression as Paxil or Zoloft.
Seasonal Affective Disorder (SAD)
Seasonal Affective Disorder is generally experienced with a change in seasons. Typically, depression symptoms will starts in the late fall and early winter and decrease during the spring and summer months. Research shows using bupropion consistently can prevent the onset of SAD.
Smoking Cessation
Slow release bupropion may be helpful to those looking to quit smoking. Marketed as the brand name Zyban, this treatment reduces your desire for nicotine and is twice as effective in helping you quit. Studies also indicate using bupropion alone is effective in helping you quit your smoking habit for good.
Although smoking cessation treatments can cause adverse reactions, a 2007 study in Cochrane System Review indicated you are not at increased risk for adverse events by taking this medication. In fact, fewer than 10 percent of patients using Zyban stopped treatment because of undesirable effects.
Effectiveness
According to the 2005 Primary Care Companion to the Journal of Clinical Psychiatry, bupropion is effective in the treating major depressive disorder. When used by alone bupropion reduces depression scores just as well as other classes of antidepressants. In a large seven-year study, 21.3 percent of patients experienced fewer depression symptoms by using sustained-release bupropion.
Other studies have shown there are some advantages to using a sustained-release bupropion in addition to a selective serotonin reuptake inhibitor (SSRI) such as Prozac or Celexa. Results from a 2006 study found that 30 percent of patients taking Celexa with poor control of their depression symptom had better control after adding sustained-release bupropion to their treatment regimen.
This same study also found when sustained-release bupropion was added to an SSRI treatment, there was a greater reduction in the number and severity of symptoms, fewer side effects, and adverse events. In fact, only 12.5 percent participants taking sustained-release bupropion in addition to Celexa stopped their treatment because of the side effects. The American Psychiatric Association also suggests that you may be more likely to improve symptoms of fatigue and sleepiness when taking bupropion XL when compared to some SSRI antidepressants.
You may find that your sleep, energy, or appetite improves within one to two weeks after starting the medication. You may need four to six weeks to see an improvement in your mood and renewed interest in your regular activities. Returning to your normal activities may be early signs that the treatment is working.
How to Take Wellbutrin
It is important to take your medication as prescribed. If you are taking XL or SR, do not crush, chew or, divide the pill. Crushing or chewing the pill will alter the release rate. It is also important you take your medication at the same time each day. If you miss a dose of your medication, do not take an extra pill to make up for the missed dose. Take your next pill at your regular time.
- Do not change your dose or stop taking your medication suddenly. Doing so can cause unpleasant withdraw symptoms. When discontinuing bupropion it is best to taper the medication over the course of several weeks. Tapering allows your healthcare provider to detect any recurring symptoms while you are still being treated. You are at greater risk for your symptoms to return during the first 2 months after stopping your treatment. It is important that you schedule a follow-up visit with your provider so you can be monitored carefully.
- Do not use alcohol during your treatment. Drinking alcohol with this medication may increase your risk for seizure. Do not drive a car or use heavy machinery until you know how the medication will affect you.
Speak with your healthcare provider if you have questions or concerns about your treatment.
Side Effects
More than 40 million patients have used Wellbutrin at least once in their lifetime. Compared to other antidepressants, such as Prozac or Lexapro, this treatment is less likely to cause sexual dysfunction and weight gain. In fact, individuals taking this medication commonly experience weight loss while on this treatment according to Primary Care Companion to the Journal of Clinical Psychiatry.
Although this medication is safe, you may experience some side effects.
The most common mild side effects include:
- Headaches
- Dry mouth
- Nausea
- Insomnia
- Constipation
- Dizziness
Other side effects are also common.
Seizure Risk
Practice Guideline for the Treatment of Patients with Major Depressive Disorders notes some individuals have experienced seizures while taking this medication. Generally, the risk of seizure while using bupropion is low. The risk for seizure increases if:
- You have a higher than the recommended dose of the medication
- You have a history of seizure
- You have an eating disorder
- You have alcohol or drug dependence or
- You are taking another medication that can increase your risk of seizure
If you have a seizure while using this medicine stop taking it immediately and call your healthcare provider right away. Do not continue to take this medication.
If you experience any side effects from bupropion, please speak to your healthcare provider about your concerns. Your provider may change your dose or adjust how you are taking the medication. If your reaction is severe, your healthcare provider may recommend a different medication.
Medication for Optimal Health
Depression is a common illness that affects individuals of all ages. It impairs your ability function in your usual activities and relationships. Smoking cigarettes create a strong dependence on nicotine and individuals are often unable to quit on their own. Using bupropion consistently under the direction of a healthcare provider can help you lead a healthy and balanced life.
