Bupropion

Bupropion is an antidepressant that treats depression without the usual negative side effects of other antidepressant medications.

Bupropionis an antidepressant that also goes by the brand nameWellbutrin. Though it has multiple uses, it is commonly used totreat depression. When compared to other antidepressants, bupropion tends to be better tolerated, having fewer unfavorable side effects.

What Is Bupropion (Wellbutrin)?

Bupropion, also known by the brand name Wellbutrin, is an antidepressant prescribed to treat depression and seasonal affective disorder, as well as help with smoking cessation. Other names for bupropion include:

• Chantix
• Aplenzin
• Forfivo
• Budeprion
• Zyban

Background and History

Nariman Mehta first made bupropion in 1969. Mehta patented the drug, along with the pharmaceutical companyBurroughs Wellcome, now known as GlaxoSmithKline, in 1974.In 1989, bupropion obtainedFDA approvalfor thetreatment of major depressive disorder.

The initial form of bupropion was an immediate-release formula, meaning the active drug was released right away after taking it. In 1996, a slow-release formula was approved that allowed the active drug to be released slowly over time, increasing the required time between doses. Finally, an extended-release version of the drug, Wellbutrin XL, was approved in 2003, which increased release time, even more, allowing for it to be taken only once a day.

Bupropion was uniquely developed as an antidepressantto improve on the existing available antidepressantsof the time. It was designed to be safer and better tolerated by patients. It has since been approved for multiple uses. In 1997, bupropion was approved for smoking cessation treatment, and in 2006 it was approved totreat seasonal affective disorder.

Now, bupropion is approved in over 50 countries for the treatment of depression and smoking cessation. In 2019, it was the fourth most prescribed antidepressant and ranked 28 amongthe most prescribed medications in the United States.

Uses for Bupropion

The most commonuse of bupropionis to treat depression. It can also be used to treat seasonal affective disorder, a condition where people experience depression in autumn and winter when there are fewer hours of daylight.

Bupropion is sometimes also used totreat attention deficit hyperactivity disorder(ADHD) when it cannot be treated using conventional medications.

Additionally, bupropion has been reported to help in thetreatment of methamphetamine addictionbyeasing symptoms of withdrawal.

Depression Treatment

Theantidepressant bupropionis used totreat depression. It is effective on its own, but can also be used in combination with other antidepressants such asselective serotonin reuptake inhibitors (SSRIs). It is commonly used for patients who do not respond well to other antidepressant medications or added as a second therapy to improve the effectiveness of other antidepressants.

Bupropion may be considered more favorable than other antidepressants due to adecreased chance of undesirable side effectslike weight gain and sexual dysfunction. It has been shown to reverse sexual dysfunction induced by other antidepressants and can lead to weight loss.

Bupropion can also be used to treat depressive episodes that occur withbipolar disorder.Bipolar disorder is characterized by mood episodes that are either elevated, where the person is experiencing increased energy and happiness, or depressed. Bupropion is thought to helpstabilize mood, avoiding the swing between the two polar ends of the spectrum.

Smoking Cessation

Bupropion has also been used forsmoking cessation. The versions of bupropion commonly used forsmoking cessationinclude Zyban and Chantix. Bupropion is approved as an initial treatment for people wishing to quit smoking. It has been shown to diminish the severity of cravings and help relieve withdrawal symptoms.

Roughly1 in 5 smokerswill successfully quit when taking bupropion and continue to be smoke-free for one year following treatment. The dose used for smoking cessation is slightly lower than that used for depression. Patients are prescribed 150 mg bupropion daily for six days, followed by 150 mg twice daily for seven to nine weeks.

How Does Bupropion Work?

Similar to other antidepressants,bupropion works byinhibiting neurotransmitter reuptake in the brain. When reuptake is prevented, more neurotransmitters are available for the brain to use. The neurotransmitters that are affected by bupropion include dopamine and norepinephrine, which differs from most antidepressants, which inhibit reuptake of serotonin or a combination of serotonin and another neurotransmitter.

Bupropion aids in smoking cessation because it interferes with the pleasurable effects of nicotine, the addictive substance found in cigarettes. Bupropion blocks nicotine from binding to receptors on nerves in the brain and throughout the body, preventing those nerves from signaling in response to nicotine.

The recommendeddose of bupropionis 100 mg three times daily, or 150 mg twice daily, for a total of 300 mg per day. A single dose of bupropion should not exceed 150 mg and a daily dose should not exceed 450 mg. More recently, asingle dose of up to 450 mghas made it easier for patients to adhere to the dosing schedule. This unique formula — also known as Wellbutrin XL, or extended-release — of the drug allows the active ingredients to be released slowly over time, giving the patient a steady dose for 24 hours.

How long does it take for bupropion to work?The effects of bupropion will not be felt immediately. It takes several weeks to months for bupropion to start alleviating the symptoms of depression. Once bupropion is working, continued use is recommended to prevent depressive symptoms from returning or withdrawal symptoms from occurring.

Effectiveness of Bupropion

Bupropion isjust as effectiveat treating depression as other common antidepressants, such as SSRIs andserotonin-norepinephrine reuptake inhibitors (SNRIs). The effectiveness is measured by comparing depression symptoms in patients receiving the antidepressant to patients taking a placebo control. Bupropion improves depression symptoms in a similar number of patients and to a similar extent as the other available antidepressants.

Side Effects

Though bupropion is generally tolerated well for both short and long-term use, there are some side effects associated with its use. Commonside effects of bupropionuse include:

• Trouble sleeping
• Headache
• Nausea or vomiting
• Dizziness
• Constipation
• Increased sweating or fever
• Tremors or shaking
• Dry mouth
• Feeling nervous
• Feeling tired or weak
• Anxiety
• Panic attacks
• Irritability
• Aggression
• Restlessness
• Blurred vision
• Ringing in ears

Though they rarely occur, if you experience major side effects, you should seek medical help immediately. The severe side effects include:

• Seizures
• Delirium
• Hallucinations
• Fast or irregular heartbeat
• Chest pain

Precautions

Bupropion should not be taken if you have also taken a monoamine oxidase inhibitor (MAOI) within the past few weeks. Bupropion is also known tointeract withseveral other drugs, includingbenzodiazepinesand sedatives commonly used totreat anxiety. Because of the many possiblebupropion interactions, it is recommended for a person to speak with their doctor about other medications they’re taking before taking bupropion.

Additionally,bupropion and alcoholshould not be mixed. Alcohol consumption with bupropion can counteract its effects and increase the risk of seizure.

Bupropion is not an addictive substance, but it can causewithdrawal symptomsif you stop using it. Therefore, a person should contact their doctor before they stop using bupropion.

As with other antidepressants, there is a chance of increased suicidal thoughts with bupropion use. The risk isgreater in youth and young adultsunder the age of 24. If a person is taking bupropion and experiences suicidal thoughts, it is important that they seek help and talk to their doctor immediately.

If you know someone experiencing suicidal thoughts, you can provide them withmental health first aiduntil they are able to get professional treatment.

Taking Bupropion While Pregnant

Drug use during pregnancycan have consequencesfor the mother and baby, so it’s important to check with a health care provider before starting medications during pregnancy.

Like some other substances, it is not known whether there are safety concerns withbupropion and pregnancy. Therefore an expectant mother should speak with her doctor beforetaking bupropion while pregnant.

To learn more about drug use during pregnancy,visit this resource pagefrom The Recovery Village.

What Happens If You Miss a Dose?

If adose of bupropion is missed,wait until the next time you would normally take the pill to take another. Do not double a dose to make up for the missed one. This action could lead to an overdose of bupropion, as the maximum single dose is 150 mg and each individual dose is usually 100-150 mg.

It is important to maintain a proper dosing schedule, as stopping bupropion use can causewithdrawalsymptoms. You should contact your doctor before completely discontinuing use. Symptoms of withdrawal include:

• Vomiting or feeling nauseous
• Headache
• Dizziness
• Numbness in hands or feet
• Recurring vivid dreams

What to Do In Case of Overdose

If it is not taken as recommended,you can overdose on bupropion. If an overdose occurs, it could potentially be life-threatening. Totreat bupropion overdose, get help immediately by calling 9-1-1 in the U.S., or call thepoison controlhelpline at 1-800-222-1222.

Symptoms ofbupropion overdoseinclude:

• Fever
• Stiff muscles
• Seizure
• Respiratory failure
• Loss of consciousness
• Irregular or fast heartbeat
• Hallucinations

Get More Information on Bupropion

For moreinformation on bupropion, you can:

• Visit Medline’s bupropioninformation page
• Talk with your primary care doctor
• Speak to another health care professional
• Call The Recovery Village, if you’re concerned that you need treatment

If you or a loved one are struggling with addiction and depression, The Recovery Village can help. To learn more about our comprehensive treatment plans,contact The Recovery Villageto speak with a representative.