Wellbutrin (Bupropion) Treatment for Depression

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Wellbutrin (Bupropion) has a stimulant effect and is used in the treatment of depression but can also be used for ADHD.

Wellbutrin and Wellbutrin SR, manufactured by GlaxoSmithKline, are medications approved by the FDA for the treatment of depression.

 Wellbutrin has also been used in an off-label capacity (not specifically approved for, but observed to be effective) to treat attention-deficit/hyperactivity disorder (AD/HD) and seasonal affective disorder (SAD), and to decrease the sexual side effects caused by other antidepressants.

Wellbutrin has a chemical structure unrelated to any other antidepressant medication. Unlike some of the other recently developed antidepressants that target the brain chemical serotonin, Wellbutrin does not affect serotonin. Although not known for sure, it may act on the brain chemicals dopamine and norepinephrine. Because of its unique makeup, Wellbutrin also has different side effects, and it may work for individuals who have not had success with other antidepressants.

Wellbutrin XL is approved only for adults 18 years and over. In some children and teens, antidepressants increase suicidal thoughts or actions. Whether or not you are taking antidepressants, you or your family should call the doctor right away if you have worsening depression, thoughts of suicide, or sudden or severe changes in mood or behavior.

You should not take Wellbutrin if you have epilepsy or a seizure disorder, an eating disorder such as anorexia or bulimia.

Fewer sexual side effects and weight gain are associated with Wellbutrin as well as fewer reports of anticholinergic symptoms (blurred vision, dry mouth, indigestion, and constipation), cardiac problems, and orthostatic hypotension (low blood pressure occurring after standing up).

There has been much talk about Wellbutrin causing seizures. In fact, the approval of Wellbutrin was temporarily delayed due to the occurrence of seizures in some patients. However, further investigation showed that seizures were primarily associated with high doses (above the current maximum recommended dose of 450 mg/day), a history of seizures or brain trauma, an eating disorder, excessive alcohol use, or taking other drugs that can also increase the risk for seizures. With new warnings and lower recommended doses, the chance of having seizures has been greatly reduced.

How does Wellbutrin interact with other medications?
Wellbutrin and Zyban should not be taken together as they contain the same active ingredient, which could cause seizures if too much is taken.

 There are also other medications that make some people more likely to have seizures, so be sure to tell your doctor what drugs you are on before taking Wellbutrin.

Withdrawal from alcohol or some street drugs while taking Wellbutrin can additionally increase the chance of having seizures.

What is the recommended dose of Wellbutrin?
Wellbutrin is available in both standard 75 mg and 100 mg tablets, and in 100 mg, 150 mg, and 200 mg sustained-release tablets.

Because Wellbutrin could cause seizures in some people, your doctor will carefully and gradually increase your dose.

The recommended beginning dose for the drug is 100 mg/day twice daily.

Your doctor should not increase this starting dose until after at least the first three days of treatment.

Once the first few days have passed, the typical dose for Wellbutrin is 300 mg/day—100 mg three times daily, with at least six hours between doses, for the standard tablets and 150 mg twice daily for the sustained-release tablets.

The maximum recommended daily dose for Wellbutrin is 450 mg.

 Sustained-release Wellbutrin, or Wellbutrin SR, should be taken whole—not chewed, crushed, or broken—so that the body correctly absorbs it.

Elderly individuals taking Wellbutrin are usually prescribed smaller doses of the medication.

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