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Wellbutrin (bupropion) for depression

Antidepressants can lift the dark, heavy moods of depression. Your doctor will recommend the treatment he or she feels is right for you, but it is important to be aware of your treatment options and to discuss them with him/her.

Wellbutrin SR and Wellbutrin XL (bupropion hydrochloride), both available in generic versions, have been around for nearly two decades. What’s new here is that the recent generic XL version makes possible once-a-day dosing for this useful antidepressant option.

Research suggests that depression may be caused by an imbalance of brain chemicals called neurotransmitters. Scientists believe that bupropion helps balance the levels of two of these neurotransmitters called dopamine and norepinepherine. It is chemically unrelated to tricyclic, tetracyclic, SSRIs, or other known antidepressant agents. (See Guide to Psych Meds.)

Bupropion has gained popularity because it is less likely to cause the weight gain or sexual dysfunction common with TCAs (tricyclics), MAOIs (monoamine oxidase inhibitors) and some other antidepressants. Indeed, one well known team of mood researchers entitled their review of this medication: “Why Isn’t Bupropion the Most Widely Prescribed Antidepressant?” (Zimmerman et al, J. Clin Psych 2005).

Wellbutrin XL (bupropion HCL XL) is taken only once a day. It is available in 150-mg and 300-mg tablets. The starting dose is 150 mg per day, which your doctor may increase to the usual adult dose of 300 mg per day. The maximum dosage for Wellbutrin XL is 450 mg per day.

Bupropion’s side effects include restlessness, insomnia, headache or a worsening of preexisting migraine conditions, tremor, dry mouth, agitation, confusion, rapid heartbeat, dizziness, nausea, constipation, menstrual complaints, and rash.

Seizures can result from 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 can also increase the risk for seizures.

In clinical trials during the product’s initial development, ten percent of 2,400 patients and volunteers discontinued treatment because of adverse effects, including: agitation and abnormalities in mental status; nausea and vomiting; seizures, headaches, and sleep disturbances; and rashes. It is important to note, however, that many of these events occurred at doses that exceed the recommended daily dose.

Antidepressants ARE NOT recommended for people who have bipolar disorder. Read more.

 

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