Wellbutrin, also known by the trade name bupropion, is an antidepressant medication. The XL version is an extended-release formula and is usually taken once daily. This prescription is often used to treat seasonal affective disorder, a form of depression occurring during the fall and winter months. It is also a standard treatment for major depression in adults. Zyban, a low-dose form of bupropion, has demonstrated effectiveness for smoking cessation and it has been licensed in the United States and the United Kingdom for this purpose.

Dosage

Doctors typically start people on low doses of the medication and increase it until the ideal dosage is achieved. The full effects of the medication may not be felt for up to four weeks. When stopping the medication, doctors may tell people to taper doses downward for two weeks before complete termination.

Important Considerations Before Use

Before use, talk with your doctor about your medical history. Your doctor will need to know if you have ever had a heart attack, had high blood pressure, diabetes, heart disease, or substance abuse problems. Alcohol can increase the side effects of Wellbutrin, particularly drowsiness.

Tell your doctor about all of your medication allergies. Additionally, tell your doctor and pharmacist which prescription and nonprescription drugs you currently take. Even herbal products like St. John's Wort can lead to unwanted drug interactions. Wellbutrin, like many antidepressants, can have a dangerous interaction with a class of drugs called monoamine oxidase inhibitors (MAOIs). If you currently take a MAOI or have stopped taking one within the last two weeks, your doctor will likely not prescribe Wellbutrin. Examples of these drugs include Marplan (isocarboxazid), Nardil (phenelzine), and Emsam (selegiline).

Wellbutrin is not approved for use in people younger than 18.

Important Information During Use

• Let your doctor know if you are breastfeeding, pregnant, or plan to become pregnant.
• Be mindful of worsening depression or thoughts of suicide. There is a small risk of suicide or self-harm with any antidepressant.
• Take this medication exactly as prescribed. Do not double up in the event of a skipped dose, and do not take more than your prescribed dosage. Do not chew or crush the tablets because this causes the drug to be released too quickly.
• Taking Wellbutrin with food will prevent stomach upset.
• You may see something that looks like a tablet in your stool. This is actually the empty casing for the medicine and does not mean that you did not get your dosage.

Side Effects

Rare, adverse psychiatric side effects of this medication may include anger, paranoia, hallucinations, and hostility. Other serious effects may include:

• Seizures
• Irrational fears
• Fever
• Rash, blisters, or hives
• Itching
• Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• Hoarse voice
• Trouble breathing or swallowing
• Chest pain
• Muscle or joint pain
• Rapid, pounding, or irregular heartbeat

Less serious side effects of this drug can include:

• Drowsiness
• Excitement
• Dry mouth
• Dizziness
• Headache
• Nausea or vomiting
• Weight loss
• Constipation
• Excessive sweating

Withdrawal

Withdrawal from Wellbutrin is usually not considered dangerous. Gradual tapering of the dose minimizes any withdrawal effects while allowing faster reinstatement of the medication should symptoms of depression return. Possible symptoms of withdrawal may include:

• Nausea or vomiting
• Intense and frequent dreams
• Headache
• Vertigo
• Changes to senses and perception
• Numbness of extremities

References:

1. Medication Guide Wellbutrin XL. (June 2011). Retrieved from http://www.fda.gov/downloads/Drugs/DrugSafety/UCM172744.pdf
2. Use of Psychiatric Medications for Mental Health Concerns. (n.d.). Retrieved from https://www.uhs.uga.edu/caps/medications.html
3. Wellbutrin XL - bupropion hydrochloride tablet, extended release. (December 2009). Retrieved from http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=14812

Page content reviewed by James Pendleton, ND