Introduction:
Welcome to our comprehensive guide on Wellbutrin®, a commonly prescribed medication for treating various mental health conditions. If you or someone you know has been prescribed Wellbutrin, it is important to understand how the medication works and its potential benefits and risks.
Wellbutrin is a brand name for the generic drug bupropion, which belongs to a class of medications called antidepressants. While it is primarily used to treat depression, Wellbutrin is used for other conditions such as seasonal affective disorder, smoking cessation, and attention deficit hyperactivity disorder (ADHD).
In this article, we will delve into the uses of Wellbutrin, how it works, and the potential side effects associated with its use. We will also discuss some frequently asked questions about Wellbutrin and provide helpful tips on how to use the medication safely and effectively. Whether you are a patient taking Wellbutrin or simply want to learn more about the medication, we hope this guide will provide you with the information you need to make informed decisions about your mental health treatment.
What are all the uses for Wellbutrin?
Major Depressive Disorder (MDD)
According to the DSM-5, MDD is likely when patients experience 5 or greater symptoms, including a depressed mood, and there is no other reason for the symptoms.
Depressive symptoms may include:
- Depressed mood
- Loss of interest/pleasure
- Weight loss/gain
- Insomnia/hypersomnia
- Psychomotor agitation/retardation
- Fatigue
- Feeling worthless or excessive/inappropriate guilt
- Decreased concentration
- Thoughts of death/suicide
Wellbutrin is often prescribed to treat MDD. Patients typically start with one 100 mg immediate-release tablet twice a day and then increase to three times a day. After appropriate dosing has been established patients may choose to use either a 12-hour or 24-hour extended-release form. Starting with immediate-release will help the prescriber perfect the dose. The maximum dose per day is 450 mg. Doses beyond 450 mg show no extended benefit.
Seasonal Affective Disorder (SAD)
Seasonal affective disorder is a type of depression that occurs most noticeably at the beginning of fall. Light therapy for fall-onset along with antidepressant medications often helps. Fall-onset SAD is often attributed to the shorter days and less sunlight.
Wellbutrin used for SAD is dosed beginning with one 150 mg 24-hour extended-release tablet once every morning and may be increased to 300 mg ER after 7 days if needed. Treatment generally begins in September and continues through early spring. In spring, decrease the dose by 150 mg per day for two weeks prior to stopping the medicine.
Smoking Cessation
Wellbutrin used for smoking cessation begins with one 150 mg 12-hour extended-release tablet once daily in the morning for 3 days and then is increased to one 150 mg 12-hour extended-release tablet twice daily. Treatment lasts 7 to 12 weeks. Smoking should be stopped after being on treatment for 5 – 7 days.
Is Wellbutrin used for ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is frequently diagnosed in children, although adults are being more frequently diagnosed due to better understanding of how ADHD affects overall quality of life.
Symptoms may include:
- Poor attention to detail, careless mistakes
- Poor ability to stay on task
- Appears to not listen when spoken to directly
- Often does not follow through or complete assignments
- Reluctance to complete tasks that do not interest them
- Difficulty organizing tasks
- Loses things frequently
- Easily distracted
- Forgetful
- Fidgets/inability to be still
- Inability to stay seated
- Runs about or restless
- Unable to enjoy leisure activities quietly
- Always on the go
- Excessively talks
- Blurts out answers
- Difficulty waiting for their turn
- Frequently interrupts/intrudes
Wellbutrin is not considered first-line therapy for ADHD but is sometimes used off-label. Off-label means that Wellbutrin is not officially approved for the treatment of ADHD; however, doctors may still choose to use the medication. When choosing to use Wellbutrin for ADHD the recommended starting dose is one 100 mg immediate-release tablet taken twice daily, and then increased to three times daily if needed. The maximum recommended dose per 24 hours is 450 mg. Once dose adjustments are completed patients may choose to use either the 12-hour extended-release tablets or the 24-hour extended-release tablets
What is the Best Thing About Wellbutrin?
The best thing about Wellbutrin is when compared to other antidepressants, patients experience fewer issues with insomnia, sexual dysfunction, and sleepiness.
Wellbutrin may also lead to weight loss in some people. If too much weight is one of your concerns, then this may be a good choice for you.
Does Wellbutrin Give You Energy?
It can. When depression is reduced, patients often have increased energy. Patients taking Wellbutrin commonly have more energy. It is recommended to take the last dose prior to 5 o’clock in the evening to help prevent this extra energy from disturbing your sleep.
How Do You Know if Wellbutrin is Working?
Wellbutrin (bupropion) is a distinct type of medication known as a norepinephrine and dopamine reuptake inhibitor, or NDRI. Essentially, it increases the availability of both norepinephrine and dopamine which can affect and improve mood.
You may expect to see improvements in sleep, energy, or appetite within 1 – 2 weeks of beginning Wellbutrin, however, it may take 6 – 8 weeks to feel like your old self. Treating depression often can seem frustrating because you want to feel better right away. Choosing the best medication first helps to reduce the time it takes for you to feel better.
Can Wellbutrin be Taken for Years?
Yes. Wellbutrin is generally well tolerated, helping to prevent relapse, with few side effects in the long term. Many minor side effects diminish with treatment.
What is the Success Rate of Wellbutrin?
Treating depression is multifaceted. Treatment typically includes both cognitive behavioral therapy (CBT) and medication therapy. Antidepressant medications in general help 54% of adults have a 50% reduction in symptoms. Knowing your genetics may help determine whether Wellbutrin is the best medicine for your symptoms.
Approximately 62% of people report a positive experience with Wellbutrin used for their depression treatment. 21% report a negative experience. Experiences may vary because of each person’s personal genetic profile.
Up to 76% of patients using Wellbutrin may show an improvement in their ADHD symptoms.
What are the Downsides to Wellbutrin?
What are the most common side effects of bupropion?
The most common side effects include:
- Anxiety
- Constipation
- Dizziness
- Dry mouth
- Fast heartbeat
- Flatulence
- Headache
- Itching
- Nausea
- Ringing in the ears
- Sweating
- Trouble sleeping
- Tremor
Bupropion is contraindicated in patients who have a history of seizures, bulimia, or anorexia. It is also recommended to avoid alcohol use. Patients who have bipolar disorder may experience more manic episodes.
Can Stopping Wellbutrin Treatment Cause Withdrawal Symptoms?
Yes. Abruptly stopping may lead to withdrawal symptoms, especially in patients who are on higher doses. Symptoms may not occur for a few days since the medication takes time to leave your system. It is recommended to taper the dose when discontinuing. Wellbutrin withdrawal symptoms, however, are typically mild.
What are the Most Serious Side Effects that I or a Caregiver Should Monitor for when Taking Bupropion?
When starting any antidepressant medication, always watch for clinical worsening and suicide ideation. Energy and motivation increase prior to the depression symptoms decreasing, increasing the risk of suicide.
Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, restlessness, and hypomania or mania are common precursors to increased suicidal ideation. These should be discussed with the prescriber if observed.
If your loved one’s depression worsens or persists; or if severe abrupt symptoms occur, it may be appropriate to consider discontinuing Wellbutrin.
If the patient experiences seizures, confusion, unusual changes in mood or behavior, vision changes, fast or irregular heartbeat, or manic episodes notify the prescriber right away.
How will this Drug Interact with Your Other prescriptions?
Bupropion metabolism is affected by the CYP2B6 gene. Any medication that affects the enzyme produced may also then affect Wellbutrin. Several medicines should be avoided in conjunction with the use of bupropion; including but not limited to acetazolamide, cannabidiol, clonazepam, gabapentin, phenytoin, and most seizure medications. Certain antidepressants, antipsychotics, and heart medications may also be interact with Wellbutrin. If you are taking one of these other medications, speak with your doctor and pharmacist to determine the best course of action.
Conclusion
Wellbutrin can be a great addition to your mental health regimen. Taking this medication is generally safe in the long term with few or minor side effects and many benefits. If you are in need of a medication to help with your mental health, ClarityX offers the Mindwell test to help you and your prescriber decide whether Wellbutrin, or an alternate medication, may be more appropriate. Depression and smoke cessation can be difficult. Let ClarityX help you choose the medication that will most likely benefit you.
References
- https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.158.2.282
- https://cpicpgx.org/genes-drugs/
- https://elsevier.health/en-US/preview/bupropion#adverse-reactions
- https://n.neurology.org/content/neurology/suppl/2016/10/19/WNL.0000000000003265.DC1/Appendices_e-1_through_e-8.pdf
- https://online.epocrates.com/drugs/1408/bupropion-hydrochloride#adult-dosing
- https://online.epocrates.com/drugs/1408/bupropion-hydrochloride#patient-education
- https://www.drugs.com/comments/bupropion/for-depression.html?search=&sort_reviews=most_recent#reviews
- https://www.drugs.com/comments/bupropion/wellbutrin-for-depression.html
- https://www.drugs.com/monograph/bupropion.html#warnings
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/seasonal-affective-disorder
- https://www.mdcalc.com/calc/10195/dsm-5-criteria-major-depressive-disorder
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1163271/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837968/
- https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30036-5/fulltext
- mayoclinic.org/di
