Wellbutrin (bupropion)

Wellbutrin is an antidepressant medication that works in the brain. However, it works differently than any other antidepressant, as it works on dopamine, norepinephrine and noradrenaline. For this reason, Wellbutrin does not have some of the typical side effects that we sometimes see with other antidepressants that work with serotonin - like weight gain and sexual side effects. In fact, Wellbutrin can actually lead to weight loss and it is used to treat sexual dysfunction!

Wellbutrin is approved for the treatment of major depressive disorder (MDD), seasonal affective disorder (SAD), and to help people quit smoking (smoking cessation). It can also be prescribed "off-label" to treat ADHD (due to it’s action with dopamine), Bipolar Depression, and sexual dysfunction. “Off-label” simply means that it hasn’t been approved by the Food and Drug Administration for this condition. Lastly, this medication is used in combination with another medication (naltrexone) to create a weight loss medication called Contrave.

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How Long Does It Take For Bupropion To Work?

Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.

After starting bupropion, symptoms gradually decrease over a period of weeks. In MDD and SAD, sleep and other physical symptoms may improve before there is noticeable improvement in mood or interest in activities. Once symptoms are under control, MDD usually requires long-term treatment to help prevent the return of depressive symptoms. If you are using bupropion for SAD or smoking cessation, the length of your treatment may be shorter, but really depends from one individual to another.

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Common side effects:

Headache, weight loss, dry mouth, trouble sleeping (insomnia), nausea, dizziness, constipation, fast heartbeat, and sore throat. These will often improve over the first week or two as you continue to take the medication. We avoid use of this medication in anyone that has a history of seizure, as there is some correlation between seizures and higher doses of buproprion.

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Summary of FDA Black Box Warnings:

Because Wellbutrin is classified as an antidepressant, it does carry a black box warning that there is the potential for suicidal thoughts or actions. Your provider at Psychiatric Edge will discuss this with you in more detail, but it is something we want you to be aware of. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications. This risk may persist until significant remission occurs.

There are different versions of Wellbutrin and your provider will discuss this with you. However, the most commonly used version is Wellbutrin XL and the doses range from 150mg to 450mg (where most patients end on 150-300mg).

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Written by:

Joseph Gagnon Jr.