What to Know About Wellbutrin (Bupropion)

An antidepressant approved to treat MDD and SAD

In This Article

Wellbutrin (bupropion) is an antidepressant that treats a number of conditions. It comes as an immediate-release, sustained-release, or extended-release tablet that is taken orally. 

One factor that makes Wellbutrin especially unique among antidepressants is that it doesn't tend to affect your libido and sexual function. In fact, it's often prescribed along with other antidepressants to help counter the sexual side effects found in other types like loss of desire.

side effects of wellbutrin
Verywell / JR Bee

Uses

Wellbutrin is approved by the Food and Drug Administration (FDA) to treat major depressive disorder (MDD) and seasonal affective disorder (SAD).

Off-Label Uses

Wellbutrin is also used off-label to help with symptoms of attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, anxiety, and obesity.

Additionally, another brand of bupropion (the active ingredient in Wellbutrin) called Zyban is used to help people quit smoking. Other off label uses sometimes include social anxiety disorder, PTSD, and even some forms of nerve pain.

Before Taking

Wellbutrin is often used as a first-line antidepressant in the treatment of major depressive disorder and seasonal affective disorder. Your doctor will evaluate your symptoms and current health status to determine if Wellbutrin is right for you.

Precautions and Contraindications

Your doctor may not prescribe this drug if you have certain health conditions.

  • You should not take Wellbutrin if you have an eating disorder, angle-closure glaucoma, or a seizure disorder.
  • People with bipolar disorder may be at an increased risk of experiencing manic, mixed, or hypomanic episodes after taking Wellbutrin. While bupropion is sometimes prescribed off-label to treat depressive episodes, it is not approved for the treatment of bipolar depression. Those with bipolar disorder may also have an increased risk of experiencing suicidal thoughts after taking Wellbutrin.
  • Your doctor may recommend a reduced dosage of the drug if you have a history of kidney problems, kidney disease, or liver problems.
  • Never take Wellbutrin if you have a known allergy to bupropion. You should contact emergency services immediately if you begin to experience allergic symptoms such as rash, swelling, hives, itching, and difficulty breathing.
  • The drug should not be used by breastfeeding women or by children.

Wellbutrin is a pregnancy category C drug, meaning that it has been shown to have adverse effects on the fetus in animal studies and that not enough studies have been conducted to determine the effect it may have in humans.

For this reason, the drug should only be used during pregnancy if your doctor has determined that the potential benefits outweigh the risks.

Because older adults may have reduced kidney function, they may require smaller doses since the drug remains in the body longer.

Other NDRIs

Among antidepressants, bupropion is in a category all its own—it's the only medication in its class, called norepinephrine-dopamine reuptake inhibitors (NDRIs), that boosts the neurotransmitters norepinephrine and dopamine.

By contrast, selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine) and Zoloft (sertraline) affect serotonin, while serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta (duloxetine) and Effexor (venlafaxine) boost norepinephrine and serotonin.

Dosage

Wellbutrin is offered in three different formulations and dosing varies for each version:

  • Immediate release: The regular formulation, simply named Wellbutrin, is an immediate release medication, which means that it begins to work shortly after you take it. Because it acts quickly, it can be taken up to three times a day. This formulation is used to treat major depressive disorder (MDD). A starting dose is usually 100mg taken twice a day and potentially increased to 100mg taken three times a day. The maximum dose is 150mg per single dose.
  • Sustained-release: Wellbutrin SR, the sustained release version, also treats MDD. This formulation is typically started at 150mg once a day and potentially increased to 150mg twice a day. It can be increased to a maximum of 200mg taken twice a day.
  • Extended-release: Taken once a day, Wellbutrin XL is used to treat MDD and to prevent seasonal affective disorder (SAD). It's typically started out as a dose of 150mg once a day and can be increased to 300mg or even 450mg maximum, both taken once a day.

Modifications

In some cases, your doctor may prescribe a modified dosage of the drug due to possible side effects or another health concern.

  • With liver impairments: The dosage is often lowered to a maximum dose of 75mg per day for those with moderate to severe liver impairment.
  • With kidney problems: Your doctor may also lower your dosage or the frequency of use if you have kidney impairments.
  • After or before MAOIs: If you have previously taken a monoamine oxidase inhibitor (MAOI) or are switching to an MAOI, you should allow 14 days between the discontinuation of your previous drug and the initiation of your new treatment.

How to Take and Store

You should always take your medication as directed. Immediate release Wellbutrin tablets can be broken if necessary, but they are small enough that that is not usually needed. The drug can be taken on an empty stomach or with food and should be stored at room temperature, protected from light and moisture.

If you happen to miss a dose of bupropion, take it as soon as you remember. Any remaining doses for the day should be taken at least four hours apart. Never take two doses at once to make up for a missed dose. Taking two doses at the same time can increase your risk of experiencing a seizure or an accidental overdose.

Never stop taking your medication suddenly. If you stop suddenly, your symptoms may worsen or you may experience withdrawal. If you want to stop taking Wellbutrin, talk to your doctor about tapering off of your medication gradually.

Side Effects

Wellbutrin in any form isn't without side effects, some of which are serious. If your doctor prescribes Wellbutrin for you, it's important to be aware of what symptoms to look out for.

Some are merely bothersome and likely to disappear as your system gets used to the medication, but others may be serious and should prompt you to call your doctor right away to let them know that you're having problems.

Common

Side effects may occur but they usually go away within a few weeks as your body adjusts. The most common side effects for Wellbutrin, Wellbutrin SR, and Wellbutrin XL include:

  • Abdominal pain
  • Anxiety
  • Appetite loss
  • Changes in the way food tastes
  • Constipation
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Flushing
  • Gas
  • Hair loss
  • Headache
  • Increased sweating
  • Insomnia
  • Joint aches
  • Nausea
  • Nervousness
  • Restlessness
  • Ringing in your ears
  • Tremors
  • Urinating more than usual
  • Vomiting
  • Weakness
  • Weight loss

Severe

Some side effects of Wellbutrin can be severe or even potentially life-threatening. Get medical help right away if you experience any of the following while taking any version of Wellbutrin: 

  • Allergic reaction including skin rash; hives; itching; difficulty breathing; a feeling of tightness in your chest; swelling of your mouth, face, or tongue; and/or unusual hoarseness—all signs that you may be having a serious allergic reaction to the drug
  • Aggressiveness
  • Agitation
  • Changes in menstrual cycle
  • Changes in sexual desire or function
  • Changes in vision
  • Chest pain
  • Confusion
  • Dark urine
  • Delusions or hallucinations
  • Difficulty breathing
  • Exaggerated feelings of well-being
  • Fainting
  • Fever, chills, or a sore throat
  • Hearing problems
  • Hostility
  • Impulsiveness
  • Inability to sit still
  • Pale-colored stools
  • Panic attacks
  • Rapid or irregular heartbeat
  • Seizures
  • Severe headache
  • Severe or lingering joint or muscle pain
  • Severe or lingering nausea, vomiting, or stomach pain
  • Severe or lingering nervousness, restlessness, or insomnia
  • Swollen, blistered, or peeling skin
  • Trouble concentrating
  • Unusual swelling
  • Worsening depression and/or suicidal thoughts
  • Yellow skin or eyes

Warnings and Interactions

Seizures and suicidal thoughts are two of the most serious potential side effects of Wellbutrin. Seizures are rare with this drug, but do be aware that the risk of seizures is about four times greater with Wellbutrin than with other antidepressants.

For that reason, it's especially important to let your doctor know if you have or have had a seizure disorder; you take any other medications that contain bupropion, such as Zyban (for quitting smoking); or you have or have had an eating disorder such as anorexia or bulimia, as seizures are more likely to occur with these disorders.

Antidepressant drugs like Wellbutrin may increase the risk of suicidal thoughts and behavior in children, teens, and young adults up to age 24, especially when they first start taking the medication or when there's a change in their dose.

If you have a child taking Wellbutrin or another medication for treating depression, keep a close eye out for signs of self-harm or suicidal thinking.

Interactions

There are a number of potential interactions that can occur when other substances are taken at the same time as Wellbutrin. Other medications may influence how bupropion works or increase the risk of side effects. These include:

  • Adderall (amphetamine and dextroamphetamine)
  • Antipsychotics such as Risperdal (risperidone) or Haldol (haloperidol)
  • Blood thinners
  • Corticosteroids including prednisone
  • Diabetes medications including Glucophage (metformin)
  • Monoamine oxidase inhibitors (MAOIs)
  • OTC pain relievers such as ibuprofen
  • Other antidepressants including Prozac (fluoxetine), Zoloft (sertraline), and Effexor (venlafaxine)
  • Thyroid medications such as Synthroid (levothyroxine)

Using Wellbutrin with alcohol may also influence the frequency and severity of side effects, including seizures and suicidal thoughts.

A Word From Verywell

Check in with your doctor about any side effects you're experiencing with Wellbutrin if they're severe, bothersome, get worse, or don't go away. Again, the most common ones are the least serious and are likely to be temporary. Get help right away if you have any side effects that could be serious or life-threatening.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

In either case, don't stop taking Wellbutrin until you've checked with your doctor first. Going cold-turkey off of any antidepressant can cause your symptoms to come back or get worse.

Also, stopping abruptly can lead to discontinuation syndrome, an array of flu-like symptoms such as stomach upset, headache, strange sensations, and muscle aches. If you need to stop taking Wellbutrin, your doctor will guide you in gradually tapering off of it.

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Article Sources
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