Wellbutrin

Wellbutrin SR (bupropion hydrochloride sustained-release) is a widely prescribed antidepressant belonging to the aminoketone class, distinct from commonly used selective serotonin reuptake inhibitors (SSRIs). It is specifically formulated to provide a steady release of medication over a 12-hour period, ensuring stable plasma concentrations and consistent therapeutic effect. Clinically, it is recognized for its efficacy in managing major depressive disorder and as an aid to smoking cessation treatment, with a notably favorable side effect profile regarding weight and sexual function. Its mechanism of action is believed to involve the inhibition of neuronal reuptake of dopamine and norepinephrine, with minimal effect on serotonin, which underpins its unique clinical benefits.

Features

• Active ingredient: Bupropion hydrochloride (sustained-release)
• Available in 100 mg and 150 mg tablet strengths
• Designed for twice-daily dosing (every 12 hours)
• Belongs to the aminoketone class of antidepressants
• Not associated with significant serotonin reuptake inhibition
• FDA-approved for major depressive disorder and smoking cessation

Benefits

• Reduces symptoms of depression such as low mood, loss of interest, and fatigue
• Lower incidence of sexual dysfunction compared to SSRIs
• Minimal weight gain, with some patients experiencing weight loss
• Helps reduce nicotine cravings and withdrawal symptoms
• Does not commonly cause sedation; may improve energy and focus
• Suitable for patients who have not responded to or tolerated other antidepressants

Common use

Wellbutrin SR is primarily indicated for the treatment of major depressive disorder (MDD) in adults. It is also approved as an aid to smoking cessation treatment to reduce nicotine cravings and withdrawal symptoms. Off-label, it may be used to manage symptoms of seasonal affective disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD), though these uses should be carefully evaluated by a healthcare provider. Its unique neurochemical profile makes it a preferred option for patients concerned about sexual side effects or weight changes associated with other antidepressants.

Dosage and direction

The recommended starting dose for Wellbutrin SR is 150 mg once daily, preferably in the morning. After at least three days, the dose may be increased to 150 mg twice daily, with at least 8 hours between doses. The maximum recommended dose is 400 mg per day, given as 200 mg twice daily. Doses should be swallowed whole and not crushed, chewed, or divided, to maintain the sustained-release properties. It is advised to take Wellbutrin SR with food to minimize potential gastrointestinal upset. Dosage adjustments should be guided by a healthcare professional based on clinical response and tolerability.

Precautions

Patients should be monitored for worsening depression, suicidality, or unusual changes in behavior, especially at the beginning of treatment or after dosage changes. Wellbutrin SR may lower the seizure threshold; caution is advised in patients with a history of seizure disorder, head trauma, or conditions predisposing to seizures. It should be used cautiously in patients with hepatic or renal impairment, and dosage adjustment may be necessary. Alcohol consumption should be minimized or avoided due to increased risk of seizures. Abrupt discontinuation should be avoided; taper under medical supervision if needed.

Contraindications

Wellbutrin SR is contraindicated in patients with a known hypersensitivity to bupropion or any component of the formulation. It must not be used in individuals with a current or prior diagnosis of bulimia or anorexia nervosa due to increased seizure risk. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated; at least 14 days should elapse between discontinuing an MAOI and initiating Wellbutrin SR. It is also contraindicated in patients undergoing abrupt discontinuation of alcohol or sedatives.

Possible side effect

Common side effects may include dry mouth, nausea, headache, insomnia, dizziness, and sweating. Less frequently, patients may experience tremors, agitation, anxiety, tinnitus, or skin rash. Wellbutrin SR is associated with a dose-dependent risk of seizures; incidence is approximately 0.1% at doses up to 300 mg/day and 0.4% at 400 mg/day. Hypertension, sometimes severe, may occur. Allergic reactions, though rare, can include angioedema and anaphylaxis. Any unusual or severe side effects should be reported to a healthcare provider promptly.

Drug interaction

Wellbutrin SR is metabolized primarily by CYP2B6; inhibitors or inducers of this enzyme may affect its plasma levels. Concomitant use with other drugs that lower seizure threshold (e.g., antipsychotics, antidepressants, theophylline, systemic corticosteroids) may increase seizure risk. It may interact with drugs metabolized by CYP2D6 (e.g., certain antidepressants, beta-blockers, antipsychotics), potentially increasing their levels. Use with levodopa or amantadine may increase adverse effects. Caution is advised when combining with sympathomimetics or drugs affecting dopamine or norepinephrine.

Missed dose

If a dose of Wellbutrin SR is missed, it should be taken as soon as remembered, unless it is close to the time of the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose to make up for a missed one is not recommended, as it may increase the risk of adverse effects, including seizures. Patients should maintain a consistent dosing routine to ensure optimal therapeutic effect.

Overdose

Overdose of Wellbutrin SR may lead to severe and potentially fatal outcomes. Symptoms can include seizures, hallucinations, tachycardia, cardiac arrhythmias, hypotension, loss of consciousness, and fever. Management involves supportive care, including securing airway, monitoring vital signs, and administering activated charcoal if presented early. Seizures should be controlled with benzodiazepines; other symptoms treated symptomatically. Due to the risk of delayed seizures, medical observation for at least 24 hours is advised. Contact a poison control center or emergency department immediately if overdose is suspected.

Storage

Wellbutrin SR should be stored at room temperature, between 20°C to 25°C (68°F to 77°F), in a tightly closed container. It must be kept away from light, moisture, and excessive heat. Tablets should not be removed from blister packs until immediately before use. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Dispose of unused medication properly, following local guidelines or through a drug take-back program.

Disclaimer

This information is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here. Individual responses to medication may vary.

Reviews

Clinical studies and patient reports generally indicate that Wellbutrin SR is effective in alleviating depressive symptoms with a favorable side effect profile, particularly regarding sexual function and weight. Many users appreciate the increased energy and absence of emotional blunting commonly associated with other antidepressants. However, some report initial side effects such as insomnia or anxiety, which often subside with continued use. It is consistently rated well for smoking cessation support. As with any antidepressant, individual experiences vary, and it may not be effective for all patients. Always discuss treatment options with a healthcare professional.