blog

Patient Education: Bupropion (Wellbutrin)

Written by Dr. Rahul Bansal | Oct 14, 2024 8:19:22 PM

Bupropion is a medication prescribed by your healthcare provider, selected based on current evidence-based guidelines to best address specific mental health conditions. While effective, it's important to understand that all medications come with potential side effects. As a patient or caregiver, being informed about these risks and benefits is crucial. Equally essential is knowing how to monitor for side effects, and understanding the strategies to reduce their occurrence or manage them effectively. This guide aims to empower you with this knowledge, ensuring a well-informed approach to your or your child's treatment.

What is Bupropion?

Bupropion is a Dopamine Norepinephrine Reuptake Inhibitor. Bupropion works by increasing the levels of dopamine and norepinephrine in the brain.

 

 

When is Bupropion prescribed to Children & Adolescents?

Your doctor may prescribe Bupropion  for

  • Depression
  • Seasonal Affective Disorder
  • Post-traumatic Stress Disorder (PTSD)
  • Post Menstrual Dysphoric Disorder (PMDD)
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • To help with stopping smoking 
  • Antidepressant induced sexual dysfunction



 

 

What is the Dose of  Bupropion?

  • For sustained release (SR) formulations, dose typically ranges from 100 to 400 mg and for extended release (XR) formulations, from 150 to 450 mg.
  • Started at a low dose, gradually increasing to effectiveness.
  • Capsules should be swallowed whole and not chewed or crushed.

 

Medication Guidelines: What you need to know

  • Take your medication consistently every day as directed by your healthcare provider, rather than using it only when you feel you need it.

  • While some patients may notice improvement within the first two weeks of starting treatment, it may take up to eight weeks to experience the medication's full benefits.

  • Abruptly stopping SSRIs can lead to a discontinuation syndrome, which may cause symptoms like dizziness, chills, lightheadedness, fatigue, headache, muscle aches, nausea, diarrhea, tremors, shock-like sensations, and tingling.

  • After the first episode of depression is resolved, staying on the effective dosage for at least one year is needed to minimize the risk of symptom recurrence. Following this period, your healthcare provider will guide you through a gradual tapering-off process and stop the medication entirely. This approach ensures a smoother transition and reduces the likelihood of relapse. For second and subsequent episodes of depression and for other mental health disorders, treatment may need to be indefinite.

  • Combining Bupropion with certain medications can lead to a dangerous condition called Serotonin Syndrome, caused by excessive serotonin levels in the body. Symptoms include anxiety, agitation, confusion, sweating, rapid heartbeat, high blood pressure, fever, stomach problems, tremors, muscle stiffness, spasms, and heightened reflexes. Over-the-counter agents and supplements such as Dextromethorphan (DXM), St. John's Wort, certain cough and cold medications, over-the-counter migraine medications, 5-HTP, and L-tryptophan can also interact with Bupropion  to induce serotonin syndrome. It's vital to consult your primary care provider or psychiatrist before starting any new prescription or over-the-counter medication.

What can be the possible

side-effects from the medication?

Your child may experience some side effects from the medication initially. Most of these side effects are mild and improve over time. The medication is started at a low dose to minimize these side effects. If side effects persist, consult your healthcare provider.

Nausea: These can be mitigated by taking your medication with meals.

Sleep Disturbances: If you find it difficult to sleep, try taking your medication in the morning.

Dry Mouth, Constipation: Regular hydration can alleviate this symptom. Try to drink water frequently throughout the day.

Headache: May happen initially but usually improves over time. Consult with your provider if persistent. Reducing the dosage or splitting it into two daily doses might help. 

Activation (feeling unusually energized, restless anxious or agitated): Lowering the dose temporarily can be helpful. Contact your provider for guidance on how much to reduce and how to slowly increase it again as your body adapts to the medication.

Decreased Appetite: May happen initially but usually improves over time. Adding high healthy high calorie snacks to diet can be helpful.

Tremor: Reducing the dosage or splitting it into two daily doses might help. As your body adjusts, your provider may gradually increase the dose back to the original level if needed.

Stomach upset: Reducing the dosage or splitting it into two daily doses might help. As your body adjusts, your provider may gradually increase the dose back to the original level if needed.

 

Serious but Rare Side-Effects

 

 



    • Seizures: Not a common side effect. Risk is higher with rapid dose increases, with doses above the recommended maximums and in patients at risk for seizures. Risk of seizure also depends on dose and formulation and is higher with immediate release formulations as compared to sustained release and extended release formulations. With extended formulations at doses within the recommended dose range is comparable to other antideprssants. Chewing dividing or crushing SR or ER tablets can also increase the risk of seizures.


    • Angle Closure Glaucoma: Bupropion has been linked to an increased risk of acute angle-closure glaucoma, especially in adults under 50, according to a case-controlled study. In contrast, other studies indicate it may lower the risk of open-angle glaucoma. If you experience symptoms such as eye pain, vision changes, swelling, or redness, please seek immediate emergency medical care, as untreated angle-closure glaucoma can lead to permanent blindness.

 

 

 

 

To learn more about this medication please visit MedlinePlus, a official US government website, part of National Library of Medicine and managed by National Institute of Health by clicking HERE