Generic name: Bupropion hydrochloride
Other brand names: Wellbutrin SR, Wellbutrin XL
Wellbutrin is prescribed to help relieve major depression. Symptoms include a severely depressed mood (for 2 weeks or more) and loss of interest or pleasure in usual activities accompanied by sleep and appetite disturbances, agitation or lack of energy, feelings of guilt or worthlessness, decreased sex drive, inability to concentrate, and sometimes, suicidal thoughts or behavior.
Wellbutrin is thought to work by altering levels of the brain chemicals norepinephrine and dopamine. It is not chemically related to other antidepressants such as tricyclics (Elavil), MAO inhibitors (Nardil, Parnate), or serotonin re-uptake inhibitors (Paxil and Prozac).
Most important fact about Wellbutrin
Wellbutrin is associated with an increased risk of seizures. This risk is greater at higher doses (approximately 4 in 1,000 patients at dosages of 300 to 450 milligrams a day). Certain factors increase the risk of seizure, including:
A history of head trauma or previous seizure
Central nervous system tumor
Severe liver disease such as cirrhosis
A history of eating disorders, including anorexia and bulimia
Excessive use of alcohol, or abrupt withdrawal from alcohol or sedatives
Taking medications that lower the seizure threshold (see “Possible food and drug interactions when taking this medication”)
To minimize the risk of seizures, dose increases should be done gradually, and the total daily dose of Wellbutrin should not exceed 450 milligrams. Additionally, the doctor should be aware of all your medical conditions, and you should not take any other medications (both prescription and over-the-counter) unless the doctor approves.
How should you take Wellbutrin?
Take Wellbutrin exactly as prescribed by your doctor. The usual dosing regimen is 3 equal doses spaced evenly throughout the day. Allow at least 6 hours between doses. Your doctor will probably start you at a low dosage and gradually increase it; this helps minimize side effects.
If Wellbutrin works for you, your doctor will probably have you continue taking it for at least several months.
–If you miss a dose…
Take it as soon as you remember. If it is within 4 hours of your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.
–Storage instructions…
Store at room temperature. Protect from light and moisture.
What side effects may occur?
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Wellbutrin.
- Side effects of Wellbutrin may include:
Agitation, constipation, dizziness, dry mouth, excessive sweating, headache, nausea, vomiting, skin rash, sleep disturbances, tremor
- Side effects of Wellbutrin SR may include:
Agitation, constipation, dizziness, dry mouth, insomnia, nausea, rash, sweating, weight loss
- Side effects of Wellbutrin XL may include:
Abdominal pain, agitation, anxiety, constipation, diarrhea, dizziness, dry mouth, heart palpitations, increased urination, insomnia, muscle soreness, nausea, rash, ringing in the ears, sore throat, sweating
You should take Wellbutrin SR, the sustained-release form, in 2 doses, at least 8 hours apart. Wellbutrin XL extended-release tablets should be taken once a day in the morning. Swallow Wellbutrin SR and Wellbutrin XL tablets whole; do not chew, divide, or crush them.
Special information if you are pregnant or breastfeeding
If you are pregnant or plan to become pregnant, notify your doctor immediately. Wellbutrin should be taken during pregnancy only if clearly needed.
Wellbutrin does pass into breast milk and may cause serious reactions in a nursing baby; therefore, if you are a new mother, you may need to discontinue breastfeeding while you are taking this medication.
Recommended dosage
No single dose of Wellbutrin should exceed 150 milligrams.
ADULTS
Wellbutrin
At the beginning, your dose will probably be 200 milligrams per day, taken as 100 milligrams 2 times a day. After at least 3 days at this dose, your doctor may increase the dosage to 300 milligrams per day, taken as 100 milligrams 3 times a day, with at least 6 hours between doses. This is the usual adult dose. The maximum recommended dosage is 450 milligrams per day taken in doses of no more than 150 milligrams each.
Wellbutrin SR
The usual starting dose is 150 milligrams in the morning. After 3 days, if you do well, your doctor will have you take another 150 milligrams at least 8 hours after the first dose. It may be 4 weeks before you feel the benefit and you will take the drug for several months. The maximum recommended dose is 400 milligrams a day, taken in doses of 200 milligrams each.
If you have severe cirrhosis of the liver, your dosage should be no more than 75 milligrams once a day. With less serious liver and kidney problems, the dosage will be reduced as needed.
Wellbutrin XL
The usual starting dose is 150 milligrams taken once a day in the morning. If this dose is well tolerated after a minimum of 3 days, the doctor may increase the dose to 300 milligrams, also taken once a day in the morning. If no improvement is seen after several weeks of treatment, the doctor may increase the dose to a maximum of 450 milligrams once a day.
If you have severe liver damage, use this drug with extreme caution. Your dose should not exceed 150 milligrams every other day. People with mild to moderate liver damage or kidney impairment will be prescribed a lower dose as well.
CHILDREN
The safety and effectiveness in children under 18 years old have not been established.
Overdosage
There have been rare reports of death after an overdose of Wellbutrin. If you suspect an overdose, seek medical attention immediately.
- Symptoms of Wellbutrin overdose may include:
Hallucinations, heart failure, loss of consciousness, rapid heartbeat, seizures
- Symptoms of Wellbutrin SR overdose may include:
Blurred vision, confusion, jitteriness, lethargy, light-headedness, nausea, seizures, vomiting
- An overdose that involves other drugs in combination with Wellbutrin may also cause these symptoms:
Breathing difficulties coma fever rigid muscles stupor
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