Norepinephrine-Dopamine Reuptake Inhibitor (NDRI)

Wellbutrin (Bupropion)

Generic: Bupropion

A unique antidepressant that works differently from SSRIs, often with fewer sexual side effects

Important: This information is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider before starting, stopping, or changing any medication.

Overview

Wellbutrin (bupropion) is an atypical antidepressant that works differently from most other depression medications. Unlike SSRIs, Wellbutrin affects dopamine and norepinephrine rather than serotonin. It's often chosen when other antidepressants have caused unwanted side effects like weight gain or sexual dysfunction. At Next Step Psychiatry, we carefully evaluate whether Wellbutrin is the right choice for your specific situation.

How Wellbutrin Works

Wellbutrin works by blocking the reuptake of dopamine and norepinephrine in the brain, increasing the availability of these neurotransmitters. This mechanism is different from SSRIs and can provide benefits for energy, motivation, and focus in addition to mood improvement. The medication typically takes 2-4 weeks to reach full effectiveness.

What Is Wellbutrin Used For?

Major Depressive Disorder (MDD)
Seasonal Affective Disorder (SAD)
Smoking cessation (as Zyban)
Off-label: ADHD symptoms
Off-label: Augmentation for treatment-resistant depression
Off-label: Weight management (as Contrave component)

Dosage Information

Starting Dose

150 mg once daily (SR) or 150 mg once daily (XL)

Typical Dose

300 mg daily (150 mg twice daily SR or 300 mg once daily XL)

Maximum Dose

450 mg per day

Important Notes:

  • Available in immediate-release (IR), sustained-release (SR), and extended-release (XL) formulations
  • XL formulation is typically preferred for once-daily dosing
  • Should be taken in the morning to avoid insomnia
  • Doses should be at least 8 hours apart for SR formulation
  • Do not crush or chew extended-release tablets

Side Effects

Common Side Effects

These may occur when starting the medication and often improve over time:

Dry mouth
Headache
Nausea
Insomnia or sleep difficulties
Dizziness
Constipation
Increased heart rate
Agitation or restlessness
Tremor
Sweating

Serious Side Effects (Seek Medical Attention)

Seizures (risk increases at higher doses)
Severe allergic reactions
Changes in blood pressure
Mania or hypomania
Suicidal thoughts (especially in young adults)
Psychosis or paranoia
Severe skin reactions

Important Warnings

  • !Increased seizure risk - contraindicated in patients with seizure disorders
  • !Do not use with MAO inhibitors
  • !Contraindicated in patients with bulimia or anorexia due to seizure risk
  • !Avoid abrupt discontinuation of alcohol or sedatives while starting
  • !May worsen anxiety initially
  • !Black box warning for suicidal thoughts in young adults

When to Seek Immediate Medical Help

Contact your doctor immediately or go to the emergency room if you experience:

  • Seizures or convulsions
  • Severe allergic reaction (rash, difficulty breathing, swelling)
  • Thoughts of suicide or self-harm
  • Manic symptoms (racing thoughts, decreased need for sleep, risky behavior)
  • Severe agitation or panic attacks
  • Irregular heartbeat or chest pain
  • Confusion or hallucinations

Drug Interactions

Tell your doctor about all medications, supplements, and herbal products you take. Important interactions include:

MAO inhibitors - dangerous interaction, do not combine
Other medications that lower seizure threshold
Alcohol - increases seizure risk
CYP2D6 inhibitors may increase bupropion levels
Medications metabolized by CYP2D6 may have increased effects

Frequently Asked Questions

Why do people choose Wellbutrin over other antidepressants?

Wellbutrin is often chosen because it typically doesn't cause sexual side effects or weight gain - common issues with SSRIs. It can also help with energy and focus, making it a good choice for people who experience fatigue with depression.

Can Wellbutrin help with ADHD?

While not FDA-approved for ADHD, Wellbutrin is sometimes used off-label for ADHD symptoms, particularly when stimulants aren't appropriate or when ADHD co-occurs with depression.

How long does Wellbutrin take to work?

Most people notice some improvement within 1-2 weeks, but full effects typically take 4-6 weeks. It's important to continue taking it as prescribed even if you don't feel immediate effects.

Crisis Support

If you're experiencing a mental health crisis or thoughts of suicide, call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. Help is available 24/7.

Other Medications We Prescribe

Questions About Wellbutrin?

Our psychiatrists provide expert medication management and can help determine if Wellbutrin is right for you.

4145 Lawrenceville Hwy NW, Suite 100, Lilburn, GA 30047

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