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- What is bupropion, and how does it work (mechanism of action)?
- What brand names are available for bupropion?
- Is bupropion available as a generic drug?
- Do I need a prescription for bupropion?
- What are the side effects of bupropion?
- What is the dosage for bupropion?
- Is bupropion safe to take if I'm pregnant or breastfeeding?
- What else should I know about bupropion?
What is bupropion, and how does it work (mechanism of action)?
Bupropion is an antidepressant medication that affects chemicals within the brain that nerves use to send messages to each other. These chemical messengers are called neurotransmitters. Many experts believe that depression is caused by an imbalance among the amounts of neurotransmitters that are released. Nerves, in a process referred to as reuptake, may recycle released neurotransmitters. Bupropion works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine; an action that results in more dopamine, serotonin, and norepinephrine to transmit messages to other nerves. Bupropion is unique and unlike other antidepressants in that its major effect is on dopamine, an effect that is not shared by the selective serotonin reuptake inhibitors or SSRIs (for example, paroxetine [Paxil], fluoxetine [Prozac], sertraline [Zoloft]) or the tricyclic antidepressants or TCAs (for example, amitriptyline [Elavil, Endep], imipramine [Tofranil], desipramine [Norpramin]). The FDA approved bupropion in December 1985.
What brand names are available for bupropion?
Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Aplenzin
What are the side effects of bupropion?
The most common side effects associated with bupropion are agitation, dry mouth, insomnia, headache, nausea, constipation, and tremor. In some people, the agitation or insomnia is most marked shortly after starting therapy. Some patients may experience weight loss. Uncommonly, patients may experience manic episodes or hallucinations. Four of every 1000 persons who receive bupropion in doses less than 450 mg/day experience seizures. When doses exceed 450 mg/day, the risk increases ten-fold. Other risk factors for seizures include past injury to the head and medications which can lower the threshold for seizures. (See drug interactions.)
Antidepressants increased the risk of suicidal thinking and behavior (suicidality in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of bupropion or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
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What is the dosage for bupropion?
Bupropion immediate release tablets are usually is given in one, two or three daily doses. For immediate-release tablets, no single dose should exceed 150 mg and each dose should be separated by 6 hours.
For depression, the recommended dose of immediate-release tablets is 100 mg 3 times daily (300 mg/day) maximum dose is 450 mg daily. The initial dose is 100 mg twice daily. The dose may be increased to 100 mg 3 times daily after three days and 150 mg 3 times daily after several weeks if the response is not adequate. .
The initial dose of sustained-release tablets is 150 mg daily; target dose is 150 mg twice daily; maximum dose is 200 mg twice daily.
The initial dose of extended-release tablets is 150 mg daily; target dose is 300 mg daily; maximum dose is 450 mg daily. Alternatively initiate at 174 mg daily and increase to 348 mg daily after 4 days and up to a maximum dose of 522 mg daily after 4 weeks. Extended release tablets are administered once daily.When used for smoking cessation, bupropion (Zyban) usually is started as 150 mg once daily for three days, and then the dose is increased to 150 mg twice daily for 7 to 12 weeks if the patient tolerates the starting dose.
Smoking is discontinued two weeks after starting bupropion therapy.
The dose for seasonal affective disorder is 150 mg once daily. Wellbutrin SR is given as two daily doses. Wellbutrin XL is given as one dose daily, up to 300 mg daily using extended release tablets. Alternatively treatment may be started with 174 mg daily and increased to a target dose of 348 mg day. Start treatment in the autumn prior to onset of seasonal depressive symptoms, and continue through the winter season.
Is bupropion safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of bupropion in pregnant women. In one study, there was no difference between bupropion and other antidepressants in the occurrence of birth defects. Bupropion should only be used in pregnancy if the benefit outweighs the potential risk.
Bupropion is secreted in breast milk.
What else should I know about bupropion?
How should I keep bupropion stored?
Tablets should be kept at room temperature, 15 C to 25 C (59 F to 77 F).
Reference: FDA Prescribing Information
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