Who is Wellbutrin not good for?

Around 1 in 1,000 people who use Wellbutrin are at risk of a seizure. Wellbutrin is not suitable for people who are susceptible to seizures, as it can lower the seizure threshold, making it easier for a seizure to occur.

medicalnewstoday.com - Wellbutrin (bupropion): Uses, side effects, and precautions

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Wellbutrin, or bupropion, is a prescription antidepressant. Doctors prescribe it to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). They can also recommend it to help people stop smoking. Bupropion is available under the brand names Wellbutrin, Zyban, Aplenzin, and Forfivo XL. This article outlines what Wellbutrin or bupropion is, some of the conditions it treats, and how to use it. It also provides information on safety, recommended dosage, potential side effects, and interactions with other medications. What is Wellbutrin? Share on Pinterest J B Reed/Bloomberg via Getty Images Wellbutrin is a type of antidepressant that belongs to a class of drugs known as aminoketones. The Food and Drug Administration (FDA) approved it for clinical use in the United States in 1985 . Healthcare professionals frequently prescribe it to help with: MDD

treat depression associated with bipolar disorder

promote weight loss in people who have obesity It is one of few antidepressants that do not cause sexual dysfunction as a side effect. Function Bupropion, or Wellbutrin, is different from other antidepressants. It is a norepinephrine-dopamine reuptake inhibitor (NDRI) and is the only antidepressant in this category. As an NDRI, it boosts levels of neurotransmitters — dopamine and norepinephrine, or noradrenaline — by blocking their reuptake. Experts do not fully understand how Wellbutrin exerts its neurological function. However, it is a very potent dopamine reuptake inhibitor, and a person’s mood can improve significantly as a result of increasing dopamine levels. Dopamine is the hormone responsible for the brain’s pleasure reward system. In addition to being an antidepressant, bupropion — the active ingredient in Wellbutrin — acts as a nicotine receptor antagonist. It blocks nicotine binding sites and alters neurotransmitters in the brain to relieve withdrawal symptoms that can occur when people stop smoking. Research on bupropion as the first-line medication for smoking cessation among adults suggests that it is the most effective drug treatment option for improving abstinence rates among adolescent smokers. Dosage Wellbutrin is available as an oral tablet in immediate-release (IR), sustained-release (SR), and extended-release (XL) forms. The dosage and form of the medication that a healthcare professional recommends will depend on a person’s medical condition and response to treatment. IR tablet The IR form of Wellbutrin starts acting immediately after a person takes it. According to the FDA, Wellbutrin IR is available in 75-milligram (mg) and 100-mg doses. A doctor will recommend a total starting dosage of 200 mg per day. This means a person will use 100 mg of the tablet twice daily. The doctor may increase a person’s dosage to 100 mg three times per day in 6-hour intervals. The maximum dosage is 450 mg per day, taken as 150 mg three times daily. SR tablet The SR form of Wellbutrin can be more potent in treating MDD since it dissolves slowly and acts over an extended period. The FDA states that it is available in 100-, 150-, and 200-mg doses. A doctor will start a person at 150 mg once per day and potentially increase the dosage to 150 mg twice per day. If a person’s symptoms do not improve, the doctor will increase their dosage to 200 mg twice daily. XL tablet The XL form of Wellbutrin has a slightly slower onset and can improve symptoms for a longer period than other forms. According to the FDA, this form is available in 150- and 300-mg oral doses. Doctors recommend it as follows for the treatment of MDD and SAD and to help people quit smoking: MDD: A doctor will start a person at 150 mg once daily and increase the dosage to 300 mg once daily after 4 days. SAD: A doctor will start treatment in the autumn before the onset of SAD symptoms in the winter. They will prescribe a dosage of 150 mg once per day and increase it to 300 mg once per day. Smoking cessation: A doctor will prescribe a starting dosage of 150 mg per day and carefully increase it to 300 mg per day. The maximum dosage is 450 mg per day. This means a person will take 150 mg three times per day, in 8-hour intervals. To avoid adverse reactions, a person should always follow a doctor’s instructions when taking Wellbutrin. A person should disclose any other medications they are taking and discuss any side effects with the doctor. They should also avoid using more doses than the doctor recommends.

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How do you take Wellbutrin? Health experts recommend that a person take Wellbutrin by swallowing it whole. To reduce the risk of side effects, people should avoid breaking, cutting, or chewing the tablets. They can take it either with food or on an empty stomach. If a person takes Wellbutrin for smoking cessation and SAD, the length of treatment may be shorter. However, those using it for MDD may need long-term treatment to prevent a relapse. What happens if you miss a dose? According to the National Alliance on Mental Illness, if a person misses a dose, they should take it as soon as they remember. People should avoid taking two doses at once but should take the remaining doses for the day, evenly spaced at least 4 hours apart. Uses Researchers have conducted clinical trials on the use of Wellbutrin in treating different health conditions. However, significant evidence supports its use only for depression treatment and smoking cessation. Depression A 2016 review that compared the effectiveness of Wellbutrin and selective serotonin reuptake inhibitors (SSRIs) suggests that Wellbutrin is as effective as SSRIs in treating depression. Additionally, in a 2022 study, researchers analyzed the effectiveness of different antidepressants in people aged 60 and older who were living with depression. They found that bupropion can offer the same benefits as other antidepressants. A person may begin to experience the therapeutic effects of the medication in the second week of using it. Health experts recommend that people continue taking Wellbutrin even after their symptoms improve, unless their doctor recommends that they stop. To help reduce the risk of relapse, a doctor will gradually reduce a person’s dose before advising them to stop taking the medication. Smoking cessation According to the Centers for Disease Control and Prevention (CDC) , bupropion can help reduce nicotine cravings. A doctor will prescribe a dosage of 150 mg once daily for 3 days and then twice daily for 7–12 weeks. Off-label uses Although it is not FDA-approved for these uses, bupropion may be an effective option for the following: ADHD: The authors of 2017 review found low quality evidence that bupropion could decrease the severity of ADHD symptoms. However, more research is necessary. The authors state that bupropion may be an alternative treatment option for those with ADHD who cannot or choose not to take stimulant drugs. The authors of found low quality evidence that bupropion could decrease the severity of ADHD symptoms. However, more research is necessary. The authors state that bupropion may be an alternative treatment option for those with ADHD who cannot or choose not to take stimulant drugs. Weight loss: A 2019 review found that people who took bupropion lost weight. A found that people who took bupropion lost weight. Depression associated with bipolar disorder: A 2016 study found that bupropion significantly reduced the severity of bipolar disorder in some people. Side effects In the first days after starting treatment, a person may experience agitation, restlessness, and insomnia. Reducing the dose temporarily or avoiding bedtime doses may help relieve these symptoms. Seizures Taking Wellbutrin can cause seizures. The risk is related to the dose a person takes. The IR tablets, particularly in high doses, have the greatest chance of causing seizures. To lower their risk of seizure, a person should not take more than 300 mg per day. If a person is susceptible to seizures, Wellbutrin is not suitable for them, as it can lower their seizure threshold, making it more likely that they will experience a seizure. Other adverse effects Common side effects, which affect more than 10% of people who take this medication, include: tachycardia , or fast heart rate

, or rhinitis

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pharyngitis , or inflammation of the pharynx that causes a sore throat

, or inflammation of the pharynx that causes a sore throat insomnia

headache

agitation

dizziness

weight loss

constipation

dry mouth

nausea

tremor

blurred vision Fewer than 10% of people who use Wellbutrin experience rare side effects such as: skin rash

sweating

ringing in the ears

shakiness

stomach pain

muscle pain

suicidal thoughts

anxiety glaucoma Bupropion can increase the risk of suicidal ideation or behavior in children, adolescents, and young adults. For this reason, the FDA has issued boxed warnings on the use of bupropion to alert people and their doctors about its dangerous side effects. Suicide prevention If you know someone at immediate risk of self-harm, suicide, or hurting another person: Ask the tough question: “Are you considering suicide?”

Listen to the person without judgment.

Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.

Stay with the person until professional help arrives.

Try to remove any weapons, medications, or other potentially harmful objects. If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988. Click here for more links and local resources. Precautions Wellbutrin may not be suitable for those who experience seizures or have any factors that can increase the chance of seizures, including: severe head injury

stroke

brain tumor Health experts recommend that people avoid drinking alcohol when using Wellbutrin. However, abruptly stopping alcohol consumption can result in a seizure in those who have a dependency on alcohol. Those with alcohol use disorder should speak with a doctor. Anaphylaxis If a person has an allergy to any of the ingredients in Wellbutrin, a severe allergic reaction known as anaphylaxis can occur. A 2015 case report suggests that bupropion can trigger delayed onset anaphylaxis. Skin reactions Research from 2015 and 2021 suggests that bupropion can trigger severe skin reactions. A skin reaction can appear as a lesion, a blister, or acne. A person should immediately contact a doctor if they have any worsening symptoms. Pregnancy and breastfeeding Wellbutrin is a class C medication. This means there are currently no human studies on how it affects pregnancy. Interactions with other medications People should not use bupropion if they take monoamine oxidase inhibitors (MAOIs) such as: selegiline (Emsam)

isocarboxazid (Marplan)

phenelzine (Nardil)

tranylcypromine (Parnate) A person should avoid taking Wellbutrin within 2 weeks of stopping MAOIs. Similarly, to prevent fatal drug interactions, individuals should not start taking MAOIs within 2 weeks of stopping Wellbutrin. The following medications can increase the risk of seizures if a person takes them alongside bupropion: antipsychotic medications