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When Wellbutrin is combined with talk therapy for the treatment of depression, individuals find that they have a positive change in mood and thinking. For some, Wellbutrin is combined with SSRI medications such as Prozac, Lexapro or Zoloft to treat depression. The use of two medications works better for some people because they both regulate the neurotransmitters in the brain that can affect symptoms of depression.

Drug Interaction Studies

Instruct patients to store WELLBUTRIN at room temperature, between 68°F and 77°F (20°C to 25°C) and keep the tablets dry and out of the light. Patients should be advised that taking WELLBUTRIN can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle-closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle-closure glaucoma, when diagnosed, can be treated definitively with iridectomy. Open-angle glaucoma is not a risk factor for angle-closure glaucoma. Patients may wish to be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure (e.g., iridectomy), if they are susceptible see WARNINGS AND PRECAUTIONS. Educate patients on the symptoms of hypersensitivity and to discontinue WELLBUTRIN if they have a severe allergic reaction.

Reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. The majority of these subjects had evidence of pre-existing hypertension. Monitoring of blood pressure is recommended in patients who receive the combination of bupropion and nicotine replacement. Such monitoring should include daily observation by families and caregivers. Prescriptions for WELLBUTRIN should be written for the smallest quantity of tablets consistent with good patient management, in order to reduce the risk of overdose.

If you need to stop taking Wellbutrin, your provider can guide you in gradually tapering off. Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. Check with your doctor right away if blurred vision, eye pain, or any other change in vision occurs during or after treatment. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor). Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. This medicine may cause some wellbutrin uses, dosage, side effects people to have a false sense of wellbeing, or to become drowsy, dizzy, or less alert than they are normally.

Potential For WELLBUTRIN To Affect Other Drugs

If your side effects last longer, are severe, or worsen, contact your healthcare provider right away. Your dosage may need to be changed or the medication switched to ease these effects. The FDA has also approved a medication called Contrave, which is a combination of bupropion and naltrexone, for weight loss. It is only approved for people with a BMI of 30 or higher, or for people with a BMI over 27 who also have a weight-related condition such as high cholesterol, type 2 diabetes, or high blood pressure.

• Do not chew, crush, or break Wellbutrin extended-release tablets — they should always be swallowed whole.
• Studies in rodents and primates demonstrated that bupropion exhibits some pharmacologic actions common to psychostimulants.
• Bupropion works to regulate chemicals in your brain called norepinephrine and dopamine.
• It may take 4 weeks or longer before you feel the full benefit of bupropion.

Get Smarter About Mental Health

They can advise you about anxiety treatment options and weight management. Findings in clinical trials, however, are not known to reliably predict the abuse potential of drugs. Nonetheless, evidence from single-dose trials does suggest that the recommended daily dosage of bupropion when administered orally in divided doses is not likely to be significantly reinforcing to amphetamine or CNS stimulant abusers.

Bupropion is primarily metabolized to hydroxybupropion by CYP2B6. The conditions and duration of exposure to WELLBUTRIN varied greatly, and a substantial proportion of the experience was gained in open and uncontrolled clinical settings. During this experience, numerous adverse events were reported; however, without appropriate controls, it is impossible to determine with certainty which events were or were not caused by WELLBUTRIN. The following enumeration is organized by organ system and describes events in terms of their relative frequency of reporting in the database. The efficacy of WELLBUTRIN in the treatment of a major depressive episode was established in two 4-week controlled inpatient trials and one 6-week controlled outpatient trial of adult subjects with MDD see Clinical Studies. If Wellbutrin side effects do occur, they will usually go away within a week or two of starting the medication, as your body begins to adjust.

• This is because symptoms of SAD generally occur during winter and diminish in spring.
• Bupropion may increase pressure inside the eye and cause or worsen a certain type of eye problem called narrow-angle glaucoma, which can lead to blindness.
• Other side effects not listed may also occur in some patients.
• Neither form of Wellbutrin is FDA approved for weight loss or anxiety at this time.

Treatment

The use of Wellbutrin can result in some serious but rare side effects and should always be used under the supervision of a qualified medical provider. The likelihood of serious bupropion side effects increase as the dosage of the drug is increased. No, Wellbutrin does not typically relieve anxiety symptoms and may in fact cause anxiety in some people. Wellbutrin should usually be avoided in persons with anxiety disorders.

Monitor plasma digoxin levels in patients treated concomitantly with WELLBUTRIN and digoxin see CLINICAL PHARMACOLOGY. It is generally agreed that acute episodes of depression require several months or longer of antidepressant drug treatment beyond the response in the acute episode. It is unknown whether the dose of WELLBUTRIN needed for maintenance treatment is identical to the dose that provided an initial response.

Other Interactions

Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell your doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away. If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Keep WELLBUTRIN and all medicines out of the reach of children. In vitro tests show that bupropion is 84% bound to human plasma proteins at concentrations up to 200 mcg/mL. The extent of protein binding of the hydroxybupropion metabolite is similar to that for bupropion, whereas the extent of protein binding of the threohydrobupropion metabolite is about half that seen with bupropion. For the findings of LVOTO and VSD, the studies were limited by the small number of exposed cases, inconsistent findings among studies, and the potential for chance findings from multiple comparisons in case control studies.

What are the side effects of bupropion (Wellbutrin)?

Instruct patients that WELLBUTRIN tablets should be swallowed whole and not crushed, divided, or chewed. Bupropion inhibits the reuptake of dopamine and norepinephrine. Concomitant use of MAOIs and bupropion is contraindicated because there is an increased risk of hypertensive reactions if bupropion is used concomitantly with MAOIs.

She provides clinical expertise for press/public initiatives on Talkspace research and mental health in the news. She provides support with writing, providing quotes and medically reviewing clinical content. Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards. All drugs have the risk of interacting with other medications.

When used concomitantly with WELLBUTRIN, it may be necessary to decrease the dose of these CYP2D6 substrates, particularly for drugs with a narrow therapeutic index. Table 2 summarizes the adverse reactions that occurred in placebo-controlled trials at an incidence of at least 1% of subjects receiving WELLBUTRIN and more frequently in these subjects than in the placebo group. In some cases, a patient already receiving therapy with WELLBUTRIN may require urgent treatment with linezolid or intravenous methylene blue.

Following a single dose in humans, peak plasma concentrations of hydroxybupropion occur approximately 3 hours after administration of WELLBUTRIN and are approximately 10 times the peak level of the parent drug at steady state. The elimination half-life of hydroxybupropion is approximately 20 (±5) hours, and its AUC at steady state is about 17 times that of bupropion. The times to peak concentrations for the erythrohydrobupropion and threohydrobupropion metabolites are similar to that of the hydroxybupropion metabolite. However, their elimination half-lives are longer, 33 (±10) and 37 (±13) hours, respectively, and steady-state AUCs are 1.5 and 7 times that of bupropion, respectively. Lifetime carcinogenicity studies were performed in rats and mice at bupropion doses up to 300 and 150 mg/kg/day, respectively. These doses are approximately 6 and 2 times the MRHD, respectively, on a mg/m² basis.