side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more
Brand & Generic Names; Drug Class
|US brand name: Wellbutrin|
|Generic name: bupropion|
|Drug Class: Antidepressants|
|Learn More about Wellbutrin’s Generic & Worldwide Availability|
Wellbutrin’s Approved & Off-Label Uses (Indications)
US FDA Approved Treatment(s)Major depressive disorder. The extended release (XL) flavor is also approved for seasonal affective disorder (SAD)
Popular Off-Label UsesWeight loss, Bipolar depression, ADD/ADHD, Crohn’s disease, Restless leg syndrome (RLS), Pathological gambling, Treating SSRI/SNRI-induced sexual dysfunction.
How Long Until Wellbutrin Starts Working (Onset of Action)
Usually two-three weeks. Like all antidepressants, especially reuptake inhibitors, you should give it up to a month, maybe six weeks, before giving up, barring any really nasty side effects or you can tell nothing positive is happening at all. Meds that work on dopamine tend to act quickly, so it could start having positive results in a few days.
Likelihood of Working
Pretty freaking good. The side effects or something else may make it suck too much to keep taking it, or there’s too much potential for trouble in the first place, but Wellbutrin is one of those meds that usually work. Sometimes a little too well.Learn how Wellbutrin Compares with Other Drugs
How to Take Wellbutrin
Manufacturer’s RecommendationsGlaxo-Smith Kline (GSK) says this for the Sustained Release (SR) form:
Initial Treatment: The usual adult target dose is 300 mg/day, given as 150 mg twice daily. Dosing should begin at 150 mg/day given as a single daily dose in the morning. If the 150-mg initial dose is adequately tolerated, an increase to the 300-mg/day target dose, given as 150 mg twice daily, may be made as early as day 4 of dosing.
Increasing the Dosage Above 300 mg/day: As with other antidepressants, the full antidepressant effect may not be evident until 4 weeks of treatment or longer. An increase in dosage to the maximum of 400 mg/day, given as 200 mg twice daily, may be considered for patients in whom no clinical improvement is noted after several weeks of treatment at 300 mg/day. --the Wellbutrin PI sheet
The XL form has the same dosages, but with just one dose a day.
The only thing I don’t like is raising the dosage after three days. I really think you should wait at least five, preferably seven-eight days (see steady state below) before going up to the next higher dosage.
I <3 Wellbutrin
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How to Stop Taking Wellbutrin (Discontinue, Withdrawal)
Based on its complex pharmacokinetics, your doctor should be recommending that you reduce your dosage by 100–150mg a day (for the more popular SR and XL forms, 75mg for the immediate release form), every 5–7 days (a week is just easiest way to keep track of things) if you need to stop taking it. There have been reports of more than the usual problems that come from stopping any crazy med abruptly, or just too quickly. These include mania (not uncommon when you stop taking antidepressants cold turkey), dystonia (painful muscle contractions & spasms). Learn More about Taking and Discontinuing Wellbutrin
Wellbutrin’s Pros and Cons
Low chance of sexual side effects, unless you consider making you hornier with or without premature/spontaneous orgasms sexual side effects. None of the weight gain associated with SSRIs & SNRIs. Often a very effective and relatively fast-acting antidepressant, as dopamine and norepinephrine reuptake inhibition are frequently part of, if not the answer for a lot of people.
Anything used recreationally, so it can be abused and has to be avoided by anyone with an eating disorder or other addictive behaviors. The abuse potential is a serious problem, as Wellbutrin is one of the few modern antidepressants that can kill you if you take too much.
Interesting Stuff your Doctor Probably didn’t Tell You about Wellbutrin
Bupropion is also the active ingredient in Zyban, a drug used to quit smoking. Depending on your HMO schedule or your health insurance, you may want to get a prescription for Zyban. Why? Sometimes it’s cheaper. While mental health coverage is now supposed to be treated like everything else by health insurance providers, the pervasive anti-crazy bigotry guarantees that won’t be the case. While smokers are treated like second-class citizens, non-crazy smokers are still considered human and don’t get anywhere near as much shit as we do for taking drugs to quit smoking. And some insurance companies have a points system like car insurance. If you get too crazy, your rates go way up, but if you do something positive like try to quit smoking, your rates go down. So check with the person who works in your doctor’s office about the rates and the system, and see if you need to game the system with a prescription for the same drug with a different name and lower maximum dosage.
Best Known for
Right now: Being marketed by Glaxo sales reps, and Dr. Drew, as the “happy, horny, skinny pill.”
In-Depth Pros & Cons
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Wellbutrin’s Side Effects (Adverse Reactions)
Typical Side EffectsAgitation, anxiety, insomnia, weight loss (it’s undergone trials both as, and part of, a weight loss medication), headache, dry mouth, nausea, constipation, dizziness. Most of these are transitory, but the weight loss, agitation and insomnia tend to stick around.
Uncommon Side EffectsStrange body odor, sweating, nervousness and tremor. Basically it could make you look like the guilty party, so you better have a damn good alibi at all times in case some big, unsolved crime goes down. Also: seizures.
Freaky Rare Side EffectsChange in hair color. They swore Lady Clairol wasn’t involved! There was also new hair, possibly in unusual places. Painful erections, unusual ejaculations, ballism, and outright impotence. You know you’re the butt of one of God’s little jokes if you become impotent or get one or more of the dick-pain side effects and hornier.
Learn More about Wellbutrin’s Side Effects.
TMI at times
Medicine Is The Best Medicine
I <3 Wellbutrin
What You Really Need to be Careful About
Seizures, especially if you’ve either had seizures before (thank you Dr. Obvious), an eating disorder, or have recently stopped drinking a shitload of booze every day.
bupropion’s Half-Life & How Long Until It Clears Your System
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on bupropion’s pharmacokinetics page.
How bupropion Works
the current best guess at any rateBased upon the Communications Interference Hypothesis of psychiatric and neurological conditions, bupropion effectively raises the norepinephrine and dopamine levels in your brain by letting your synapses soak in those tasty brain juices for longer than usual by slowing (inhibiting) the mechanism of norepinephrine and dopamine transmission deeper into the neurons (reuptake).
Learn More than You Probably Ever Wanted to Know about How bupropion Works
AKA mechanism/method of action, pharmacodynamics
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Ratings, Reviews, Comments, PI Sheet, and More
While Wellbutrin has the potential make you happy, horny, skinny, and quit smoking, it is only consistent at making you not depressed - which probably counts as happy so long as you don’t end up all irritable, anxious, and pissed off3 - and helping you to stop smoking, while being unlikely to make you gain weight or affect your libido. Weight loss and treating sexual dysfunction are off-label uses of Wellbutrin and, like most off-label uses, you only want to try it if the regular treatments don’t work, because the odds aren’t as good or the side effects are worse. Or both.
Really, Dr. Drew… oh, wait, Dr. Drew just took GSK’s money and told everyone the facts as they were known - like it is less likely to cause weight gain or sexual side effects than SSRIs - except for that part about taking a shitload of money from GSK. It was another doctor, who wasn’t as famous, who was repeating what the pharm reps were telling him about the happy, horny, skinny pill. Maybe. If you don’t need it to keep from falling to the floor in a fetal position and sobbing for hours if the newspaper reprinted yesterday’s sudoku. They should have known better than that.
There’s more news. The FDA pulled the approval of Teva/Impax 300 mg Budeprion XL.4 I have more information about that on the Generic Availability page, the Expanded Comments page, and in a topic about this on the Crazy Talk forum.
As if I didn’t go on long enough already.
Get all critical about Wellbutrin
Rating 4.0 out of 5 from 447 criticisms.
Vote Distribution: 25 – 15 – 16 – 24 – 171 – 196
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If you’re still feeling judgmental as well as just mental5, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.
Get all judgmental about the Wellbutrin (bupropion) Overview
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Consumer experiences with and questions about Wellbutrin on Crazymeds Wellbutrin discussion board. Sign up for a free account to post your own.
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It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
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- Wellbutrin’s Full US Prescribing Information
- Faught, Edward. “Topiramate in the treatment of partial and generalized epilepsy.” Neuropsychiatric disease and treatment 3.6 (2007): 811-821.
- Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition ISBN:978-0521673761 by Stephen M. Stahl © 2008 Published by Cambridge University Press.
- Primer of Drug Action 12th edition by Robert M. Julien Ph.D, Claire D. Advokat, Joseph Comaty © 2011 ISBN:978-1429233439 Published by Worth Publishers.
- The Prescriber’s Guide (Essential Psychopharmacology Series) Third edition by Stephen Stahl © 2009 Published by Cambridge University Press.
- Clinical Handbook of Psychotropic Drugs 18th edition Adil S. Virani, K. Bezchlibnyk-Butler, J. Jeffries © 2009 Published by Hogrefe & Huber Publishers.
- Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 An imprint of Elsevier.
- Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton
- The Complete Guide to Psychiatric Drugs Edward Drummond, M.D. © 2000. Published by John Wiley & Sons, Inc.
- PDR: Physicians’ Desk Reference 2010 64th edition
- Healing Anxiety & Depression Daniel G. Amen, M.D., and Lisa C. Routh, M.D. © 2003. Published by G.P. Putnam’s Sons.
2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
3 Along with other symptoms of a dysphoric mania. Not all manias are happy-happy joy-joy, kids.
4 Technically the FDA asked Teva & Impax to voluntarily remove Budeprion XL from the market, much like the way the IRS assists us in voluntary compliance with tax code. Go ahead, search irs.gov for the phrase "promote voluntary compliance", with or without quotes. I feel so much better about myself knowing I've been volunteering for my country.
5 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
6 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.
If you have any questions not answered here, please see the Crazymeds Wellbutrin discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)
|Last modified on Sunday, 20 July, 2014 at 13:21:04 by JerodPoore||Page Author Jerod Poore||Date created 27 March 2011 at 14:50:23|
|“Wellbutrin (bupropion): a Synopsis for the Educated Consumer.” by Jerod Poore is copyright © 2011 Jerod Poore||Published online 2011/03/27|
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|Plain text:||Poore, Jerod. “Wellbutrin (bupropion): a Synopsis for the Educated Consumer.” Crazymeds (crazymeds.us). (2011).|
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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
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‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas? I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.