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US Brand Name: Wellbutrin / Wellbutrin
SR / Wellbutrin XL Generic Name: bupropion hydrochloride What is Wellbutrin / Wellbutrin SR / Wellbutrin XL: Wellbutrin/ Wellbutrin SR /
Wellbutrin XL is an antidepressant, specifically a multiple reuptake inhibitor What are Wellbutrin / Wellbutrin SR / Wellbutrin XL's FDA Approved Uses: Wellbutrin / Wellbutrin SR / Wellbutrin XL is approved to treat:
What are Some of Wellbutrin / Wellbutrin SR / Wellbutrin XL's Off-Label Uses: Additionally Wellbutrin is also prescribed for:
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Wellbutrin / Wellbutrin SR / Wellbutrin XL's pros and cons:
Wellbutrin's Pros: Low chance of sexual side effects, unless you consider making you hornier a sexual side effect. Among the currently approved antidepressants Wellbutrin (bupropion hydrochloride) has the least chance of triggering mania in the bipolar, just so long as you're taking a real mood stabilizer, such as an anticonvulsant or lithium. None of the weight gain associated with SSRIs. Often a very effective antidepressant, as dopamine and norepinephrine reuptake are sometimes the answer for someone.
Wellbutrin's Cons: Despite Glaxo's assertions, the SR form does cause minor seizure events in people with no prior history at the higher dosages. Wellbutrin (bupropion hydrochloride) can be used recreationally, so it can be abused. It has to be avoided by anyone with an eating disorder, between the lower seizure threshold and potential of abuse as an eating disorder enabler.
Wellbutrin / Wellbutrin SR / Wellbutrin XL's Typical Side Effects: Agitation,
anxiety, insomnia, weight loss (bupropion is undergoing trials as 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.
Wellbutrin (bupropion hydrochloride) is often used to counter the side effects of other
medications.
These aren't all the side effects possible, just the
most popular ones.
Wellbutrin / Wellbutrin SR / Wellbutrin XL's Not So Common Side Effects: Strange
body odor, sweating, nervousness and tremor. Basically Wellbutrin 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.
These may or may not happen to you don't, so don't
be surprised one way or the other.
Wellbutrin / Wellbutrin SR / Wellbutrin XL's Freaky Rare Side Effects:Change in
hair color. They swore Lady Clairol wasn't involved! There was also new hair, possibly in
unusual places Some men reported painful erections, unusual ejaculations and outright
impotence, which are just one some of God's little jokes when you combine those with
Wellbutrin's tendency to make you hornier.
You aren't going to get these. I promise.
For all side effects read the PI sheet Hell, read all of them below and really indulge your cyberchondria.
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Interesting Stuff Your Doctor Probably Won't Tell You about Wellbutrin: Strattera (atomoxetine) and Wellbutrin (bupropion hydrochloride) because they don't play well together in your brain. They both want to grab the same precursors to activate the reuptake inhibition of norepinephrine. And as it turns out that Wellbutrin (bupropion hydrochloride) does norepinephrine reuptake in its own right adding Strattera (atomoxetine) might be tweaking the norepinephrine just a bit too much. So if you want to control norepinephrine and dopamine reuptake individually, you have to go totally off label and use Mirapex (pramipexole dihydrochloride) or one of the other anti-Parkinson's medications for dopamine control. There are some people who use Wellbutrin (bupropion hydrochloride) recreationally. They get high off of it like an amphetamine. That's why you don't see any other selective dopamine reuptake inhibitors in this country, despite there being other ones available overseas. God forbid anyone have any fun in this country. Bupropion hydrochloride is also sold as 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 instead of Wellbutrin. Why? Sometimes it's cheaper. Sometimes you may not have any mental health coverage on your health insurance but you can get drugs to quit smoking. And some insurance companies they 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 Zyban prescription instead of a Wellbutrin SR prescription. It's the same damn drug as the sustained release form of Wellbutrin. The only issues will be with dosages. You can't take as much Zyban as you can Wellbutrin.
Wellbutrin / Wellbutrin SR / Wellbutrin XL's Dosage and How to Take Wellbutrin / Wellbutrin SR / Wellbutrin XL's: The initial dose of Wellbutrin SR (bupropion hydrochloride) is 150mg in the morning. If that is tolerated the target dose of 300mg a day may be tried as early as four days later, split into two 150mg doses with at least eight hours between each dose. But you really should wait at least a week. If after four weeks there is no improvement you may opt to go up to 400mg a day, split into two 200 mg doses. The initial dose of the older immediate release flavor of Wellbutrin (bupropion hydrochloride) is 100 mg a day, which may be increased by 100 mg a day with a titration period of at least three days. With the immediate release flavor you can really play around with things, dosing you in 75-150 mg increments three to four times a day with a minimum of four hours between each dose up to a maximum of 450 mg a day. The dosage for the XL form follows that of the SR form, except that it is taken once a day. I really think you should wait at least seven-eight days (see steady state below) before going up to the next higher dosage. The wacky metabolism of Wellbutrin (bupropion hydrochloride), and the fact that it's one of the metabolites that works on norepinephrine tells me that you should wait until things settle down in your system first.
Days to Reach a Steady State: Eight days for the SR form. The
metabolism of the immediate release form is just too wacky to pin down a steady state (see
below).
How Long Wellbutrin / Wellbutrin SR / Wellbutrin XL's Takes to Work: Like all antidepressants you should give Wellbutrin (bupropion hydrochloride) a month before giving up, barring any really nasty side effects. However it usually starts working within two weeks. |
Wellbutrin's Half-Life: Things get really complicated with Wellbutrin's half-life. Most drugs are happy to be metabolized into one metabolite and that's what acts on your brain. Sometimes it's not the drug you take that does the work, it's the metabolite. Some drugs get metabolized twice, so you have two things working on your brain. Not Wellbutrin (bupropion hydrochloride). It gets metabolized into three metabolites and they in turn get metabolized again and all of that is what acts on your brain. So Wellbutrin (bupropion hydrochloride) itself has a half-life of 12-30 hours, and each of its metabolites have half-lives of 15-25, 23-43 and 24-50 hours. But wait, there's more! Another metabolite floats around after all that! However that last one is still an unknown factor. You piss it out, but does it do anything? Who knows?
Average Time it takes for Wellbutrin / Wellbutrin SR / Wellbutrin XL to Clear Out of Your System: So how long does it take to get clean of Wellbutrin? Four to eight days. For some people, maybe longer.
How to Stop Taking Wellbutrin /
Wellbutrin SR / Wellbutrin XL: 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 week if you need to stop taking it, if not more
slowly than that. Based on the wacky half-lives above. For more
information, please see the page on how to safely stop taking
these crazy meds.
If you've worked your way up to a particular dosage, it's usually best to
spend this many days at the next lowest dosage before going down the next lowest dosage
before that and so forth. This is the least sucky way to avoid problems when stopping any
psychiatric medication. Presuming you have the option of slowly tapering off them.
How Wellbutrin Works In Your Brain: There have been lots of conflicting data published. But I think I finally got it straightened out. According to Dr. Preskorn, Wellbutrin (bupropion hydrochloride) lets your brain soak in norepinephrine and dopamine longer. Those are two of the three neurotransmitters that, along with serotonin, my wild-ass guess / rule of thumb states will cover up to 80% of the problems with depression. Of course the trick is figuring out which of the three are screwed up, and to what extent.
Nom de Plume is also in the camp that Wellbutrin (bupropion hydrochloride) is a combined dopamine & norepinephrine medication.
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Comments: Approved to treat depression in 1985, these days Wellbutrin (bupropion hydrochloride) generally means the new once-a-day form, Wellbutrin XL, or the somewhat older sustained released (SR) version, now available as a generic. But the older immediate release form is still in use. Wellbutrin for the bipolar is tricky, although not as tricky as the SSRIs. Recent research has shown that people in the bipolar spectrum have less dense prefrontal cortices than the non-bipolar, and dopamine and norepinephrine reuptake does a lot of work in the prefrontal cortex, so that's probably the reason why. However, when Wellbutrin (bupropion hydrochloride) does trigger mania it's like Zoloft (setraline) in that it's more often a dysphoric mania than a euphoric one. Wellbutrin (bupropion hydrochloride) is generally too be avoided by anyone with a seizure disorder. Allegedly Wellbutrin SR is considered to be better tolerated by people with seizure disorders, but the more recent PI sheets has both the SR and XL forms contraindicated for any with a seizure disorder. One thing that struck me is the wording of the clinical trials of Wellbutrin SR. It looks as if Glaxo screened anyone with the slightest hint of a history or propensity of seizure activity from the SR trials. So while the nature of the SR formulation might be somewhat safer, it might not be all that much safer. I can't state that for a fact, as I haven't read the trials. I have read of people's experiences taking Wellbutrin SR and had a dialogue with a few of them, comparing their experiences with my absence seizures and other petit mal and simple partial events. Too often what they described read as seizure events, despite their having no prior history of seizure a disorder. In any event the chance of seizures with any version of Wellbutrin (bupropion hydrochloride) shoots up exponentially once you start reaching the upper limits of the therapeutic dose, or cross the threshold into experimental ranges. So at the lower to middle range dose, any form of Wellbutrin (bupropion hydrochloride) combined with an anticonvulsant isn't going to be as threatening as long as alcohol and stimulants are avoided. This raises the entire issue, do you want to take Wellbutrin (bupropion hydrochloride) at all at 300-400mg a day? The simple answer is, if it helps you and you neither drink too much nor have a history of seizure events, then go for it! But wait, do you even know what a seizure event is? Here, check out this page of epilepsy symptoms. If you've experienced anything like that in the past, make an appointment to see a neurologist right now. Otherwise what you're looking out for are the simple partial events and the absence seizure events. The simple partial events are reported more often, but here's the deal - often someone has to tell you if you've had an absence seizure. I had absence seizures for over 35 years before Mouse told me that I was having them. They were just written off as being part of my autism. Wellbutrin (bupropion hydrochloride) is really tough on your liver. With the triple metabolism your liver is going to be very busy with Wellbutrin (bupropion hydrochloride). The ever-popular CYP450 enzymes are used for some of the metabolism, other enzymes, as yet unidentified, are used for the other metabolisms. The only warning about alcohol and Wellbutrin (bupropion hydrochloride) concerns seizures. In the real world you don't know what the combination is going to get you, you may be able to hold your liquor better or you may become a total lightweight. In either case expect your hangovers to be much worse than they were before Wellbutrin (bupropion hydrochloride) . I recommend greatly reducing your alcohol intake when taking Wellbutrin (bupropion hydrochloride) , just because of the amount of work your liver does already. Like any reuptake inhibitor Wellbutrin (bupropion hydrochloride) can poop out on you. If it does your only option is the highly experimental off label usage of Mirapex (pramipexole dihydrochloride) or one of the other anti-Parkinson's medications for the dopamine and adding Strattera (atomoxetine) or Edronax (reboxetine) for the norepinephrine. Good luck in getting those prescriptions. In general the slower release forms are better for most people, so XL will be better than SR and SR is better than immediate release. But not always. While the buffering of the release does make the side effects a lot less harsh in almost all cases, for many people the immediate release forms are more effective. Or SR works better than XL. Mileage always varies. I've read conflicting reports if you can cut the SR tablets or not. Personally I advise against cutting up any tablet that isn't immediate release, but check with your doctor and your pharmacist about cutting the SR tablets. You may just wind up with the immediate release flavor. The XL tablets cannot be cut up. |
Other Brand Names / Foreign / Overseas Availability: Zyban (for smoking
cessation)
Buxon (Chile)
Odranal (Argentina, Colombia)
Quomen (Thailand)
Well (Korea)
Wellbutrin SR (Argentina, Canada, Chile, Colombia, Korea, Paraguay, Peru,
Singapore, Uruguay)
Zyban (Brazil, Bulgaria, Canada, Denmark, England, France, Germany, Hong Kong,
India, Ireland, Israel, Korea, New Zealand, Singapore)
Zyban LP (France)
Zyban Sustained Release (Australia)
성분, 웰부트린엑스엘정, 함량 (Well,
Wellbutrin and Zyban respectively, I think, in Korean)
Have questions about Wellbutrin? Want to read about experiences other people have had with Wellbutrin? Check out our Wellbutrin Board.
Who makes Wellbutrin/ Wellbutrin SR / Wellbutrin XL: GlaxoSmithKline
Sample US Cost of Wellbutrin: $152 for 30 tablets of 150mg of Wellbutrin
XL, $90 for 90 tablets of 150mg of
the generic 12-hour bupropion SR. As of this writing you want to avoid the
generic version of the XL forumulation.
As of 03/11/2008. Full retail for the uninsured. Go ahead and gloat, citizens of
civilized countries and all of you with full medical coverage.
Sample Canadian Cost of Wellbutrin:
$172 for 90 tablets of 150mg of Wellbutrin XL. $109 for 60 tablets of
Wellbutrin SR. $65 for 60 tablets of 150mg generic bupropion SR.
As of
03/11/2008. In US dollars, for re-importation to the US. Does not include any
shipping charges.
Per Mosby's Drug Consult the following manufacturers of generic bupropioon produce a generic that has been tested and rated as being actually within the 20% bioequivalence / bioavailability range allowed by law. See the page on Brand vs. Generic medications for more information as well as the board on the Crazy Meds Talk forum. I'm listing manufacturers of the SR flavor only as the XL version of the generic is worthless as of this writing.
Eon Labs Manufacturing Inc and Teva Pharmaceuticals USA (100mg only) Watson Pharmaceuticals (both 100mg and 150mg)
Remedy Find Rating for Depression
Remedy Find Rating for Bipolar Depression
Check for Drug-Drug Interactions
Full US Patient/Prescribing/Physician Information Sheet - immediate release
Full Patient/Prescribing/Physician Information Sheet - SR
Full Patient/Prescribing/Physician Information Sheet - XL
Canadian Monograph from Internet Mental Health
New Zealand Zyban Data Sheet for doctors
UK Zyban Summary of Product Characteristics (What doctors read)
UK Zyban Patient Information Leaflet
Korean 성분, 웰부트린엑스엘정, 함량 PI Sheet.
Please see the section on how to read these sheets. Don't freak out about every potential side effect. Look at the odds of something having happened during the clinical trials.
The Overlords of the 12 Zernox Galaxies have compelled me through messages in the Sunday Chronicle to beg you for funds to help squash the Arachnoid uprising. So if this site has been of use and/or amusement to you, we'd be grateful if you could donate some cash.
Visit the Support Page for how you can help if you don't have any money laying around. This includes reviewing Crazy Meds for Amazon.com and/or
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Crazy Meds Home Crazy Meds Talk About Antidepressants About SSRIs About Anticonvulsants / Mood Stabilizers About Atypical Antipsychotics About Benzodiazepines About Stimulants Finding a Doctor Sites with More Information Support Group Sites About Crazy Meds Visit my autistic - bipolar - epileptic blog
Take care, and keep taking your crazy meds!
Jerod
If you still have unanswered questions about this or other medications, including which
one is, or combination of meds are the best for you, your best bet is to ask on Crazy Meds Talk. Better
yet, if you want to let the world know how they worked out for you and want to help out
others in their quest for the correct meds, join the party.
If you want to discuss your issues, I suggest checking out one of the various
support groups online.
Otherwise, if you're letting me know about how much you like or hate the site, or
need to let me know about medication effects in private, then just drop a note to jerod23
at gmail dot com Honestly, I usually don't have a lot of time to answer e-mail
these days. The snide autoresponse message that may or may not hit your mailbox is
going to tell you the same thing.
Another problem is that you may not get a response even if I wanted to send you one.
You see, so many dickweeds with malicious intents and too much time on their hands have
appropriated the crazymeds.org domain name to use for their spam, viruses and the
like. Subsequently some lazy-ass e-mail protection software authors just go by the
domain name, and not the IP address. So I've been blacklisted because of the actions
of others. Or the software just doesn't like the domain name because of the
"crazy" and/or "meds." Or your question about a particular
medication will set off spam flags. So the e-mail just wouldn't go through
regardless. Sorry.
Hey, did you find this page all by itself through Google or some other search engine? Great! But to really appreciate the entire site, you need to start here.
Dead tree references:
Physicians' Desk Reference Edition 60 Lori Murray Senior Editor, Michael DeLuca, PharmD Drug Information Specialist, et al. © 2006. Published by Thomson PDR.
Mosby's 2007 Drug Consult The editorial review panel is two pages long, from Darrell R. Abernethy, MD, PhD to Karen Zaglaniczny, PhD, CRNA, FAAN. © 2007. An imprint of Elsevier.
Essential Psychopharmacology Stephen M. Stahl, M.D., Ph. D. © 2000. Second edition. Published by Cambridge University Press
Essential Psychopharmacology of Depression and Bipolar Disorder Stephen M. Stahl, M.D., Ph. D. © 2001. Published by Cambridge University Press
The Complete Guide to Psychiatric Drugs Edward Drummond, M.D. © 2000. Published by John Wiley & Sons, Inc.
Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton
End of books used for this article.
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Created Monday, November 10, 2003
Last updated Saturday, December 05, 2009
Copyright © 2003 - 2008 Jerod Poore. All rights reserved.
Almost all of the material on this site is copyright © 2002, 2003, 2004, 2005, 2006, 2007 and 2008 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 the following disclaimer, I'm cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and 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. Nobody on this site is a doctor, therapist, or a pharmacist. We don't portray them either here or on TV. Only doctors can diagnose and treat an illness. Some doctors tend to 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 medication. Self-prescribing is just as dangerous. All information on this site has been obtained through personal experience, the experiences of my friends, the experiences of people reported on online support groups, and from sources that are referenced throughout the site. Know your sources! As such the information presented here is not a substitute for real medical advice from your real doctor, just a compliment to it. No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. All brand names of the drugs listed in this site are the trademarks of the companies listed after them in the pages about the drugs, even though those companies may or may not have been acquired by other companies who may or may not be listed in this site by the time you read this. Always read the PI sheet that comes with your medications and never ever throw them away. If you didn't get a PI sheet, demand one. Loudly. Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they're paid advertisements, or they're something you should read to 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. Very little information about visitors to this site is collected or saved. And from time to time I do look at search terms used to find it in an effort to make the information I present more relevant. Use only as directed. Void where prohibited.
"Everything is true, nothing is permitted." - Jerod Poore
