WARNING

Bupropion, commonly known by the brand name Wellbutrin, is an antidepressant medication used to treat depression and seasonal affective disorder. While it can be effective for many people, there are several risks associated with its use:

• Seizures: Bupropion can lower the seizure threshold, especially at higher doses or in individuals with certain medical conditions, such as a history of seizures or eating disorders.
• Psychiatric Effects: Some people may experience new or worsening psychiatric symptoms such as anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, or restlessness while taking bupropion.
• Suicidal Thoughts: Like many antidepressants, bupropion may increase the risk of suicidal thoughts or behavior, particularly in children, teenagers, and young adults.
• Serotonin Syndrome: Bupropion can interact with other medications to cause serotonin syndrome, a potentially life-threatening condition characterized by symptoms such as confusion, hallucinations, fever, sweating, shivering, shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea.
• Hypertension: Bupropion may increase blood pressure, which can be problematic for individuals with hypertension or cardiovascular disease.
• Allergic Reactions: In rare cases, bupropion can cause allergic reactions such as rash, itching, swelling, severe dizziness, or trouble breathing.
• Other Side Effects: Common side effects of bupropion include dry mouth, headache, nausea, constipation, sweating, and tremor.

It’s important for individuals considering bupropion to discuss these risks with their healthcare provider and to be closely monitored during treatment, especially during the initial stages of medication initiation or dose adjustment.

Why is this medication prescribed?

Bupropion is primarily prescribed for the treatment of depression, but it is also used to help people quit smoking by reducing cravings and withdrawal symptoms. Additionally, it can be prescribed off-label for conditions such as seasonal affective disorder (SAD), attention deficit hyperactivity disorder (ADHD), and as an adjunct treatment for bipolar disorder.

How should this medicine be used?

When using bupropion, it’s important to follow your healthcare provider’s instructions carefully. Here are some general guidelines for how bupropion should be used:

• Dosage: The dosage of bupropion varies depending on the condition being treated and individual factors such as age and medical history. Your healthcare provider will determine the appropriate dosage for you.
• Timing: Bupropion is usually taken orally, either once or twice daily. For depression, the extended-release formulation is typically taken once daily in the morning. For smoking cessation, the immediate-release formulation may be taken twice daily.
• Consistency: It’s important to take bupropion regularly and at the same time(s) each day for the best results. Do not stop taking bupropion suddenly without consulting your healthcare provider, as this can cause withdrawal symptoms.
• Duration: Continue taking bupropion for the full duration prescribed by your healthcare provider, even if you start to feel better. It may take several weeks for the medication to take full effect.
• Quitting Smoking: If you are using bupropion to quit smoking, it’s often recommended to start the medication 1 to 2 weeks before your quit date. This gives the medication time to build up in your system and can improve its effectiveness in reducing cravings and withdrawal symptoms.
• Monitoring: Your healthcare provider may need to monitor your progress and adjust your dosage as needed. Be sure to attend all follow-up appointments and report any side effects or concerns.

Always consult your healthcare provider for personalized advice on how to use bupropion safely and effectively for your specific condition.

Other uses for this medicine

Some of these off-label uses may include:

• Seasonal Affective Disorder (SAD): Bupropion may be used to alleviate symptoms of SAD, a type of depression that occurs at the same time every year, usually during the fall and winter months.
• Attention Deficit Hyperactivity Disorder (ADHD): Bupropion is sometimes used off-label as an alternative or adjunct treatment for ADHD, particularly in adults.
• Bipolar Disorder: In some cases, bupropion may be used as an adjunct treatment for bipolar disorder, often in combination with mood stabilizers or other medications.

What special precautions should I follow?

Special precautions should be taken when using bupropion. Here are some important considerations:

• Seizure Risk: Bupropion can lower the seizure threshold, increasing the risk of seizures, especially at higher doses. Individuals with a history of seizures, eating disorders, or certain medical conditions should use bupropion with caution.
• Psychiatric Symptoms: Some people may experience new or worsening psychiatric symptoms such as anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, or restlessness while taking bupropion. Close monitoring is necessary, especially during the early stages of treatment.
• Suicidal Thoughts: Like many antidepressants, bupropion may increase the risk of suicidal thoughts or behavior, particularly in children, teenagers, and young adults. Patients should be closely monitored, especially when starting treatment or adjusting the dosage.
• Serotonin Syndrome: Bupropion can interact with other medications to cause serotonin syndrome, a potentially life-threatening condition characterized by symptoms such as confusion, hallucinations, fever, sweating, shivering, shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Inform your healthcare provider about all medications you are taking to avoid interactions.
• Hypertension: Bupropion may increase blood pressure, so individuals with hypertension or cardiovascular disease should use it cautiously and under close medical supervision.
• Allergic Reactions: In rare cases, bupropion can cause allergic reactions such as rash, itching, swelling, severe dizziness, or trouble breathing. Seek medical attention immediately if you experience any allergic symptoms.
• Pregnancy and Breastfeeding: The safety of bupropion during pregnancy and breastfeeding is not well-established. Consult your healthcare provider before using bupropion if you are pregnant, planning to become pregnant, or breastfeeding.

Always discuss any concerns or questions about bupropion with your healthcare provider before starting or adjusting treatment. They can provide personalized guidance based on your medical history and individual needs.

What special dietary instructions should I follow?

Regarding dietary instructions, there are no specific dietary restrictions for bupropion. However, it’s essential to maintain a balanced diet and stay hydrated while taking the medication, as with any antidepressant.

What should I do if I forget a dose?

• If it’s close to the time of your next dose: Skip the missed dose and take your next dose at the regular time. Do not double the dose to make up for the missed one.
• If there’s significant time before your next dose: Take the missed dose as soon as you remember. However, if it’s nearing the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.

What side effects can this medication cause?

Bupropion, like any medication, can cause side effects. Not everyone experiences side effects, and their severity can vary from person to person. Some common side effects of bupropion include:

• Dry mouth: Bupropion can reduce saliva production, leading to a dry sensation in the mouth.
• Headache: Some individuals may experience headaches while taking bupropion.
• Nausea: Bupropion can cause feelings of nausea or stomach discomfort in some people.
• Insomnia: Difficulty falling asleep or staying asleep may occur, especially when bupropion is taken close to bedtime.
• Agitation or restlessness: Bupropion can sometimes increase feelings of agitation or restlessness, particularly at higher doses.
• Tremor: Shaking or tremors in the hands or other parts of the body may occur as a side effect of bupropion.
• Increased sweating: Some individuals may notice increased sweating while taking bupropion.
• Changes in appetite: Bupropion can affect appetite, leading to changes in eating habits or weight.
• Dizziness: Feeling lightheaded or dizzy may occur, especially when standing up quickly from a sitting or lying position.
• Rash or itching: In rare cases, bupropion can cause allergic reactions such as rash or itching.

It’s essential to report any side effects to your healthcare provider, especially if they are severe, persistent, or concerning. Your healthcare provider may be able to adjust your dosage or suggest strategies to manage side effects effectively. Additionally, some side effects may diminish over time as your body adjusts to the medication.

What should I know about storage and disposal of this medication?

When it comes to storing and disposing of bupropion:

• Storage: Store bupropion at room temperature away from moisture and heat. Keep it tightly closed in its original container, out of reach of children and pets.
• Disposal: Dispose of unused or expired bupropion properly. Do not flush it down the toilet or pour it down the drain unless instructed to do so. Instead, check with your pharmacist or local waste disposal company for guidance on how to dispose of medications safely.

In case of emergency/overdose

• Seek medical attention: If you suspect an overdose of bupropion or experience severe symptoms such as seizures, loss of consciousness, rapid heartbeat, hallucinations, or severe confusion, seek immediate medical help. Call your local emergency services or go to the nearest emergency room.
• Poison control: You can also contact your local poison control center at 1-800-222-1222 (in the United States) for guidance on what to do in case of an overdose.

What other information should I know?

• Regular monitoring: Your healthcare provider may need to monitor your progress and adjust your dosage as needed. Attend all follow-up appointments and report any side effects or concerns.
• Avoid alcohol: Limit or avoid alcohol consumption while taking bupropion, as it can increase the risk of side effects such as seizures and dizziness.
• Inform healthcare providers: Make sure to inform any healthcare providers involved in your care (such as doctors, dentists, and pharmacists) that you are taking bupropion. This includes disclosing any other medications, supplements, or herbal products you are using.
• Pregnancy and breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of using bupropion with your healthcare provider. The safety of bupropion during pregnancy and breastfeeding is not well-established.
• Driving and operating machinery: Bupropion may cause dizziness, drowsiness, or blurred vision. Use caution when driving or operating machinery until you know how bupropion affects you.
• Medication interactions: Bupropion can interact with other medications, including prescription drugs, over-the-counter medications, and herbal supplements. Inform your healthcare provider about all medications you are taking to avoid potential interactions.

By following these guidelines and staying informed about bupropion, you can use the medication safely and effectively under the guidance of your healthcare provider.