Wellbutrin (Bupropion): Uses, Side Effects, Dosage

Wellbutrin — also known by the generic name bupropion — is a widely used antidepressant in the class of drugs known as norepinephrine-dopamine reuptake inhibitors (NDRIs). NDRIs are believed to alter levels of the neurotransmitters dopamine and norepinephrine in the brain, which help relieve symptoms of depression. This makes Wellbutrin a popular choice for treating major depressive disorder (MDD) and seasonal affective disorder (SAD), among other mental health conditions. 

It’s estimated that more than 29 million people use Wellbutrin. If you’re considering taking it, it’s important to learn what it is, how it works, pros and cons, side effects, dosage information, and more. 

Read on to learn more about Wellbutrin and all that you should know about this antidepressant. 

What is Wellbutrin?

Wellbutrin is an FDA-approved atypical antidepressant medication that’s used to treat some types of depression and help with smoking cessation. It’s also sometimes prescribed off-label — that is, not FDA-approved for the use of, but has been found to help — to treat symptoms of attention-deficit hyperactivity disorder (ADHD) and other mental health conditions. 

Wellbutrin treatment is thought to work by stopping the transport of the neurotransmitters dopamine and norepinephrine back into nerve cells, effectively boosting levels in the brain to improve mood, motivation, stress response, and other things related to depressive symptoms. 

Wellbutrin Uses

Wellbutrin comes in two forms — Wellbutrin XL (extended-release, which also comes in the generic bupropion XL) and Wellbutrin SR (sustained-release, also available via bupropion SR). Although they work the same way and have the same active ingredient, Wellbutrin XL differs in that it’s an extended-release drug that’s released into the body more slowly and stays in your system longer. Follow the medical advice of your psychiatrist or healthcare provider to determine which form of Wellbutrin treatment you should take.

Wellbutrin uses include:

Wellbutrin XL: Treats depression and can help prevent seasonal affective disorder.

Wellbutrin SR: Treats depression and can help some people quit smoking by reducing nicotine withdrawal symptoms. 

Depression

Wellbutrin increases dopamine and norepinephrine levels in the brain by preventing reabsorption. When levels of these neurotransmitters stay elevated, they can effectively reduce or relieve symptoms of depression. There is much research that supports the efficacy of Wellbutrin in treating major depressive disorder (MDD). One meta-analysis found that the drug was effective in reducing depression scores in 24 out of 27 trials. 

Depression symptoms often include: 

Feelings of persistent sadness

Loss of interest in things once found pleasurable

Change in appetite 

Change in sleep patterns

Feelings of worthlessness or guilt

Having difficulty concentrating or making decisions 

Seasonal affective disorder

Seasonal affective disorder (SAD) is a type of depression that comes with the changing of the seasons. It can cause a seasonal pattern marked by lack of energy, change in appetite, weight gain, excessive sleeping, and loss of interest in activities once enjoyed. 

In studies, when started in the fall, Wellbutrin XL was found effective in preventing recurrent symptoms related to SAD. Though symptoms can (and often do) resolve on their own in the spring and summer months, people who have an intense experience might benefit from a drug like Wellbutrin. 

Off-label uses might include:

Anxiety

Sexual dysfunction

Fatigue

Some anxiety disorders — like PTSD and social anxiety disorder

Attention-deficit hyperactivity disorder (ADHD)

Pros & Cons of Wellbutrin

Pros of WellbutrinCons of WellbutrinEffective antidepressantPotential side effects include dry mouth, headache, insomnia, nausea, agitationCan be effective in people who don’t see improvement in depression symptoms with other classes of drugsMay increase blood pressureLow risk of weight gain from WellbutrinMust be dosed carefully to reduce the risk of some side effects, like seizuresNegative sexual side effects are less commonNot suitable for people with a history of seizures, eating disorders, and some psychiatric conditionsMight help reduce cravings and withdrawal symptoms in people who are quitting smokingCan take several weeks before seeing/feeling the full effects

Side Effects of Wellbutrin

Like any drug, Wellbutrin has the risk of side effects. In general, studies show that Wellbutrin is well-tolerated, with low rates of sexual dysfunction and the possibility for weight loss instead of weight gain (which is a potential side effect of most other antidepressants). Not everyone will experience these Wellbutrin side effects, but it’s important to know what to look for if you start taking this drug. If you begin to experience side effects not listed on the boxed warning label, reach out to a medical professional. 

Some potential side effects of Wellbutrin include: 

Dry mouth

Headache

Insomnia

Nausea

Agitation

Constipation

Dizziness

Sweating

Increased heart rate

Tremor

Blurred vision

Loss of appetite

Weight loss

Anxiety

Irritability

Seizures (rare but can be more common at higher doses)

High blood pressure (especially at higher doses or for someone with preexisting hypertension)

Wellbutrin Dosage

Optimal Wellbutrin dosage will vary from person to person depending on factors like age, weight, the condition being treated, other conditions and medications, family history, and more. 

You should always discuss dosage with your doctor to ensure you take the appropriate amount for your symptoms and condition. 

Take Wellbutrin exactly as directed. Do not chew, crush, or break Wellbutrin extended-release tablets — they should always be swallowed whole. 

Forms

Wellbutrin comes in multiple forms – tablets are available in:

Sustained-release (SR)

Extended-release (XL)

Dosage

Dose will depend on the condition being treated and symptom severity, among other things. 

Major depressive disorder (MDD): The starting dose is usually 100 – 150 mg 1 – 2 times daily. After a few days, your doctor might increase your dose to 3 times per day. The maximum dose is 300 – 450 mg daily, depending on which form your doctor prescribes.

Seasonal affective disorder: The starting dose is generally 150 mg per day. After a week (7 days), your dose may be increased to 300 mg once per day. Treatment often begins in the fall, before symptoms start, and is typically discontinued in the early spring.

Additional Considerations

Beyond dosing considerations, there are other factors to keep in mind if you’re planning to take Wellbutrin for depression. For example, you should try to take this medication at or around the same time daily. This ensures a stable and consistent level of the drug in your bloodstream, maximizing efficacy. 

You can take Wellbutrin with or without food, but you should avoid alcohol as it can increase the risk of seizures or other side effects. 

Interactions

All drugs have the risk of interacting with other medications. For this reason, it’s essential to inform your doctor of anything else you’re taking besides Wellbutrin. This includes natural or over-the-counter (OTC) supplements or vitamins. 

Drugs known to interact with Wellbutrin include:

Selective serotonin reuptake inhibitors (SSRIs) 

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Monoamine oxidase inhibitors (MAOIs)

Tricyclic antidepressants (TCAs)

Antipsychotic medications

Anticonvulsant medications

Nicotine replacement therapy (NRT)

Alcohol

Warnings

Wellbutrin can increase your risk for serious health conditions. Warnings when taking this drug can include, but aren’t limited to, the following:

Increased risk of seizure

Psychiatric symptoms, like an increase in suicidal thoughts and behaviors

Neuropsychiatric events, such as hallucinations, increased agitation, paranoia, delusional thinking, and mania in some people

Hypertension 

Allergic reactions — while rare, cases of angioedema (extreme swelling) and anaphylaxis (a severe, potentially life-threatening allergic reaction) have been reported in some people who take Wellbutrin

“Wellbutrin is not to be taken in a patient with a history of seizures. If taken, it increases the likelihood of them having another seizure.”

– Talkspace psychiatrist Dr. Dion Metzger, MD

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are considered the gold standard treatment for depression. They improve mood and emotion by upping serotonin levels in the brain. SSRIs are often the first type of drug that’s tried because they’re generally well-tolerated and have fewer side effects than some other types of antidepressants. 

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) block the reabsorption of both serotonin and norepinephrine in the brain. These neurotransmitters are important in mood regulation, memory, and the sleep-wake cycle. 

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are an older class of drugs and typically are only suggested if SSRIs and SNRIs haven’t reduced depression symptoms. TCAs were initially developed for psychotic episodes but were later found to effectively treat depression in some people. 

Atypical antidepressants

If Wellbutrin (which is also an atypical antidepressant) doesn’t seem to be working, your doctor may decide to start you on a different medication in this same class. Some other atypical antidepressants can be an excellent alternative to Wellbutrin.

“An alternative to Wellbutrin is an SNRI (Serotonin and Norephrine Reuptake Inhibitor) such as Pristiq or Effexor XR. SNRI’s can boost the neurotransmitter norepinephrine to help with concentration and energy, similarly to Wellbutrin’s benefits.”

– Talkspace psychiatrist Dr. Dion Metzger, MD

Get Wellbutrin Prescribed Online

Before you can get a prescription for Wellbutrin online, you’ll need a diagnosis from a licensed doctor or mental health provider like a psychiatrist. Talkspace offers convenient, affordable, and easily accessible online therapy and medication consultations, prescriptions, and management. 

Talkspace is a reliable resource for all your mental health needs. You’ll be connected with a qualified professional who’s experienced and ready to help. 

You don’t have to live in the grips of depression or another mental health condition. Talkspace can help you with therapy and, if needed, medication so you can take charge of your mental health and get back to living a healthy, happy, productive life. 

Connect with an online psychiatrist about Wellbutrin today.