Brand & Generic Names; Drug Classes
|US brand name: Wellbutrin|
|Generic name: bupropion|
|Primary drug class: Antidepressants|
|Additional drug class(es): Miscellaneous - as Zyban|
Approved & Off-Label Uses (Indications)
Wellbutrin’s US FDA Approved Treatment(s)Major depressive disorder. The extended release (XL) flavor is also approved for seasonal affective disorder (SAD)
Uses Approved Overseas but not in the US
The US and Canada are the only countries I’ve found so far where bupropion is approved as an antidepressant. Everywhere else on the planet where you find bupropion it’s approved only for smoking cessation, usually under the Zyban trade name.
Off-Label Uses of WellbutrinWeight loss, Bipolar depression, ADD/ADHD, Crohn’s disease, Restless leg syndrome (RLS), Pathological gambling, Treating SSRI/SNRI-induced sexual dysfunction.
When & If Wellbutrin Will Work
Wellbutrin’s Usual Onset of Action (when it starts working)
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.
Taking and Discontinuing
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 SR 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. Assuming you have the luxury of not feeling like killing yourself every hellish hour you’re awake.
How to Stop Taking Wellbutrin (discontinuation / 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).