US Brand Name: Wellbutrin / Wellbutrin SR / Wellbutrin XL

Other Brand Names: Zyban (for smoking cessation)
Odranal (Colombia)
Quomen (Thailand)
Well 웰부트린 (Korea)
Zyban LP (France)
Zyban Sustained Release (Australia)
Generic Name: bupropion hydrochloride

Other Forms: Wellbutrin SR, Wellbutrin XL,

What is Wellbutrin / Wellbutrin SR / Wellbutrin XL: Wellbutrin/ Wellbutrin SR / Wellbutrin XL is an antidepressant, specifically a multiple reuptake inhibitor
Read up on these sections if you haven’t done so already, because they cover a lot of information about multiple medications that I’m not going to repeat on many pages.  I’m just autistic that way about not repeating myself.

What are Wellbutrin / Wellbutrin SR / Wellbutrin XL’s FDA Approved Uses: Depression, Smoking Cessation (as Zyban)

What are Wellbutrin / Wellbutrin SR / Wellbutrin XL’s Off-Label Uses: Weight Loss, Bipolar Depression, ADD/ADHD, Fibromyalgia, Arthritis, Chronic Fatigue, Multiple Sclerosis, Lupus, Headaches, Irritable Bowel Syndrome (IBS)

Wellbutrin / Wellbutrin SR / Wellbutrin XL’s pros and cons:  Pros: Low chance of sexual side effects, unless you consider making you hornier a sexual side effect. Amongst the currently approved antidepressantsWellbutrin (bupropion hydrochloride) has the least chance of triggering mania in the bipolar.  No weight gain associated with SSRIs. Often a very effective antidepressant, as dopamine and norepinephrine reuptake are sometimes the answer for someone.

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.

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.

For all side effects read the PI sheet  Hell, read all of them below and really indulge your cyberchondria.

Interesting Stuff Your Doctor Probably Won’t Tell You: You can’t mix 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).
When you’re fully saturated with the medication and less prone to peaks and valleys of effects. You still might have peaks of effect after taking many meds, but with a lot of the meds you’ll have fewer valleys after this point. In theory anyway.

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 seethe 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.

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.

 

 

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