Drugs On Review

What is Wellbutrin?

Wellbutrin is GlaxoSmithKline’s brand name for bupropion, a non-tricyclic antidepressant. It is an aminoketone and is believed toinhibit reuptake of norepinephrine and dopamine. It binds selectively to dopamine and is also a nicotinic acetylcholine receptor antagonist

Wellbutrin acts by selectively inhibiting the reuptake of norepinephrine and dopamine.

What does Wellbutrin look like?

Wellbutrin is sold as a round pill in a wide range of colors, each representing a different strength. The strength of Wellbutrin pills ranges from 75 to 300 mg. All pills are imprinted with “Wellbutrin” and the strength in milligrams. There are also several slow release versions of the drug.

Wellbutrin dosing and administration

In treating depression, the standard starting dose of Wellbutrin is 100 mg twice daily increasing after several days to 100 mg three times daily. Because Wellbutrin carries a risk of seizure, no individual dose should be more than 150 mg. No more than 450 mg total should be taken in any 24 hours period. Because it may take up to four weeks for the drug to reach peak levels, any titration of the dose will be done very gradually. Wellbutrin may be taken with or without food. If possible you should avoid taking the final dose of the day close to your bedtime because one possible side effect of this drug is insomnia. Wellbutrin should be taken at the same time each day to maintain a stable blood plasma concentration.

Common adverse effects from Wellbutrin

The most common side effects of Wellbutrin are agitation, dry mouth, constipation, headaches, nausea or vomiting, vertigo, sweating, tremors, insomnia, anorexia, vision disturbances, tachycardia, confusion, aggression, cardiac arrhythmia and hearing disturbances. Less common are menstrual problems, hypertension, palpitations, increased appetite, dyspepsia, decrease in libido, erectile dysfunction, taste disturbances, hypotension and fainting. Serious side effects of Wellbutrin which should be reported to your doctor immediately include seizures, suicidal ideation, anxiety or panic attacks, risk-taking behavior, restlessness, mood swings, hallucinations or allergic reactions. In very rare cases Wellbutrin may cause hair loss, acne, ulcers, chest congestion, high or low blood glucose levels, memory loss and redness of the skin.

Wellbutrin and sexual side effects

Wellbutrin may diminish libido in up to 3.1 percent of patients but may also be responsible for an increase in sex drive. Erectile dysfunction and the inability to ejaculate have also been reported.

Wellbutrin warnings and precautions

Because of the risk of seizure at the beginning of therapy it is important that the dosage of Wellbutrin be begun at a low level and gradually increased to a therapeutically effective level. It is also important to discuss any history of heart, liver, kidney or bipolar disorder with your doctor before beginning Wellbutrin therapy. It is also important for the doctor to make a careful differential diagnosis of depression as bipolar disorder may sometimes present with very similar symptoms to depression. Any family history of bipolar disorder should also be taken into account. Like all antidepressants, Wellbutrin may be responsible for suicidal ideation or behavior and other behavioral disturbances including anxiety, agitation, aggression, hyperactivity and hallucinations.

Interactions with Wellbutrin

Wellbutrin is known to interact with alcohol, other antidepressants, antipsychotics, amantadine, all beta blockers, arrhythmia drugs, Plavix, cyclophosphamide, doxorubicin, efavirenz, monoamine oxidase inhibitors, nelfinavir, nicotine therapy, orphenadrine, ritonavir, lopinavir, steroids, theophylline, thiotepa and ticlopidine.

Wellbutrin and pregnancy

Wellbutrin has been shown to increase the risk of birth defects and low fetal weight in rabbits. However depression may also have a negative effect in pregnancy and the risk of Wellbutrin side effects must be weighed against this.