Depression can feel frustrating, even overwhelming, if you can’t access personalized care. For those suffering from this mental illness, taking antidepressants could be a significant step towards improving their mental health.

Commonly known by the brand names Wellbutrin, Zyban, Budeprion SR, Aplenzin, Buproban, and Forfivo XL, one medication often used to treat depression is bupropion. On this page, we’ve outlined some important information about the drug.

What is bupropion?

What is bupropion? How does it work?

Bupropion is an antidepressant approved to treat conditions such as depression, seasonal affective disorder and smoking cessation. It may sometimes be used off-label to treat attention-deficit/hyperactivity disorder (ADHD) or depression associated with bipolar disorder.

Bupropion belongs to a class of medications called norepinephrine-dopamine reuptake inhibitors (NDRI); they also are nicotine receptor antagonists. NDRIs work by stopping the removal of neurotransmitters, norepinephrine and dopamine from the brain. These chemicals are usually present in low levels in those with depression, and balancing the levels of these neurotransmitters can help improve mood and reduce depressive episodes. It also works as on nicotine receptors in the brain to help reduce nicotine cravings and withdrawal in smokers.

How is bupropion typically used?

Bupropion is often taken orally, one tablet once or twice daily. The medication may be taken with or without food. The recommended dose in most cases is one 100 mg tablet twice daily initially, but this may be increased by a doctor in patients not responding to lower doses. In many cases, doctors start patients on a low dose to ramp it up over time to prevent negative reactions. 

It may take months before you observe the full effects of the medication. However, you should not stop the use of bupropion without first talking to your doctor as the medication should not be stopped abruptly. If you need to stop bupropion, your doctor would help achieve this safely by lowering your dose over time till it is safe to stop completely. 

If you miss a dose of the medication, try to take it as soon as possible. However, if you remember the missed dose close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule to avoid taking double doses.  

Bupropion should not be taken by people with an allergy to bupropion, epilepsy/seizure disorder, anorexia or bulimia, people who are taking MAOI antidepressants, or those who abruptly stop alcohol or benzodiazepine medications.

What are some possible side effects?

Some common side effects of bupropion include:

• Anxiety
• Excitement
• Drowsiness
• Difficulty falling asleep or staying asleep
• Constipation
• Dry mouth

Some serious (but uncommon side effects) include:

• Seizures
• Confusion
• Rash or blisters
• Hallucinating 
• Rapid, pounding, or irregular heartbeat fever
• Suicidality

Call 911 or seek emergency care if you notice any severe side effects. You can find a more comprehensive list of bupropion side effects here. 

Why do these side effects occur? 

Any medication can potentially lead to side effects, and a person’s likelihood of having side effects depends on many factors, including age, lifestyle, and the type of medication itself. Side effects may occur because drugs often have broad or poorly targeted effects, or the drug target itself may have many downstream effects on the body. 

Bupropion increases the levels of norepinephrine and dopamine in the brain for its therapeutic effects. These neurotransmitters are also involved in some other activities of the body like heart rate or sleep. An increased level of these neurotransmitters can affect these other activities.    

Many non-serious side effects of mental health medications like bupropion go away after a few weeks as your body gets used to the medication. However, if a side effect persists, is intolerable, or severely hinders your ability to go about your daily life, talk to your doctor, because this might be a sign that the medication is not a good fit. 

How do your genes relate to bupropion? 

Genetics can affect your body’s response to medication. Bupropion reduces the activities of CYP2D6. Other medications that are broken down by CYP2D6 would be broken down more slowly when taken alongside bupropion. These drugs stick around in your body for longer than average and may lead to side effects. To prevent this, drugs that are broken down by the CYP2D6 gene are to be avoided when taking bupropion. 

One way to predict whether you’ll have a positive outcome while taking bupropion is by taking a genetic test to determine what genetic variations you have and how they affect medication metabolization. Your DNA can help your doctor rule out less suitable medications and make more informed decisions so that you can get better, faster.

Special Precautions

• Patients with kidney and liver conditions might require dosage adjustment when using bupropion. 
• Bupropion can only be used by pregnant and breastfeeding mothers with the prescription of a doctor who should ensure the benefits of the medication are more than any existing risks.
• Your doctor should be notified of any other medications you are taking to ensure they are safe to take alongside bupropion. 
• Also notify your doctor if you have any history of eating disorders, seizures, anxiety, diabetes, head injury, glaucoma before taking bupropion. 

If you show signs of an allergic reaction to bupropion (hives, difficulty breathing, rash, swelling), call 911 or go to the nearest emergency department.

Some medications, vitamins, and herbs may interfere with now bupropion works. Make sure to tell your doctor about all other medications you are taking before starting bupropion to avoid negative interactions. For full details, see the FDA’s full list of precautions. 

Looking to find the right medication for your mental health? Join Prairie today to connect to expert providers and affordable medication options.