Wellbutrin in Mental Health: What Is Bupropion Used for and How Does It Work?
When mental health issues such as depression become too much of a challenge to cope with, the option of medication might enter the equation. Medication can help create a more stable foundation for focusing on long-term recovery, but each type can have different benefits and side effects.
If bupropion comes up in a conversation about mental health treatment, a variety of questions might run through your mind. And looking the medication up online may not help clarify any concerns. You may even come across varying opinions on bupropion’s benefits – from people calling it a “wonder” drug, to others thinking it did nothing for their symptoms.
Mission Connection can help shed light on whether bupropion is a suitable option for your symptoms and needs. This article can also help, as it covers…
- What bupropion (Wellbutrin) is
- How bupropion works for treating mental health conditions
- The conditions bupropion is used for
- Signs Wellbutrin is working
- Guidance on the appropriate bupropion dosage
- Bupropion side effects and risks
- How to taper bupropion
- Answers to frequently asked questions about bupropion
- Where to find professional mental health support and guidance
What Is Bupropion (Wellbutrin)?
In contrast to the majority of other antidepressants, such as SSRIs, SNRIs, and tricyclics, bupropion is known as an “atypical” antidepressant, meaning it doesn’t fit a specific category of medications. It’s a unique drug that has its own mechanism of action to improve the symptoms of mental health conditions.
Although bupropion works differently from the classic forms of antidepressants, it’s still been proven to effectively manage the symptoms of mental health issues. In fact, for many people, it works as well as other meds, including selective serotonin reuptake inhibitors (SSRIs).2
Bupropion isn’t the only atypical antidepressant. There are a variety of others which can be used to treat different conditions, including:
Trazodone (Desyrel)- Mirtazapine (Remeron)
- Nefazodone
- Vilazodone (Viibryd)
- Vortioxetine (Trintellix)
- Eskatamine (Spravato)
How Bupropion Works for Treating Mental Health Conditions
What we do know is that, similar to SSRIs and SNRIs, bupropion blocks the absorption of certain chemicals in the brain that affect mood. In the case of bupropion, these chemicals are norepinephrine and dopamine. For this reason, bupropion is sometimes called an NDRI (norepinephrine and dopamine reuptake inhibitor).
Yet, bupropion’s effects on brain chemicals may be milder than other medications. Plus, it doesn’t inhibit serotonin absorption in the way that SSRIs and SNRIs do. For this reason, bupropion may be better tolerated by people who don’t respond well to SSRIs and SNRIs.
However, evidence suggests that bupropion does produce a mild stimulant effect. Which, in combination with its unique effect on brain chemicals, may result in successful treatment of symptoms for certain people.3 In other words, while our knowledge of how bupropion works is limited, what we do know is that it can be effective for the right set of symptoms and needs.
Your provider can discuss the option of bupropion for your symptoms. While bupropion has recently been recommended as a first-line treatment for conditions such as major depression and treatment-resistant depression, other treatments may be more suitable for your needs.4
What Is Bupropion Used to Treat?
As mentioned, bupropion is primarily prescribed for treating depression, but it’s also suitable for easing the symptoms of seasonal affective disorder (SAD) and nicotine cravings. It can also be prescribed off label. Off label means that a provider may use bupropion for treating a condition it hasn’t been approved for. This isn’t something to be alarmed by; off label prescribing often happens when other options haven’t worked or there’s no available treatments.
For instance, bupropion is sometimes used to treat the depressive episodes in bipolar disorder and issues associated with attention-deficit hyperactivity disorder (ADHD).5 The following information covers some of the conditions bupropion is most commonly prescribed for and why.
Wellbutrin for Depression
According to the National Institute of Mental Health (NIMH), roughly 21 million adults in the U.S. experienced at least one depressive episode in 2021. Unfortunately, depression can be highly difficult to cope with, as it can lead to ongoing feelings of hopelessness and loss of interest in activities.
Recent guidelines on depression suggest that bupropion works well as a first line medication for moderate to major depression, often easing symptoms when other treatments have proven to be ineffective. However, the biggest barrier reported seems to be the availability of the medication and patient preferences for another type of drug.4
Wellbutrin for ADHD
Yet, some of the recent research around bupropion’s benefits for ADHD show mixed outcomes. While it may work to ease symptoms and tends to have low risks of side effects, it may be best for people with mild issues.6 However, when all the information is pooled together, it appears that extended release bupropion may provide some relief.
Bupropion and Smoking Cessation
Smoking cessation refers to the efforts people make when trying to give up smoking, including behavioral techniques and medication. Bupropion is FDA approved for helping people give up smoking, as it is a safe and affordable smoking cessation drug. It works by targeting the dopamine receptors in the brain, reducing nicotine cravings.
Studies show that bupropion can help one in five people quit smoking, but it has been linked to side effects such as dry mouth and insomnia. However, these could be symptoms of nicotine withdrawal, not bupropion side effects.7
Signs Wellbutrin Is Working
In general, the National Alliance on Mental Health reports that sleep, energy, and appetite may be the first signs that Wellbutrin is working, with benefits starting at the one to two week mark. However, it may take up to two months for the more severe symptoms of conditions such as depression to improve.8
If it takes time for you to see an improvement, try not to be discouraged. Pay attention to the earlier signs and use them as guidance that the drug is having a physical effect. If you continue to be concerned, speak to your provider. They may consider upping your dosage or trialing another medication.
What Is the Appropriate Bupropion Dosage?
The bupropion dosage typically depends on different factors, including age, symptoms, and reaction to the medication. The following chart covers the recommended dosage for varying conditions – your provider will typically start you on the lowest dose before shifting up to the maximum required for seeing improvements.
Bupropion Dosage List:9
Bupropion comes in immediate release (IR), sustained release (SR), and extended release (ER) form. The following chart covers the typical dosage for bupropion hydrochloride.
- Depression:
- Immediate Release form: Typically started at 100 mg two to three times daily, with a maximum dosage of 450 mg divided into up to four doses throughout the day.
- Sustained Release form: Usually begins at 150 mg one to two times daily, with a maximum daily dosage of 400 mg, ensuring that each dose doesn’t exceed 200 mg.
- Extended Release tablets: Started at 150 to 300 mg once daily, with a maximum of 450 mg per day.
- Depression:
- Seasonal Affective Disorder:
- Immediate Release form: Generally prescribed at a dose of 150 to 300 mg once daily, with a maximum of 300 mg per day.
- Sustained Release form: Given at 174 to 348 mg once daily, with the upper limit being 348 mg daily.
- Smoking Cessation:
- Typically treated with the sustained-release formulation, which usually lasts between 7 and 12 weeks. The starting dose is 150 mg one to two times per day, with a maximum total daily dose of 300 mg, divided into doses that do not exceed 150 mg each.
If you’re prescribed bupropion off-label, your provider will discuss the most suitable dosage based on your needs, symptoms, and reaction.
Bupropion Side Effects
Like all antidepressants, bupropion comes with a risk of side effects. However, these side effects tend to be minimal in comparison to other antidepressants, especially for those who don’t react well to SSRIs. For instance, bupropion typically causes less weight gain and sexual dysfunction than other medications.10
Yet bupropron can still cause side effects for some people, including the following. These issues should ease after a few weeks, but if they don’t your provider may discuss lowering your dose or switching meds.
Common Wellbutrin Side Effects:8
- Headaches
- Appetite and weight changes (typically loss)
- Sleep difficulties
- Dry mouth
- Difficulties falling or staying asleep
- Nausea
- Sweating
- Dizziness
- Rapid heartbeat
- Sore throat
As you get used to the medication, these effects should ease. However, there are some more serious bupropion side effects which are important to be aware of when starting treatment.
Serious Bupropion Side Effects:
- Rash
- Ringing in the ears
- Stomach and muscle pains
- Unusual thoughts or behaviors, such as delusions
- Anxiety or agitation
- Tremors or shaking
- Stomach or muscle pain
- Increased urination
- Eye pain or changes in vision
Less than 10% of people will experience these side effects. However, if you do, it’s important to contact your provider immediately. The risk of seizures and heart issues with bupropion is low, but can increase when the dosage goes up. Your provider will monitor for any physical changes, including evaluating cardiovascular health.8
Stopping Wellbutrin Safely: How to Taper Bupropion
Stopping bupropion suddenly could lead to a relapse of issues and uncomfortable Wellbutrin withdrawal symptoms. For this reason, when stopping Wellbutrin safely, it’s best to do so slowly and with professional guidance.
A provider can create a tapering plan which can minimise and manage withdrawal symptoms, allowing you to move forward with your well-being with confidence. For instance, they may recommend lowering your dose, bit by bit, over a time period of around 8 weeks to slowly reduce the medication in your system. How long it takes to taper bupropion typically depends on your dosage and length on time taking the medication.
It’s good to keep an eye out for the following Wellbutrin withdrawal symptoms during the tapering process so that you can communicate concerns with your provider.
Wellbutrin Withdrawal Symptoms:11
- Anxiety
- Difficulties sleeping, including insomnia
- Headaches
- Irritability
- Bodily aches and pains
Frequently Asked Questions About Bupropion
When trying to decide if bupropion is the right choice for your needs, it’s normal to run through every potential benefit and side effect in your mind on repeat. This can lead to a variety of questions which can be hard to find answers to in one source. For this reason, we’ve included answers to FAQs about bupropion to help give you some clarity.
Which Antidepressant Is Right for Me? Wellbutrin or SSRIs?
When it comes down to the choice between Wellbutrin vs SSRIs, the best fit for you will depend on your issues, symptoms, and reactions to medication. In other words, this may not be a question you can answer without a professional evaluation.
However, as both medications work differently, they produce varying side effects. For instance, SSRIs tend to cause more sexual dysfunction and weight gain than Wellbutrin. Plus, bupropion typically causes less drowsiness. Yet, bupropion’s seizure risk may increase with the dosage. These are all considerations your provider will discuss with you.
Does Wellbutrin Cause Anxiety?
Recent evidence shows that bupropion can cause anxiety. In fact, the risk of anxiety with Wellbutrin may be significantly higher than with other antidepressants, such as SSRIs. This effect should ease after a couple of weeks of treatment, but a provider may need to adjust the dose to manage this side effect.
Can Wellbutrin Cause Insomnia?
Yes, Wellbutrin can cause insomnia, especially in the early stages of treatment. This happens because it has a stimulating effect on the brain, but sleep disturbances as a side effect often settle with time. However, if sleep disturbances don’t ease, your provider may lower your dose or switch your medication.
How Effective Is Bupropion for Weight Loss?
Mission Connection: Holistic Support for Mental Health
When it comes to making the decision to take medication for mental health issues, the choice can feel overwhelming. Are you making the right choice? Will the side effects outweigh the benefits? Will the medication change your personality? It’s normal to be concerned, but you don’t have to make any decisions on your treatment by yourself.
Mission Connection can support you through making the best choices for your well-being. We promote the use of a holistic, combined approach to treatment when medication is needed. This means that we target the issues behind the symptoms, tailoring treatment to your unique needs.
Treatment options also don’t have to be rigid, they can be fit around your schedule, including the following:
- Residential treatment: 24/7 structured support in a peaceful environment
- Outpatient treatment: Structured support with flexible scheduling to meet the demands of daily life
- Telehealth services: Mental health support in the comfort of your own home
If you’re ready to take the next step or are simply curious about your options, contact us today to learn more about the services Mission Connection can provide.
References
- Huecker, M. R., Smiley, A., & Saadabadi, A. (2024, September 2). Bupropion. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470212/
- Patel, K., Allen, S., Haque, M. N., Angelescu, I., Baumeister, D., & Tracy, D. K. (2016). Bupropion: A systematic review and meta-analysis of effectiveness as an antidepressant. Therapeutic Advances in Psychopharmacology, 6(2), 99–144. https://doi.org/10.1177/2045125316629071
- DrugBank. (n.d.). Bupropion. DrugBank Online. https://go.drugbank.com/drugs/DB01156
- Canadian Agency for Drugs and Technologies in Health. (2024, October). Review of guidelines on bupropion for depression. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK609607/
- National Library of Medicine. (n.d.). Bupropion. MedlinePlus. https://medlineplus.gov/druginfo/meds/a695033.html
- Verbeeck, W., Bekkering, G. E., & Kramers, C. (2017). Bupropion for attention deficit hyperactivity disorder (ADHD) in adults. The Cochrane Database of Systematic Reviews, 2017(10), CD009504. https://doi.org/10.1002/14651858.CD009504.pub2
- Wilkes, S. (2008). The use of bupropion SR in cigarette smoking cessation. International Journal of Chronic Obstructive Pulmonary Disease, 3(1), 45. https://doi.org/10.2147/copd.s1121
- National Alliance on Mental Illness. (n.d.). Bupropion (Wellbutrin). https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/bupropion-wellbutrin/
- Drugs.com. (2023, August 3). Bupropion dosage guide + max dose, adjustments. https://www.drugs.com/dosage/bupropion.html
- Patel, K., Allen, S., Haque, M. N., Angelescu, I., Baumeister, D., & Tracy, D. K. (2016). Bupropion: A systematic review and meta-analysis of effectiveness as an antidepressant. Therapeutic Advances in Psychopharmacology, 6(2), 99. https://doi.org/10.1177/2045125316629071
- Drugs.com. (2023, August 25). Can I stop taking Wellbutrin suddenly or should I taper off? https://www.drugs.com/medical-answers/stop-taking-wellbutrin-suddenly-taper-3574885/
- Liu, Y., Han, F., Xia, Z. et al. The effects of bupropion alone and combined with naltrexone on weight loss: a systematic review and meta-regression analysis of randomized controlled trials. Diabetol Metab Syndr 16, 93 (2024). https://doi.org/10.1186/s13098-024-01319-7
