The first Wellbutrin prescription can be confusing
The doctor calls it an antidepressant, then says it might be more stimulating than sedating. It can decrease appetite. It generally causes less sexual inhibition compared to other antidepressants. The same drug is also used to help people quit smoking
It’s all the same medication, bupropion
Wellbutrin is a brand name for depression treatment, while bupropion appears in other medications such as Zyban (for smoking cessation) and combination products that serve a variety of purposes
It can be an excellent choice for some people, but enough jitteriness early on makes it unloved by others by day three
Day three should also be too soon to be judging based on that
What Wellbutrin is meant to change
Depression can sap your momentum before making you feel sad. Piles of work take over; you can’t concentrate. You sleep for ten hours and feel as though you’ve only slept for an hour
Bupropion can be incredibly valuable when exhaustion and demotivation are the dominant effects. It mainly acts on norepinephrine and dopamine, not serotonin, which makes it feel different to SSRIs like Lexapro or Zoloft
“Feels different” doesn’t mean it’s stronger
Some people report increased wakefulness within the first week; mood takes longer to improve. Enjoyment, engagement and self-confidence can return in bits and pieces over a few weeks.
A good response to treatment can be surprisingly mundane. The person picks up a cooking habit again and makes a phone call they’ve been avoiding. Work is still work, but not an impossible task
The first week may feel too energetic
Wellbutrin can lead to dryness in the mouth, headaches, sweating, nausea, and constipation. Appetite can drop; sleep may become lighter or more difficult.
Then there’s the coffee issue
Someone who regularly drinks three cups of coffee may find that the second one has made their hands shake; their mind is on overdrive. Cutting out caffeine for a while can make this easier, temporarily.
Bupropion in the morning can help with insomnia, although the timing depends on whether the prescription is immediate-release, SR or XL; follow the label and don’t rearrange doses on your own.
Anxiety can flare up briefly. If it becomes severe, or if sleep has all but vanished, call the prescriber. It doesn’t require white-knuckling through weeks of misery.
Check the letters appended to the name
Bupropion tablets release medication at different rates
IR is immediate-release; SR is sustained-release; XL is extended-release and typically taken once daily
The milligram number isn’t everything. A 150 mg SR tablet and a 150 mg XL tablet release their contents differently and shouldn’t be swapped out for each other, either
The Wellbutrin SR tablets must be swallowed whole; attempting to crush or chew a modified-release tablet could flood the system with bupropion all at once
Missed a dose? Don’t make up for it by doubling the next one. Taking two doses in close succession increases the risk of seizures
Sex and weight: two reasons people ask for it
SSRIs can cause delayed orgasm, reduced desire, or erection problems; bupropion is less likely to cause any of these issues and can be added when sexual function is inhibited by another antidepressant
That doesn’t make it a guaranteed libido booster; depression can also reduce sexual interest, and everyone is different.
Weight gain is less common with bupropion than with a variety of antidepressants; some people even lose weight due to decreased appetite.
Wellbutrin isn’t a general weight-loss aid, and is also completely inappropriate for people with a current or previous history of anorexia or bulimia, as those eating disorders increase the risk of seizures
The seizure risk deserves a sincere answer about alcohol
Seizures are rare at normal prescribed doses, but there are specific conditions that can make them more likely
Bupropion should not be used by someone with a history of seizures; risk also increases if the dose is too high or doses are too close together, or another medication has lowered the seizure threshold
Heavy alcohol use can be a factor, particularly if the use has ceased suddenly; withdrawal from alcohol or benzodiazepines can also cause seizures
When the clinician asks about how much you drink, “occasionally” isn’t helpful if every occasion involves most of a bottle. It’s not about judgment, but choosing a medication safely
Don’t suddenly quit heavy alcohol use without medical help
Also, check to see if there’s duplicate bupropion. Wellbutrin and Zyban contain the same drug, even though their packaging discusses different purposes
Changes that shouldn’t be quietly observed
Bupropion can increase blood pressure, so anyone with hypertension should know their numbers, especially if they’re using nicotine patches or gum
A sudden blast of strange energy needs to be investigated if it comes alongside almost no sleep, rapid speech, reckless spending or behavior that is far outside the norm; these can be signs of mania that can uncover bipolar disorder
New suicidal thoughts, worsening depression or frightening impulsiveness need to be acted on promptly, especially after the start of treatment or a change in dose; if there’s an immediate risk of self-harm, contact emergency services or a crisis service
Hallucinations, severe confusion, facial swelling, breathing difficulty, or a blistering rash also need to be addressed urgently
How long do people stay on Wellbutrin?
The feeling of being better isn’t typically a good time to stop treatment
Continuing treatment after the symptoms have improved can reduce the chance that depression returns. The right length of treatment depends on how severe the episode was, whether depression has been experienced before, and how stable the recovery has been
Bupropion isn’t known for extreme withdrawal, but stopping it suddenly can still result in irritability, anxiety, sleep changes, and return of symptoms. Make a plan with the prescriber
Our guide on common symptoms of depression can help track whether the illness itself is improving, as well as how the medication affects the body.
Wellbutrin works best when its activating quality is matched to the person who is taking it; the aim is not to feel sped up, but to have enough energy and mental space to feel more grounded in life.
