Bupropion—known by brand names like Wellbutrin and Zyban—is a norepinephrine-dopamine reuptake inhibitor (NDRI) with several FDA-approved and off-label applications. Here’s a detailed look at its therapeutic roles:
Major Depressive Disorder (MDD)
Bupropion is widely prescribed to treat depression. It’s effective as a first-line option and for treatment-resistant cases when added to other antidepressants. Its advantages include less sedation, lower sexual side effects, and improved energy and motivation compared to many SSRIs.
Seasonal Affective Disorder (SAD)
It’s also FDA-approved for preventing depressive symptoms during winter months. It helps maintain mood stability in those prone to seasonal lows.
Smoking Cessation
As Zyban, bupropion aids individuals in quitting smoking. It reduces cravings and withdrawal symptoms without containing nicotine. When used alongside behavioral support—sometimes with nicotine patches—it can significantly increase quit rates.
Off-Label Uses
Attention‑Deficit/Hyperactivity Disorder (ADHD): Some adults and children use bupropion when stimulants aren’t effective or well-tolerated. It helps with concentration and impulse control.
Weight Management: In combination with naltrexone (Contrave), bupropion can support weight loss.
Sexual Dysfunction: It may help alleviate SSRI-induced sexual side effects.
Adjunct for Treatment‑Resistant Depression & TMS: Used alongside other antidepressants or transcranial magnetic stimulation (TMS) to enhance treatment outcomes.
How It Works
Bupropion blocks the reuptake of norepinephrine and dopamine, increasing their levels to improve mood, focus, and reward response. It also blocks nicotinic receptors, which helps reduce nicotine cravings.
Forms & Dosage
Available as immediate-release (IR), sustained-release (SR), and extended-release (XL) oral tablets. Dosages typically range between:
- Depression/SAD: 150–300 mg/day
- Smoking cessation: Around 150 mg twice daily
- ADHD (off-label): 150–450 mg/day in divided doses
Effects start in about 1–2 weeks, with full benefits seen around 6–8 weeks.
Side Effects & Precautions
Common side effects include dry mouth, insomnia, sweating, tremor, nausea, and increased anxiety. It can raise blood pressure and carries a small seizure risk—particularly at high doses or in those with seizures, head injury, or eating disorders. A boxed warning highlights increased suicide risk in individuals under 25. It’s crucial to disclose all medical conditions and medications to your provider before starting.
Monitoring & Interactions
Clinicians track blood pressure, mood, and potential side effects. Bupropion is metabolized by CYP2B6—meaning it can interact with drugs that inhibit or induce this enzyme. Always inform your provider of any concurrent medications.
Contact Us Today for a Consultation
At My Psychiatrist, we’re here to help. With six outpatient locations across South and Central Florida, our team of compassionate professionals offers therapy, medication management, and innovative treatments like TMS to support your mental health and improve your sleep. Need support? Contact us today at (877) 548-8089 to schedule an appointment and start your journey toward better sleep and peace of mind.
Bupropion FAQs
Is bupropion better than SSRIs?
It can be preferable if you’re experiencing SSRI-induced sexual dysfunction, fatigue, or weight gain. Effectiveness for depression is comparable, but side effect profiles differ.
How long until I feel better on bupropion?
You may notice early improvements within 1–2 weeks; full benefits often take 6–8 weeks.
Can bupropion help me quit smoking?
Yes—by reducing nicotine cravings and withdrawal, especially when combined with behavioral support and sometimes nicotine replacement.
Is bupropion safe for ADHD?
Off-label use can improve focus and impulsivity. Results may take weeks, and it lacks the immediate effects of stimulant medications.
Will bupropion cause weight loss?
It may help with modest weight loss, especially when combined with naltrexone, but it isn’t a primary weight-loss medication.
What about seizure risk?
Seizure risk is low at therapeutic doses but increases at high doses or if you have a history of seizures, head trauma, or eating disorders.
What should I do if experiencing suicidal thoughts?
Contact your healthcare provider right away. In emergencies, call 911 or, in the U.S., call or text 988 for the Suicide & Crisis Lifeline.
Sources
StatPearls: Bupropion overview
Mayo Clinic: Uses for depression, SAD & smoking
