Bupropion

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Wellbutrin (SR tabs), Zyban

Drug group:

Antidepressant, smoking cessation aid

Prescription needed?

Yes

What does it do?

Bupropion is useful as an aid in smoking cessation.

It is also used in the treatment of depression:

• Particularly useful when other drugs are not tolerated (eg SSRI’s and sexual dysfunction)
• Can be used with other antidepressants in patients with poor response to one drug alone
• Not recommended when depression is accompanied by severe anxiety

How does it work?

Bupropion is chemically unrelated to other classes of antidepressants, and therefore does not cause some of the side effects that sometimes make these drugs poorly tolerated.

How should it be used?

For smoking cessation: treatment is started while still smoking, commit in advance to a date within the first two weeks of treatment when smoking will stop - “target stop date”

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

• SR tabs: 150-300mg, 1–2 x daily, swallowed whole
• XR tabs: 150–300mg once daily

How quickly will it start to work?

Antidepressant effect can be faster than some other drugs, but full effect usually within 4 weeks
                    

How long will the effects last?

12-24 hours
                   

When should I stop using it?

Do not stop the drug without consulting your doctor. Treatment for smoking cessation will be stopped if smoking has not stopped completely by 7 weeks.
       

Is it safe for prolonged use?

Bupropion is used for up to 9 weeks for cessation of smoking. When used long-term for depression, blood pressure needs to be monitored as it can become raised.               

What are the possible side effects?

The following have been reported:

• More common: insomnia, poor concentration, headache, dizziness, sweating, tremor, nausea, vomiting, constipation, rash, fever, depression (smoking cessation - may be due to the withdrawal of nicotine rather than to the effects of bupropion itself)
• Less common: jaundice, confusion, anxiety
• Report to your doctor before taking your next dose if you experience: palpitations, fainting, chest pain, seizures

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: head injury, history of seizures/epilepsy, eating disorder, cancer of the nervous system, diabetes, high blood pressure, bipolar disorder, psychosis, kidney/liver problems, withdrawing from alcohol or benzodiazepine dependence
• Other medicines: Ritonavir, amantadine, levodopa, monoamine oxidase inhibitors, phenytoin, carbamazepine, valproate, tamoxifen
• Pregnancy and breast-feeding: Safety not established
• Children: Not recommended
• Over 60: Increased sensitivity to the drug’s effects, reduced dose may be necessary
• Driving and hazardous work: Caution, drug can cause impaired concentration and dizziness
• Alcohol: Avoid, enhanced sedative effects