Bupropion
Generic: bupropion hydrochloride · Brand: Wellbutrin® / Zyban® · Class: NDRI
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How It Works
Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) — the only antidepressant in this class. Unlike SSRIs and SNRIs, it does not affect serotonin at all. Instead it boosts dopamine and norepinephrine, which helps with motivation, energy, focus, and mood. It is uniquely stimulating compared to other antidepressants, causes no sexual side effects, and is associated with weight loss rather than weight gain. It is also FDA-approved to help people quit smoking.
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What It Treats
Major Depressive Disorder (MDD)Particularly helpful when fatigue, low motivation, and concentration are prominent symptoms
Seasonal Affective Disorder (SAD)FDA-approved for prevention of seasonal depression episodes
Smoking CessationFDA-approved as Zyban; reduces cravings and withdrawal symptoms
ADHDUsed off-label; dopamine boost helps with focus and impulse control
Sexual DysfunctionSometimes added to SSRIs/SNRIs to counteract sexual side effects
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Dosing Overview
| Population | Start | Typical Range | Max |
|---|---|---|---|
| Adults Depression (XL) | 150 mg | 300 mg | 450 mg |
| Adults Depression (SR) | 100 mg twice daily | 200 mg twice daily | 400 mg |
| Adults Smoking Cessation | 150 mg x 3 days | 150 mg twice daily | 300 mg |
XL (extended release) taken once daily in the morning. SR (sustained release) taken twice daily. Never crush or chew tablets. Do not take at night — can cause insomnia. Start low to reduce seizure risk.
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What to Expect — Timeline
1–2
Weeks 1–2
Body adjusting. May notice changes in sleep, appetite, or mild side effects
3–4
Weeks 3–4
Energy and motivation often improve before full mood lift
6–8
Weeks 6–8
Mood and anxiety typically improve significantly at a therapeutic dose
3–6m
3–6 Months
Full therapeutic benefit. Duration discussed based on your history and goals
⏳ Be patient. Most people need at least 4–8 weeks at a therapeutic dose before evaluating effectiveness. Do not stop without talking to your provider.
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Side Effects
Common (often temporary)
- Insomnia (take in morning)
- Dry mouth
- Headache
- Nausea
- Dizziness
- Constipation
- Increased sweating
- Agitation or jitteriness
Call us if you notice
- Seizures (dose-dependent risk)
- New or increased suicidal thoughts
- Severe agitation or anxiety
- Hypomania or mania
- Increased blood pressure
- Psychosis (rare)
Bupropion has a dose-dependent seizure risk — never exceed the maximum dose and never double up if you miss a dose. It is generally energizing and causes no sexual side effects or weight gain, which many patients appreciate.
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Tips for Success
Same Time DailyTake at the same time each day for consistent levels in your system.
With FoodTaking with food can reduce nausea and stomach upset.
Don't Stop AbruptlyAlways taper slowly with your provider guidance to avoid withdrawal effects.
Limit AlcoholAlcohol worsens depression and anxiety and increases side effects.
Tell All ProvidersLet other prescribers know what you are taking — interactions matter.
Track Your MoodJournaling or a mood app helps you and your provider see what is changing.
Morning OnlyAlways take in the morning — taking it later in the day commonly causes insomnia.
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Important Safety Information
Black Box Warning (under 25): Antidepressants may increase risk of suicidal thinking in children, adolescents, and young adults especially in the first few weeks. Monitor closely and contact us right away if new or worsening thoughts of self-harm appear.
Serotonin Syndrome: Can occur when combined with MAOIs, triptans, tramadol, or St. John's Wort. Signs include fever, agitation, rapid heart rate, and muscle twitching — seek emergency care immediately.
Drug Interactions: Do not take with MAOIs. Always share your full medication list with your provider.
Pregnancy & Breastfeeding: Discuss risks and benefits with your provider. Do not stop without consultation.
Seizure Risk: Bupropion lowers the seizure threshold. Do not exceed the maximum dose, do not crush tablets, and use with caution if you have a history of seizures, eating disorders, or alcohol withdrawal.
Eating Disorders: Bupropion is contraindicated in people with current or past bulimia or anorexia nervosa due to increased seizure risk.
Mood Changes During Quit Attempts: When used for smoking cessation, some people experience mood changes, agitation, or suicidal thoughts. Monitor closely during this period.
Questions? I am here.
Reach me between appointments if you have concerns about side effects, notice mood changes, or have questions about your medication.
360-389-3712
info@rootedmindspsychiatry.com