Once symptoms are under control, MDD usually requires long-term treatment to help prevent the return of depressive symptoms. If you are using bupropion for SAD or smoking cessation, the length of your treatment may be shorter. With input from you, your health care provider will assess how long you will need to take the medicine.
Do not stop taking bupropion or change your dose without talking with your health care provider first. Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for "switching" from depression into mania. Symptoms of mania include "high" or irritable mood, very high self-esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences for example, excessive buying sprees.
If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions, each with risks and benefits as they relate to how the illness, medications, and risks to the fetus may interact. Untreated MDD has risks to the fetus, as well as the mother.
It is important to discuss the risks and benefits of treatment with your doctor and caregivers. Bupropion has also been evaluated for smoking cessation during pregnancy and is recommended only after other therapies have failed. Bupropion hydrochloride is available in 3 different forms: immediate release IR , sustained release SR , and extended release XL. Bupropion IR is usually taken 2 or 3 times per day with hours between doses. The dose usually ranges from mg twice daily to mg three times daily, with the last dose taken mid-afternoon.
Bupropion SR is usually taken twice daily in the morning and mid-afternoon. The dose usually ranges from mg twice daily up to mg twice daily. The dose ranges from mg to mg. While there are dose ranges for each form, your health care provider will determine the form and dose that is right for you based on your response.
The dose may be increased to mg once daily. The dose for smoking cessation is bupropion SR mg once daily for 3 days and then twice daily for 7 to 12 weeks. You should not take more than one product that contains bupropion, including the products that are used to quit smoking.
Do not take more than your prescribed dose since higher doses may increase your risk of having a seizure. Since quickly increasing the dose of bupropion can cause seizures in some people, your doctor will slowly increase your dose.
You can take bupropion on an empty stomach or with food. The SR and XL forms should be swallowed whole — not chewed, crushed, or broken — so that the medication can work correctly in your body and to reduce the risk of serious side effects.
The tablet shell from the SR and XL forms may appear in your feces. Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication.
You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication. For bupropion IR or SR, if you miss a dose, take it as soon as you remember.
Take the remaining doses for the day at evenly spaced times at least 4 hours apart. DO NOT take 2 doses at once. You should not take more than your prescribed dose and doing so may increase your risk of having a seizure.
For bupropion XL, do not take an extra tablet to make up for the dose you forgot. Wait and take your next dose at your regular time the next day. Avoid drinking alcohol or using illegal drugs while you are taking bupropion because the beneficial effects of the medication may be decreased and the risk of seizures may be increased.
If you are dependent on drugs or alcohol and would like to stop, consult your healthcare provider for help. Abruptly stopping these substances can result in a seizure, especially when taking bupropion. If an overdose occurs, call your doctor or You may need urgent medical care. In a meta-analysis of 10 randomized controlled trials of depression with anxiety, outcomes for anxiety were not significantly different between bupoprion and the SSRIs, including several large trials where it was compared head-to-head with an SSRI.
The same authors of that paper reanalyzed the data looking specifically at patients with very high levels of anxiety. Those studies were done in patients with anxious depression, but what about patients with a separate anxiety disorder.
Here bupropion may not fare as well, unless that anxiety disorder is the generalized type GAD. In GAD, bupropion performed just as well as escitalopram Lexapro in a small head-to-head controlled trial. This one is partly true. Bupropion along with desvenlafaxine does carry a higher risk of causing initiation insomnia than the other antidepressants, but the difference is very small.
Most second-generation antidepressants can cause insomnia, and the rates are similar. Depression impairs sleep architecture in several ways. Bupropion reverses[7] those changes, while the SSRIs tend to make them worse. On the other hand, bupropion does stand out among the antidepressants as having a positive effect on energy. Dr Aiken does not accept honoraria from pharmaceutical companies but receives royalties from W.
Pharmacopsychiatry, ;51 4 Second-generation anti-depressants and risk of new-onset seizures in the elderly. Clin Toxicol Phila , ;56 12 Why isn't bupropion the most frequently prescribed antidepressant? J Clin Psychiatry ;66 5 Medically reviewed by Mary Lucas, RN.
It works by modifying the levels of certain chemicals in your brain. Research shows that Wellbutrin bupropion can reduce cravings and withdrawal symptoms in ex-smokers, making it easier to give up cigarettes and other tobacco products. Compared to many other antidepressants, Wellbutrin bupropion is less likely to cause some side effects, such as drowsiness, weight fluctuation and sexual dysfunction. When used as a treatment for depression, Wellbutrin buproprion usually takes around six to eight weeks before it starts fully working as a treatment for depression.
However, you may begin to experience improvements in your sleep habits, appetite and energy levels as early as one to two weeks of treatment.
It may take four to six weeks to experience a significant improvement in your mood and level of interest in activities after starting bupropion.
When used as a smoking cessation aid, typically under the name brand name Zyban, it can take several weeks for bupropion to start working, as well. Depending on your symptoms, general health and other factors, your healthcare provider may recommend that you take bupropion for seven to 12 weeks after you stop smoking.
Wellbutrin bupropion belongs to a class of medications referred to as aminoketones. It works by affecting the way your body produces neurotransmitters like dopamine and norepinephrine, which are crucial to our moods.
Neurotransmitters are a type of chemical messenger used by your body. Their job is to transport signals between neurons. You can think of them as an internal messaging system for your body, delivering instructions between neurons and from neurons to other tissue.
Norepinephrine is a neurotransmitter responsible for keeping your body alert and ready to act. It helps to increase your heart rate, pump blood throughout your body, keep you awake, alert and able to focus and recall important information. Dopamine is a neurotransmitter responsible for regulating learning, pleasure, motivation, sleep, mood and a variety of other important functions.
People with depression may have low levels of norepinephrine and dopamine. By blocking your brain from reabsorbing norepinephrine and dopamine, aminoketone medications such as Wellbutrin bupropion can increase norepinephrine and dopamine levels and treat the symptoms of depression. However, they believe that its effects on dopamine might be responsible for at least some of its effectiveness as a smoking cessation aid.
Instead, it may work by mimicking some of the effects of the nicotine in cigarettes, which also causes your brain to release extra dopamine. Bupropion is available in several dosages. Certain brands of bupropion may contain a different dosage per tablet.
For depression, a typical starting dosage of bupropion is mg to mg per day, taken either as mg tablets taken twice per day or a single mg extended-release bupropion tablet taken in the morning. The maximum dosage of bupropion for depression is mg to mg per day. After three to four days, you may need to adjust your dosage of bupropion. Follow the dosage instructions provided by your healthcare provider to make sure you take the right amount of bupropion. For smoking cessation, a typical starting dosage is one mg extended-release tablet per day for the first three days, followed by a dosage of mg per day, taken as two tablets taken at least eight hours apart, from day four.
Based on your symptoms, health history, response to the medication and several other factors, your healthcare provider may adjust your dosage of bupropion over time.
Like all antidepressants, bupropion can cause certain side effects.
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