Bupropion (Wellbutrin): What it is, How it Works, Side Effects & More

Bupropion (Wellbutrin): What it is, How it Works, Side Effects & More
Mary Lucas, RN
Medically reviewed by Mary Lucas, RN Written by Our Editorial Team Last updated 7/18/2020

Bupropion, sold under the brand names Wellbutrin®, Wellbutrin SR®, Wellbutrin XL® and Aplenzin®, is a prescription medication that’s used to treat depression and seasonal affective disorder (SAD). 

It’s also sold as a smoking cessation medication under the brand name Zyban® and for major depressive disorder under the brand name Forfivo® XL. 

Bupropion is what’s known as an atypical antidepressant. It works by modifying the levels of certain chemicals in your brain. 

Compared to many other antidepressants, bupropion is less likely to cause some side effects, such as drowsiness, weight fluctuation and sexual dysfunction.

If you’ve been diagnosed with depression or seasonal affective disorder, or if you’re a smoker looking to quit, your healthcare provider may have recommended bupropion as a treatment option.

Below, we’ve explained exactly what bupropion is, how it works and why it’s prescribed. We’ve also looked at how bupropion compares to other antidepressants, as well as the potential side effects and interactions that you should be aware of before using this medication. 

What is Bupropion (Wellbutrin)? 

Bupropion is an antidepressant medication. It’s sold in tablet form and is commonly prescribed as a treatment for conditions such as depression and seasonal affective disorder.

It’s also prescribed as a medication for smoking cessation. Research shows that bupropion can reduce cravings and withdrawal symptoms in ex-smokers, making it easier to give up cigarettes and other tobacco products. 

How Bupropion Works

Bupropion belongs to a class of medications referred to as aminoketones. Bupropion  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. 

For Depression

People with depression may have low levels of norepinephrine and dopamine. By blocking your brain from reabsorbing norepinephrine and dopamine, aminoketone medications such as bupropion can increase norepinephrine and dopamine levels and treat the symptoms of depression.

For Smoking Cessation

Currently, experts aren’t sure exactly why bupropion is effective as a treatment for people that want to quit smoking. 

However, they believe that its effects on dopamine might be responsible for at least some of its effectiveness as a smoking cessation aid. 

Unlike many other smoking cessation treatments, bupropion doesn’t contain nicotine. Instead, it may work by mimicking some of the effects of the nicotine in cigarettes, which also causes your brain to release extra dopamine

Although this doesn’t necessarily make you less addicted to nicotine, it can help you more easily deal with the symptoms of nicotine withdrawal and cravings for nicotine that often develop when you quit smoking. 

Bupropion Dosages

Bupropion is available in several dosages. Immediate-release bupropion tablets are available in strengths of 75mg and 100mg, while extended/sustained-release versions of bupropion typically contain 100mg, 150mg, 200mg, 300mg or 450mg of bupropion per tablet. 

Certain brands of bupropion may contain a different dosage per tablet. If you’re prescribed any medication containing bupropion, check the packaging that came with the medication to make sure you take the correct amount.

Typical dosages for bupropion can vary based on the type of medication (immediate-release or extended-release) and condition it’s prescribed to treat.

For depression, a typical starting dosage of bupropion is 150mg to 200mg per day, taken either as 100mg tablets taken twice per day or a single 150mg extended-release bupropion tablet taken in the morning. The maximum dosage of bupropion for depression is 300mg to 450mg 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 150mg extended-release tablet per day for the first three days, followed by a dosage of 300mg 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. 

Bupropion Side Effects and Interactions

Like all antidepressants, bupropion can cause certain side effects. Most of the side effects that can occur with bupropion are minor and temporary. However, there are also several potentially severe side effects that you should be aware of before using this medication. 

Some of the common side effects of bupropion include:

  • Abnormal dreams
  • Agitation
  • Blurred vision
  • Constipation
  • Dizziness
  • Dry mouth
  • Edema (swelling)
  • Excessive sweating
  • Headache
  • Insomnia
  • Migraine
  • Nasopharyngitis, rhinitis and other cold-like symptoms
  • Nausea
  • Sedation
  • Tachycardia (fast heart beat)
  • Tremor
  • Vomiting
  • Weight fluctuation

Many of these side effects may be mild and often disappear over the course of several days or weeks. If you experience persistent side effects from bupropion, it’s best to talk to your healthcare provider.

In general, bupropion is less likely to cause sexual dysfunction than other commonly prescribed antidepressants, such as SSRIs and tricyclic antidepressants.

Like other antidepressants, bupropion may cause serious side effects. These side effects occur in a small percentage of bupropion users. Serious side effects of bupropion include:

  • Mental health issues, such as panic attacks, changes in mood, impulsive behavior and worsened depression or anxiety.
  • Hypertension. Bupropion may contribute to hypertension (high blood pressure). If you have high blood pressure or a history of cardiovascular issues, make sure you inform your healthcare provider before using bupropion.
  • Vision issues, such as eye pain or swelling/redness of the eyes or surrounding area.
  • Seizures. Though rare, depending on dosage, anywhere from .1 percent to .4 percent of people who use bupropion experience seizures.

If you have a health condition that may contribute to seizures, or make you more susceptible to seizures than others, it’s important that you disclose this to your healthcare provider before using bupropion or similar medications. Conditions that may increase your seizure risk include:

  • Head injuries, such as head trauma
  • Active brain tumors
  • A history of epilepsy or other conditions that cause seizures
  • Withdrawal from or addiction to alcohol, benzodiazepines or illicit drugs
  • Use of other drugs that may affect your seizure susceptibility, such as other antidepressants, antipsychotics, systemic corticosteroids or theophylline

Bupropion may affect your weight and/or appetite. Before considering bupropion, make sure you inform your healthcare provider if you’ve previously had an eating disorder such as bulimia or anorexia.

Bupropion may also not be a suitable treatment for people with liver or kidney issues, diabetes or certain mental health conditions such as bipolar disorder. 

FDA “Black Box” Warning: Suicidal Thoughts and/or Behavior

As is common with antidepressants, bupropion has a “black box” safety warning from the FDA — the most serious type of FDA warning. This warning is found on bupropion medications used for treating depression — bupropion smoking cessation aids do not carry the same warning. 

This warning informs users that antidepressants can increase the risk of suicidal thinking and/or behavior in children, adolescents and young adults. Studies do not show that this risk occurs in people aged 24 and older. 

If you’re prescribed bupropion to treat depression or seasonal affective disorder and experience any sudden changes in behavior, thoughts, mood or feelings, contact your healthcare provider immediately. 

Interactions Between Bupropion and Other Medications

Bupropion can interact with other medications, including over-the-counter medications, herbal products and health supplements. 

These interactions may increase the amount of bupropion in your body or make the medication less effective. In some cases, the use of bupropion can cause dangerous interactions with other medications.

Dangerous interactions can occur when bupropion is used with monoamine oxidase inhibitors (MAOIs) — another type of antidepressant medication.

These interactions can occur if you’ve taken an MAOI within the last 14 days. If you have used an MAOI medication, such as phenelzine, isocarboxazid, tranylcypromine, selegiline or others, you must inform your healthcare provider before being prescribed bupropion.

Bupropion can interact with other antidepressant medications, including SSRIS, SNRIS, tricyclic antidepressants (TCAs) and other medications used to treat depression. Make sure to tell your healthcare provider if you currently use or have recently used any other medications to treat depression.

Other medications that can interact with bupropion include antipsychotics, beta-blockers, blood thinners, corticosteroids, antiarrhythmics, theophylline, amantadine, dopamine precursors (such as levodopa) and transdermal nicotine patches. 

To avoid interactions, inform your healthcare provider of all medications you currently use or have recently used, as well as any relevant health conditions, before using bupropion. 

Learn More About Treating Depression

If you’ve recently been diagnosed with depression, your healthcare provider may have suggested a range of different medications to treat your symptoms and improve your quality of life.

Bupropion is one of several medications used to treat depression. Others include SSRIs, SNRIs and a variety of other antidepressants. Our complete guide to medications for depression goes into more detail on the options that are available, how they work and more. 

Frequently Asked Questions about Bupropion (Wellbutrin)

How And When Should You Take Bupropion?

Take bupropion as directed by your healthcare provider. Depending on whether you’re prescribed a sustained or extended release version of bupropion, you may need to take this medication once per day in the morning or multiple times throughout the day. 

You can take bupropion with or without food. If you feel nauseous after using bupropion, it’s best to take this medication with a small- to medium-sized meal. 

If you’re prescribed bupropion as a smoking cessation aid, follow your healthcare provider’s instructions and use the medication as recommended. They may recommend starting bupropion several days before you plan to quit smoking. 

If you’re struggling to quit smoking after using bupropion for seven weeks or longer, talk to your healthcare provider. Do not suddenly stop using bupropion, adjust your dosage or start using additional smoking cessation aids without first talking to your healthcare provider. 

If you forget to take bupropion, skip the missed dose and continue using the medication as you normally would. You should not take a double dose of bupropion to make up for a missed dose. 

How Long Does it Take for Bupropion to Work?

It can take several weeks for bupropion to start working as a treatment for depression. You may experience improvements in your sleep habits, appetite and energy levels during the first 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.

For quitting smoking, it can take several weeks for bupropion to start working. Most people are advised to set a target “quit date” and start bupropion while they’re still smoking to give time for the medication to become effective. 

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. 

Can You Drink Alcohol With Bupropion?

Drinking alcohol with bupropion is not recommended. If you drink alcohol while using bupropion for depression or smoking cessation, you may be more likely to experience side effects from the alcohol and the bupropion. 

If you drink beer, wine or other alcoholic beverages frequently, talk to your healthcare provider about drinking alcohol while using bupropion before you start taking this medication. 

Can You Stop Taking Bupropion?

Like other widely used antidepressants, bupropion has the potential to cause certain withdrawal symptoms if you suddenly stop using it without tapering your dosage. 

Common withdrawal symptoms of bupropion include difficulty sleeping, balance issues, anxiety, depression, mood changes, flu-like symptoms, sweating and more. 

If you’re prescribed bupropion and no longer want to use it, do not suddenly adjust your dosage or stop taking your medication. If you’re prescribed other medications to take at the same time as bupropion, including other antidepressants, continue taking these medications as normal. 

Instead, talk to your healthcare provider about adjusting your dosage, safely tapering your bupropion dosage over time or changing to a different antidepressant or smoking cessation aid. 

Does Bupropion Contain Nicotine?

Bupropion does not contain nicotine. 

As a smoking cessation aid, its exact mechanism of action is not known, but scientists believe it may work by reducing cravings for nicotine by changing the levels of certain neurotransmitters in your brain. 

This can make the withdrawal symptoms associated with quitting easier to deal with.

Because bupropion doesn’t contain nicotine, it may be safe to use it with nicotine replacement therapy (NRT) products.

However, you should talk to your healthcare provider before you use bupropion with nicotine gum, lozenges, patches or other products containing nicotine. 

Does Bupropion Cause Weight Gain?

Although antidepressants are typically associated with weight gain, several studies of bupropion have found that it may cause weight loss.

Bupropion is one of two active ingredients in the FDA-approved weight loss drug Contrave®. In several studies, use of bupropion sustained release (SR) tablets has been associated with mild long-term weight loss.  

Not all people who use bupropion lose weight. Depending on your food intake and activity level, you may gain weight, lose weight or maintain your current weight after using bupropion.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.