Bupropion SR: Effective Relief for Major Depressive Disorder
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Bupropion SR (sustained-release) is a widely prescribed antidepressant belonging to the norepinephrine-dopamine reuptake inhibitor (NDRI) class. It is specifically formulated to alleviate symptoms of major depressive disorder by modulating key neurotransmitters in the brain, offering a therapeutic option with a distinct mechanism compared to SSRIs. Its sustained-release delivery ensures stable plasma concentrations, supporting consistent mood stabilization and reducing dosing frequency. Clinically, it is valued for its favorable side effect profile, particularly the low incidence of sexual dysfunction and weight gain.
Features
- Contains bupropion hydrochloride as the active ingredient
- Sustained-release formulation for prolonged effect
- Available in 100 mg, 150 mg, and 200 mg tablet strengths
- White to off-white, round, film-coated tablets
- Typically administered twice daily, approximately 8 hours apart
- Bioavailability unaffected by food intake
Benefits
- Effectively reduces symptoms of depression, including low mood and anhedonia
- Lower risk of sexual side effects compared to many other antidepressants
- Minimal weight gain potential, and may support weight neutrality or loss in some patients
- May improve energy, focus, and motivation due to its dopaminergic activity
- Does not commonly cause sedation, making it suitable for daytime use
- May aid in smoking cessation as an off-label benefit
Common use
Bupropion SR is primarily indicated for the treatment of major depressive disorder (MDD) in adults. It is also used off-label for seasonal affective disorder (SAD), attention deficit hyperactivity disorder (ADHD), and as an aid to smoking cessation. Its unique neurochemical profile makes it a preferred option for patients who have not responded adequately to or cannot tolerate SSRIs or SNRIs, especially when sexual dysfunction or weight concerns are prominent.
Dosage and direction
The initial recommended dose for Bupropion SR is 150 mg once daily, preferably in the morning. After at least 3 days, the dose may be increased to 150 mg twice daily, with at least 8 hours between doses. The maximum recommended dose is 400 mg per day, given as 200 mg twice daily. Dosage adjustments should be made cautiously in patients with hepatic or renal impairment. Tablets should be swallowed whole and not crushed, chewed, or divided, to maintain the sustained-release properties.
Precautions
Patients should be monitored for worsening depression, suicidality, or unusual changes in behavior, especially at the beginning of treatment or during dosage adjustments. Bupropion SR may lower the seizure threshold; use with caution in patients with a history of seizure disorder, head trauma, or other predisposing conditions. It may increase blood pressure; regular monitoring is advised. Avoid use in patients with eating disorders such as anorexia or bulimia due to increased seizure risk. Alcohol consumption should be minimized or avoided.
Contraindications
Bupropion SR is contraindicated in patients with a known hypersensitivity to bupropion or any component of the formulation. It must not be used in individuals with a current or prior diagnosis of bulimia or anorexia nervosa due to the higher risk of seizures. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated; at least 14 days should elapse between discontinuing an MAOI and initiating Bupropion SR. It is also contraindicated in patients undergoing abrupt discontinuation of alcohol or sedatives.
Possible side effect
Common side effects may include dry mouth, nausea, headache, insomnia, and dizziness. Less frequently, patients may experience tremors, agitation, anxiety, sweating, or tinnitus. Serious side effects, though rare, can include seizures, hypertension, allergic reactions, angle-closure glaucoma, and severe skin reactions. Any unusual mood or behavior changes, including hostility or suicidal thoughts, should be reported immediately to a healthcare provider.
Drug interaction
Bupropion SR is metabolized primarily by CYP2B6 and may interact with drugs that inhibit or induce this enzyme. Concomitant use with other antidepressants, antipsychotics, systemic corticosteroids, or theophylline may increase seizure risk. It may interact with drugs that affect dopamine, such as levodopa or amantadine. Caution is advised with drugs that lower the seizure threshold. Concurrent use with nicotine replacement therapy may increase the risk of hypertension. Always inform your healthcare provider of all medications, including over-the-counter and herbal products.
Missed dose
If a dose is missed, it should be taken as soon as remembered, unless it is close to the time of the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one, as this may increase the risk of adverse effects, including seizures.
Overdose
Overdose of Bupropion SR may lead to seizures, hallucinations, loss of consciousness, tachycardia, or cardiac arrest. Symptoms can also include nausea, vomiting, and agitation. In case of suspected overdose, seek emergency medical attention immediately. Treatment is supportive and may include airway management, ECG monitoring, and control of seizures with benzodiazepines.
Storage
Store at room temperature, between 20°C to 25°C (68°F to 77°F), in a tightly closed container. Protect from light, moisture, and excessive heat. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Do not disregard or delay seeking medical advice based on content provided here.
Reviews
Clinical studies and patient reports generally reflect positive outcomes with Bupropion SR, particularly regarding its efficacy in improving mood and energy with fewer sexual side effects. Some users note initial side effects like insomnia or agitation, which often subside with continued use. Individual experiences may vary; always follow your prescriber’s guidance for optimal results.