Wellbutrin SR: Effective Relief for Major Depressive Disorder
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Wellbutrin SR (bupropion hydrochloride sustained-release) is a widely prescribed antidepressant belonging to the aminoketone class, distinct from commonly used SSRIs and SNRIs. It functions primarily as a norepinephrine-dopamine reuptake inhibitor (NDRI), offering a unique mechanism of action that avoids serotonin-related side effects such as weight gain or sexual dysfunction. Clinically indicated for the treatment of major depressive disorder (MDD) and seasonal affective disorder (SAD), it is valued for its favorable side effect profile and energizing properties. Available only by prescription, Wellbutrin SR should be used under careful medical supervision to ensure optimal therapeutic outcomes and patient safety.
Features
- Active ingredient: Bupropion hydrochloride (sustained-release formulation)
- Available in 100 mg and 150 mg tablet strengths
- NDRI mechanism: inhibits reuptake of norepinephrine and dopamine
- Administered orally, typically twice daily
- Bioavailability approximately 87%; peak plasma concentration within 3 hours
- Half-life of 21 ± 9 hours; steady state reached within 8 days
- Metabolized primarily in the liver via CYP2B6
- Excreted renally (87%) and fecally (10%)
Benefits
- Redymptoms of depression, including low mood, anhedonia, and fatigue
- Lower incidence of sexual dysfunction and weight gain compared to SSRIs
- May improve focus, energy, and motivation in some patients
- Sustained-release formulation supports consistent drug levels and simplified dosing
- Non-serotonergic mechanism offers an alternative for SSRI-resistant cases
- FDA-approved for both major depression and seasonal affective disorder
Common use
Wellbutrin SR is primarily indicated for the treatment of major depressive disorder (MDD) in adults. It is also approved for the prevention of seasonal affective disorder (SAD). Off-label uses may include attention-deficit/hyperactivity disorder (ADHD), though this is not an FDA-approved indication. It is sometimes used adjunctively with other antidepressants to counteract sexual side effects or augment therapeutic response. Clinical use should always align with a comprehensive treatment plan under psychiatric or primary care guidance.
Dosage and direction
The recommended starting dose for Wellbutrin SR is 150 mg once daily in the morning. After at least three 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. Doses above 300 mg per day should be used only in patients who show no clinical improvement after several weeks at lower doses. Tablets should be swallowed whole and not crushed, chewed, or divided. Administration with food may reduce the incidence of gastrointestinal side effects.
Precautions
Patients should be monitored for worsening depression, suicidality, or unusual changes in behavior, especially at the beginning of treatment or after dose changes. Wellbutrin SR may lower the seizure threshold; use with caution in patients with a history of seizure disorder, head trauma, or concomitant medications that lower seizure threshold. It may increase blood pressure; regular monitoring is advised. Hepatic or renal impairment may require dose adjustment. Use in pregnancy only if clearly needed; bupropion passes into breast milk. Alcohol should be avoided due to increased seizure risk.
Contraindications
Wellbutrin SR is contraindicated in patients with a seizure disorder or history of epilepsy. It must not be used in individuals with a current or prior diagnosis of bulimia or anorexia nervosa due to increased seizure risk. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated; at least 14 days should elapse between discontinuing an MAOI and initiating Wellbutrin SR. Hypersensitivity to bupropion or any component of the formulation is also a contraindication.
Possible side effects
Common side effects include dry mouth, nausea, headache, insomnia, and dizziness. Less frequently, patients may experience sweating, tremor, anxiety, or tinnitus. Serious side effects, though rare, include seizures, hypertension, allergic reactions, and angle-closure glaucoma. Neuropsychiatric events such as agitation, hallucinations, or suicidal ideation have been reported. Any severe or persistent side effects should be promptly reported to a healthcare provider.
Drug interactions
Wellbutrin SR is a substrate of CYP2B6; inhibitors (e.g., ticlopidine, clopidogrel) or inducers (e.g., ritonavir, carbamazepine) of this enzyme may affect its levels. Concomitant use with other drugs that lower seizure threshold (e.g., antipsychotics, antidepressants, theophylline) increases seizure risk. It may interact with drugs metabolized by CYP2D6 (e.g., beta-blockers, SSRIs). Caution is advised with levodopa and amantadine. Avoid use with MAOIs.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next 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. Consistent dosing is important to maintain steady-state plasma concentrations.
Overdose
Overdose may lead to seizures, hallucinations, tachycardia, or loss of consciousness. Fatal outcomes have been reported, often involving multiple drugs. Symptoms may include nausea, vomiting, and ECG changes such as QTc prolongation. Management is supportive; activated charcoal may be useful if given early. Seizures should be treated with benzodiazepines; ECG and vital sign monitoring are essential. Contact a poison control center immediately in case of suspected overdose.
Storage
Store at room temperature (20–25°C or 68–77°F), in a tightly closed container, away from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Dispose of unused medication properly via a drug take-back program or according to FDA guidelines.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Do not disregard professional medical advice or delay in seeking it because of something you have read here.
Reviews
Clinical studies and patient reports generally indicate that Wellbutrin SR is effective in improving depressive symptoms with a favorable side effect profile for many individuals. Some users note improved energy and minimal weight gain, though experiences with side effects like insomnia or anxiety vary. Always consult a healthcare professional to determine if this medication is appropriate for your specific condition.