Wellbutrin (bupropion) is an antidepressant in the norepinephrine–dopamine reuptake inhibitor (NDRI) class. It is approved to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). By increasing norepinephrine and dopamine signaling, it can help improve low mood, lack of energy, reduced motivation, and impaired concentration. Unlike many SSRIs, Wellbutrin is less likely to cause weight gain or sexual dysfunction, which makes it an important option for patients concerned about those adverse effects.
Clinicians also use bupropion to support smoking cessation, typically under the brand name Zyban or as generic bupropion SR. Some patients notice increased alertness and focus; while bupropion is not FDA-approved for ADHD, it is sometimes used off-label in that context when clinically appropriate. Because it can be activating, Wellbutrin may be preferred when fatigue and psychomotor slowing are prominent, but it can worsen anxiety or insomnia in some people.
Wellbutrin comes in immediate-release (IR), sustained-release (SR), and extended-release (XL) tablets, offering dosing flexibility for symptom patterns, tolerability, and adherence. Choice of formulation and dose should be individualized with a licensed prescriber.
Dosing is individualized, but common starting regimens for MDD include: XL 150 mg once daily in the morning for several days, then increase to 300 mg once daily if tolerated; or SR 150 mg once daily for 3 days, then 150 mg twice daily (doses at least 8 hours apart). The IR formulation, when used, is typically divided into three daily doses at least 6 hours apart. Do not crush, split, or chew SR/XL tablets; altering the release mechanism can markedly increase side effects and seizure risk.
The usual effective dose for depression is 300 mg/day (as XL once daily or SR twice daily). Some patients may require up to 450 mg/day, but higher doses increase the risk of seizures. For SAD, XL 150–300 mg once daily is commonly used during high-risk months. For smoking cessation (bupropion SR), a typical plan is 150 mg once daily for 3 days, then 150 mg twice daily, with a planned quit date in week two. Your clinician will tailor timing and formulation based on your medical history, concurrent medications, and side-effect profile.
Take doses in the morning to minimize insomnia. If you take SR twice daily, schedule the second dose mid-afternoon to avoid sleep disruption. Consistency matters: take it at the same time each day. If bothersome nausea occurs, taking with a small meal may help.
Seizure risk is dose-related and increases with certain conditions. Use extreme caution if you have a history of seizures, significant head trauma, brain tumor, severe hepatic impairment, or if you use other medicines that lower the seizure threshold. Do not exceed prescribed doses, and avoid rapid dose escalations.
Because Wellbutrin is activating, it can cause or worsen anxiety, agitation, and insomnia. It may raise blood pressure and heart rate; monitor if you have hypertension or cardiovascular disease. All antidepressants carry a boxed warning for increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Close monitoring is essential, especially during initiation or dose changes.
Patients with bipolar disorder require careful evaluation; antidepressants can precipitate mania or hypomania without a mood stabilizer. Angle-closure glaucoma can be triggered in susceptible individuals. Discuss pregnancy and breastfeeding with your clinician; data do not show a major teratogenic signal, but risk–benefit should be individualized. Reduce or avoid alcohol; heavy use increases seizure risk and can worsen mood symptoms. Some urine drug screens may show false positives; inform the lab and your clinician that you take bupropion.
Do not use Wellbutrin if you have a seizure disorder or a current or prior diagnosis of bulimia or anorexia nervosa, as these markedly increase seizure risk. It is contraindicated during abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs.
Avoid concomitant or recent monoamine oxidase inhibitor (MAOI) use. Allow at least 14 days after stopping an MAOI before starting bupropion, and wait 14 days after stopping bupropion before starting an MAOI. Wellbutrin is contraindicated in patients with known hypersensitivity to bupropion or any tablet components. Do not take Wellbutrin with other bupropion-containing products (e.g., Zyban, Aplenzin) to prevent unintentional overdose.
Caution is advised with linezolid or intravenous methylene blue due to risk of hypertensive reactions; coordinate with your prescriber. If you have significant hepatic or renal impairment, dose adjustments and closer monitoring are needed.
Common side effects include dry mouth, insomnia, headache, nausea, constipation, dizziness, tremor, sweating, and increased heart rate. Some patients experience anxiety, jitteriness, or restlessness, especially early in treatment. Appetite suppression and mild weight loss can occur. Compared with SSRIs and SNRIs, sexual side effects are generally less frequent.
Less common but important reactions include elevated blood pressure, rash, itching, tinnitus, and visual disturbances. Rare but serious events include seizures (risk increases with higher doses and predispositions), severe hypertension, allergic reactions (including anaphylaxis), and severe skin reactions. Neuropsychiatric symptoms (mood changes, hostility, hallucinations) have been reported, particularly in the context of smoking cessation; monitor closely and report concerning changes immediately.
If you develop signs of mania (decreased need for sleep, racing thoughts, risky behavior), suicidal thinking, severe rash, swelling of the face or throat, or seizure activity, seek urgent medical attention and contact your prescriber promptly.
Bupropion is a strong inhibitor of the CYP2D6 enzyme. It can increase levels of CYP2D6 substrates, including certain SSRIs (e.g., paroxetine), tricyclic antidepressants, antipsychotics (e.g., risperidone), beta-blockers (e.g., metoprolol), tamoxifen, and others. Dose adjustments or alternative therapies may be needed. Always inform your clinician and pharmacist about all medications and supplements you take.
Avoid MAOIs within 14 days. Use caution with drugs that lower the seizure threshold: tramadol, theophylline, antipsychotics, systemic corticosteroids, quinolone antibiotics, mefloquine, and abrupt alcohol or benzodiazepine withdrawal. Ritonavir and efavirenz can affect bupropion levels via CYP2B6; dose adjustments may be required. Inducers like carbamazepine or phenytoin may reduce bupropion efficacy. Cimetidine can increase bupropion exposure.
Nicotine replacement therapy combined with bupropion can increase blood pressure; monitor closely. Limit excessive caffeine, which may worsen jitteriness and insomnia. Herbal supplements such as St. John’s wort and kava can interact with mood, metabolism, or sedation; discuss these before use.
If you miss a dose, take it as soon as you remember unless it is close to the time for your next dose. If it is near the next scheduled dose, skip the missed dose and resume your usual schedule. Do not double up to make up for a missed dose. For SR formulations, space doses at least 8 hours apart; for IR, at least 6 hours; for XL, take once daily. Maintaining proper intervals helps reduce the risk of seizures and insomnia.
If you miss multiple doses or have persistent side effects after resuming, contact your clinician for guidance on how to restart safely.
Symptoms of bupropion overdose may include severe agitation, hallucinations, tremor, vomiting, rapid heartbeat, arrhythmias, confusion, loss of consciousness, and seizures. Overdose can be life-threatening. If you suspect an overdose, call emergency services immediately (911 in the U.S.) and contact Poison Control at 1-800-222-1222 for expert guidance. Do not induce vomiting unless instructed by medical professionals. Supportive care in a medical setting is usually required, and prolonged observation may be necessary due to delayed seizure risk with extended-release products.
Store Wellbutrin at room temperature, ideally 20–25°C (68–77°F), in a dry place away from direct light and moisture. Keep tablets in the original, tightly closed container and out of reach of children and pets. Do not store in the bathroom. Safely dispose of expired or unused medication through take-back programs or according to pharmacist guidance; do not flush unless specifically instructed. Keep a current medication list and check expiration dates regularly.
In the United States, Wellbutrin (bupropion) is a prescription-only medication. By law, pharmacies must dispense it only with a valid prescription issued after an appropriate medical evaluation. Buying Wellbutrin without prescription is unsafe and may be illegal; websites or services that claim to sell “no‑Rx” bupropion should be avoided due to risks of counterfeit products, contamination, incorrect dosing, and lack of clinical oversight.
The Urological Institute of Northeastern New York supports safe, legal access by connecting patients with licensed clinicians for evaluation—often via convenient telehealth or in-person visits. If Wellbutrin is appropriate, your provider can issue a valid prescription to be filled at a trusted, U.S.-licensed pharmacy. This structured, clinician-guided pathway protects your safety, ensures drug authenticity, and enables ongoing monitoring for effectiveness and side effects.
To verify a safe pharmacy, look for state licensure and NABP accreditation (e.g., “.pharmacy” domains) and confirm that a prescription is required. For cost concerns, ask about generics, manufacturer assistance programs, and prescription savings options. The bottom line: do not attempt to obtain Wellbutrin without prescription; instead, use lawful channels through licensed providers—such as those available at The Urological Institute of Northeastern New York—to receive individualized care and an appropriate, legitimate prescription.
Wellbutrin (bupropion) is an antidepressant that primarily inhibits the reuptake of norepinephrine and dopamine (NDRI). It does not meaningfully affect serotonin, which often means fewer sexual side effects and less weight gain. It carries a boxed warning for increased risk of suicidal thoughts in young people, especially when starting or changing dose.
Wellbutrin is FDA-approved for major depressive disorder (MDD) and seasonal affective disorder (SAD). The bupropion SR formulation is approved as Zyban for smoking cessation. Off-label, it’s sometimes used for ADHD, SSRI-induced sexual dysfunction, and as an add-on in resistant depression.
Some people notice improvements in energy, motivation, and concentration within 1–2 weeks, with mood benefits building over 4–6 weeks. For smoking cessation, start 1–2 weeks before the quit date and continue for 7–12 weeks or as directed. Consistent daily use is key.
Common effects include dry mouth, insomnia, headache, nausea, tremor, sweating, and increased heart rate. It can cause anxiety or agitation in some people, especially early on. Blood pressure can rise; periodic monitoring is wise. Serious but rare risks include seizures, allergic reactions, and angle-closure glaucoma in predisposed individuals.
Wellbutrin is generally weight-neutral or associated with modest weight loss. It’s sometimes chosen when weight gain with other antidepressants is a concern. It is not approved for weight loss, and intentional calorie restriction should be cautious due to seizure risk if severe.
Compared with SSRIs and SNRIs, Wellbutrin has a lower risk of sexual side effects and may even improve libido or arousal, especially when added to an SSRI. Individual responses vary; discuss persistent problems with your clinician.
Seizure risk is dose-related and low at standard doses; it increases at 450 mg/day and above or with rapid dose escalation. Avoid in people with a seizure disorder, current or prior bulimia or anorexia nervosa, or during abrupt alcohol/benzodiazepine withdrawal. Use caution with severe head injury, brain tumors, or medications that lower seizure threshold.
IR is taken 3 times daily, SR twice daily, and XL once daily. XL and SR offer steadier levels and may reduce side effects like jitteriness or insomnia compared to IR. Do not crush, split, or chew SR/XL tablets. Maximum typical daily doses: IR up to 450 mg (divided), SR up to 400 mg (divided), XL up to 450 mg (once daily).
Because it’s activating, Wellbutrin can worsen anxiety, restlessness, or insomnia in some people, particularly early in treatment or at higher doses. Taking it in the morning, avoiding caffeine excess, and gradual titration can help. If persistent, dose adjustments or a different medication may be better.
Do not combine with MAOIs or within 14 days of MAOI use. Bupropion is metabolized by CYP2B6; certain antivirals, clopidogrel, and other agents can alter levels. It inhibits CYP2D6, which can raise levels of some SSRIs, TCAs, antipsychotics, beta-blockers, and can reduce effectiveness of tamoxifen; monitoring or alternatives may be needed. Use caution with other drugs that lower seizure threshold (e.g., tramadol, stimulants).
Alcohol can increase seizure risk and worsen mood or sleep. Avoid binge drinking and do not abruptly stop heavy alcohol use while on bupropion. Many clinicians recommend limiting or avoiding alcohol during treatment.
Decisions are individualized. Available data do not show a clear increase in major birth defects with bupropion, though some studies raised a small, inconsistent signal for cardiac defects. In breastfeeding, small amounts pass into milk; most infants tolerate it, but monitor for irritability or poor feeding. Discuss risks and alternatives with your clinician.
Common starts: XL 150 mg once daily for 3–7 days, then 300 mg once daily; some may go to 450 mg/day if needed. SR often starts at 150 mg once daily for 3 days, then 150 mg twice daily; max 200 mg twice daily. For smoking cessation (SR), 150 mg once daily for 3 days, then 150 mg twice daily, starting 1–2 weeks before the quit date.
Take it when you remember unless it’s close to your next scheduled dose. If it’s late in the day, skip it to reduce insomnia and seizure risk. Do not double up doses.
While bupropion has fewer discontinuation symptoms than SSRIs/SNRIs, a gradual taper over 1–2 weeks helps minimize rebound symptoms like irritability or sleep changes. Always consult your prescriber before changing your dose.
Yes, it’s commonly combined to augment antidepressant response or offset SSRI-induced sexual side effects or fatigue. Monitor for additive side effects (e.g., anxiety, blood pressure changes) and for CYP2D6-related interactions.
Avoid if you have a seizure disorder, a current or prior diagnosis of bulimia or anorexia nervosa, are using an MAOI or have used one in the past 14 days, or are undergoing abrupt withdrawal from alcohol/benzodiazepines. Use caution in severe liver disease, uncontrolled hypertension, and bipolar disorder without a mood stabilizer due to risk of mania.
Wellbutrin (NDRI) is activating, less likely to cause sexual dysfunction or weight gain, and may help with low energy. Zoloft (SSRI) is often better for anxiety and has more serotonergic side effects (GI upset, sexual dysfunction). Choice depends on symptom profile, side-effect tolerance, and comorbid anxiety.
Both can boost energy, but Wellbutrin is typically more activating and less likely to cause sexual side effects or weight gain. Fluoxetine may be better for coexisting anxiety or OCD but can cause more GI upset and sexual dysfunction. Either may be appropriate depending on individual response.
Both can raise blood pressure, but venlafaxine’s effect is more prominent at higher doses and it has a well-known discontinuation syndrome if stopped abruptly. Wellbutrin has minimal discontinuation symptoms but carries dose-related seizure risk. Venlafaxine may help more with generalized anxiety; Wellbutrin often suits low-energy, low-motivation depression.
Duloxetine (SNRI) has strong evidence for neuropathic pain, fibromyalgia, and chronic musculoskeletal pain in addition to depression/anxiety. Wellbutrin does not specifically target pain but can help with fatigue and concentration. If pain syndromes co-occur, duloxetine may be preferred; if weight or sexual side effects are concerns, Wellbutrin has advantages.
Lexapro is among the most tolerable SSRIs and effective for generalized anxiety disorder. Wellbutrin can sometimes worsen anxiety initially and is not first-line for primary anxiety disorders. For depression with prominent anxiety, Lexapro may be favored; for depression with fatigue and sexual side-effect concerns, Wellbutrin may fit better.
Pristiq can raise blood pressure, cause sweating, nausea, and sexual dysfunction; it has a moderate discontinuation syndrome. Wellbutrin is more activating and more prone to insomnia and dry mouth but has fewer sexual side effects. Either can be effective; the choice hinges on symptom targets and tolerability.
Mirtazapine is sedating at lower doses and often boosts appetite and weight, making it helpful for insomnia and poor appetite. Wellbutrin is activating and often weight-neutral or modestly weight-reducing. Some patients benefit from combining them at night (with careful medical supervision).
No. Trazodone is primarily used at low doses as a sleep aid; at higher doses it is an antidepressant but is sedating and limited by side effects. Wellbutrin is a first-line antidepressant that can worsen insomnia; it’s not a sleep medication. They may be used together when appropriate.
Vortioxetine can improve cognitive symptoms of depression and tends to have fewer sexual side effects than many SSRIs/SNRIs, though GI upset is common. Wellbutrin is also favorable for sexual function and may improve energy and concentration. The best choice may depend on prior SSRI/SNRI response and GI tolerability.
Vilazodone combines SSRI action with 5-HT1A partial agonism; it often causes early GI upset but may have somewhat fewer sexual side effects than classic SSRIs. Wellbutrin is more activating, with less GI upset and fewer sexual side effects, but can increase anxiety or insomnia. Tolerability profiles often drive selection.
TCAs can be very effective but have anticholinergic effects (constipation, dry mouth, urinary retention), weight gain, and cardiac conduction risks, and are dangerous in overdose. Wellbutrin generally has a safer side-effect and cardiac profile but carries seizure risk at higher doses. TCAs may be chosen for pain or migraine prevention; otherwise, Wellbutrin is often better tolerated.
MAOIs are highly effective for atypical or treatment-resistant depression but require strict dietary restrictions (tyramine) and have extensive drug interactions. The selegiline patch reduces, but doesn’t eliminate, these concerns at higher doses. Wellbutrin avoids dietary limits and has fewer interaction risks but may be less potent for refractory cases.
SSRIs like sertraline have the most evidence and are commonly first-line in postpartum depression, including during breastfeeding. Wellbutrin can be considered if SSRIs are not tolerated or if sexual side effects or weight gain are problematic. Shared decision-making with obstetric and pediatric input is recommended.
Bupropion SR (Zyban) roughly doubles quit rates versus placebo and may help with weight control after quitting. Varenicline (Chantix) generally has higher quit rates than bupropion but can cause nausea and vivid dreams. Some patients use bupropion plus nicotine replacement; selection depends on tolerability, history, and clinician guidance.
