Overview

Even before Prozac, there was Wellbutrin. It was the first of a new generation of antidepressants and was introduced in 1985, almost two years before Prozac received FDA approval.

The company started shipping Wellbutrin to pharmacies around the country, but before prescriptions could actually be filled, a problem arose. A small study involving 50 women with an eating disorder uncovered an alarming statistic.

Four out of the fifty (8 percent) had suffered a seizure. This unexpected and alarming discovery created consternation at the FDA and the feds had the drug pulled off pharmacy shelves.

The FDA demanded additional tests, but the company resisted, maintaining that the bulimic subjects in the study were not representative of depressed patients. Prior research suggested that the seizure incidence was similar to that for other antidepressants.

For more than a year the company and the FDA argued. Eventually the company capitulated and studied an additional 3,000 patients.

The results redeemed Wellbutrin: The seizure incidence turned out to be 0.4 percent, not that different from other antidepressants and nowhere near the 8 percent seen in the small bulimia study.

Finally, in August 1989, Wellbutrin returned to pharmacy shelves, but it was almost too late. Prozac, introduced in 1987, had become a shooting star. Its incredible popularity made Wellbutrin an also-ran.

Although Wellbutrin works differently from Prozac and similar drugs (Paxil and Zoloft), doctors seemed to remember only the initial concern about seizures.

Despite its initial lack of success in the marketplace, Wellbutrin is roughly comparable to Prozac-like drugs in effectiveness.

Unlike traditional antidepressants, Wellbutrin does not cause weight gain, drowsiness, blurred vision, mental confusion, cardiovascular problems or impaired memory.

And Wellbutrin has one huge advantage over Prozac and other SSRI antidepressants. It does not lower libido, produce impotence or impair orgasms. If anything, Wellbutrin may actually stimulate sexuality for some people.

Side Effects and Interactions

Side effects associated with Wellbutrin include headache, dry mouth, agitation, insomnia, tremor, sweating, skin rash, nausea and constipation.

Other possible side effects include dizziness, nervousness, confusion, weight loss and blurred vision. Report any symptoms to your physician promptly.

Certain other medications may change the metabolism of Wellbutrin: The AIDS drug ritonavir can lead to large increases in the blood levels of the antidepressant, while the antiseizure medicine Tegretol lowers blood concentrations of Wellbutrin.

Taking antipsychotics, antidepressants, theophylline, or oral corticosteroids in combination with Wellbutrin may increase the risk of a seizure. So can sudden discontinuation of anti-anxiety pills like Ativan, Halcion or Xanax.

Other possible interactions may occur in combination with levodopa, phenelzine and tricyclic antidepressants such as amitrityline.

Because of a concern that ginkgo biloba could possibly make a person more vulnerable to seizures, it probably should not be taken together with drugs known to increase the risk of seizures. Antidepressants such as Wellbutrin belong in this category.

Interactions between the herb St. John’s wort and Wellbutrin are possible. Switching between antidepressants and herbal treatment calls for medical guidance (physicians can find a suggested protocol for gradual substitution of St. John’s wort in Hyla Cass’s book, St. John’s Wort: Nature’s Blues Buster).

Animal experiments indicate that compounds that act on dopamine in the brain, such as Wellbutrin, may affect or be affected by the herb chaste tea berry.

Check with your pharmacist and physician to make sure Wellbutrin is safe in combination with any other medicines and herbs you take.

Special Precautions

Even though the seizure risk with Wellbutrin is not as high as originally feared, a 0.4% incidence must not be ignored. The dosing schedule is extremely important in reducing this risk.

The maximum daily dose of 450 mg should not be exceeded. In the case of the sustained release (SR) formulation, the total daily dose should not exceed 400 mg.

Alcohol and certain other drugs (oral decongestants, other antidepressants, theophylline, oral corticosteroids) may potentiate the risk of seizures, so please check with a physician before consuming alcoholic beverages or taking any other medications.

Some drugs, such as Ativan, Halcion or Xanax, should be used cautiously, if at all, with Wellbutrin, because stopping them suddenly may make some people more vulnerable to seizures.

Wellbutrin may cause an exaggerated sun reaction, so people taking this antidepressant should stay out of the sun, wear protective clothing and use a broad spectrum sun block.

Taking the Medicine

Wellbutrin can be somewhat more complicated to take than other medications.

The SR (slow-release) formula is usually given as 150 mg twice a day with at least eight hours between the two doses. If the dose needs to be increased, this must be done gradually with medical supervision.

The SR (slow-release) formulation should not be chewed, crushed or split, as this might alter the absorption of this medicine.

The immediate-release tablets are usually given three times daily. No single dose should exceed 150 mg.

Dosing is usually started at 200 mg a day, given as 100 mg twice a day. This can be gradually increased to a total of 300 mg a day total. The daily dose should not be increased by more than 100 mg in a three-day period.

To minimize insomnia, the last dose of the day should not be taken at bedtime. However, immediate-release tablets should be spaced approximately six hours apart.

Food does not appear to have a significant effect upon Wellbutrin absorption, so it may be taken with or without food.

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  1. Jae
    Reply

    I switched from a generic brand to another genetic brand of bupropion about 2 weeks ago.
    Now I feel like I’m dying. Constantly dizzy…. Bad bad dizzy. I feel like I am in a fog all day. Like I just woke up all day long.
    For about a week, I had body aches like I had the flu. I also have foggy vision and headaches. This sucks.

    • Shay
      Reply

      Same here! I switched from the Sandoz 200 mg SR to the Watson 200 mg SR, and I am miserable! I will definitely be going back to the Sandoz ASAP!

  2. aa
    Reply

    My Dr put me on bupropion for anxity, it has worked wonders for me. I feel more awake, alive, able to run erands by myself. Before I wouldn’t leave my house if I didn’t have too, not alone anyway.
    I have had side effects like chest pressure as if someone was sitting on my chest. My Dr told me to stop it and changed me to xanax, horrible, horrible, horrible felt like a zombie.
    I stopped it after two weeks and restarted bupropion, just recently I have had small blistering, clustered rash develop in my inner upper and lower eye lid with lots and lots of itching. I have read about the allergic reaction on the skin but not in the eye. I’m going to stop my med and see if it goes away. I will repost if it returns after I restart it.
    The price I pay to be able to live normally!

  3. lizzie
    Reply

    Taking Wellbutrin SR has made a big change in my well being, but the most important thing I want to comment on is that a smaller dose helps me much more than a larger dose. I had to find this out through painful trial and error with my doctor.
    It seems the way my body metabolizes Wellbutrin causes serious side effects when taken in normal doses, but quitting it altogether was not the answer. Decreasing the dose was what worked.

  4. MH
    Reply

    After trying Prozac for 1 year and gaining almost 50 pounds I had to switch to something that was going to make me a much happier person. Gaining weight on top of MDD is almost the worst thing ever. So I have been on Bupropion for about 6 months now and I have to say, this was a life miracle. I felt an instant change in my mood and I have nothing but good things to say about this medication. Bupropion will make you much happier, and it will give you the motivation to actually want to do something & if losing weight is something you want to accomplish (It was for me) then this is the pill for you! You will be ready to get up and work out.
    For anyone who is curious I started at 215 I’m now at 140.

  5. ABR
    Reply

    I have read a lot of helpful information shared by others taking Bupropion after having taken the brand name Welllbutrin. I will be calling my doctor TODAY for a consult to try to get back on the brand name.
    I was put on Wellbutrin XL in 2003 after being diagnosed with breast cancer at 42 yrs old. Initially, it was 150mg, then a month later, upped to 300mg. It was prescribed for extreme fatigue, lack of energy and also to lessen the extreme hot flashes that were induced by the chemo putting me into early menopause. I didn’t really want to admit I was also depressed, but I’m sure I was. I felt wonderful! It gave me back the energy I had lost, I began exercising again and definitely helped lessen the effects of the hot flashes.
    It’s been so long ago now, that I don’t remember when I was switched a couple of times to generic brands… but it was several years ago. I just didn’t pay close enough attention! I do believe it was at the same time that I began to feel like it wasn’t working. I was upped to the max dosage of 450mg. Nothing really seemed to improve, but I was afraid to go off it. I was gaining weight due to lack of energy again, feeling very discouraged and anxious, when I hadn’t been in so long. I thought it was just me possibly becoming immune to the medication!
    Then I noticed my memory started to get worse each year, to the point I have been in tears thinking I might be getting early-onset Altzheimers. I also get fluctuating degrees of ringing in my ears. It wasn’t until a few weeks ago that I started to question the medication and not myself! I found this site and read a few of other’s stories and realized I might actually have a chance to get my life back!
    I was still a little concerned that I was grasping at straws and that it might still be me, but after reading more stories today, I’m convinced it’s not all in my head and I’m determined to find a way to feel better! BTW, even when I was concerned about the cancer recurring, I never felt so despondent, in general, as in recent years. I believe, now, that this is due to the Bupropion HCI XL, that I’ve been taking for most of the 11 years I’ve been a cancer survivor!

    • Patricia SAddler
      S.C
      Reply

      Wow thats amazing!!!!

  6. AE
    Reply

    We Texans can refuse generics? I had no idea, THANK YOU FOR YOU POST :D . I was reading all the other posts and then I knew that I too was doomed to be switched from Wellbutrin… you just saved me from a nightmare!

  7. FN
    Reply

    People say Wellbutrin may slightly help you lose weight. When I started Wellbutrin, I weighed 360 pounds. Normally I eat 3-7 POUNDS of food a day. Because of Wellbutrin, I feel like not only eating LESS THAN A THIRD of the amount I normally eat, I feel like AVOIDING JUNK-FOOD and DRINKING MOSTLY WATER. I’ve been taking it for 16 weeks now. It’s like a diet pill that won’t kill you and has many other purposes.
    Granted I sometimes experience confusion, a ***lack of self-awareness*** or very occasionally a headache, it’s definitely a great trade-off for not eating like a pig and feeling like I should just quit waking up and leaving my bed.
    So if you’re a fat depressed bastard (no offense :P) like I still sort of am, definitely try Wellbutrin if your doc recommends it.

  8. Erin
    Reply

    Hi all,
    Just wanted to share with you my experience with bupropion. I had been taking it since last fall, mainly because I needed some energy (I have mild hypothyroidism)… most anti-depressants make me sleepy, but bupropion seemed to be good for me… it never really stimulated me at all, but at least I stayed awake and it helped my mood and definitely libido!! It was awesome for seasonal affective disorder. I don’t think I could have survived the fall and winter last year without it. So, it was a good medication for me, at least in the beginning.
    My thyroid levels are under control, but I started having really bad acne and it really concerned me. It was mainly on my cheeks, the edge of my face, around my mouth and on my chin… very big and painful cystic acne and it would bleed a lot when I washed my face. My doctor put me on ortho tri cyclen and said it might help, but months later my skin was still breaking out.
    For a week I was on vacation and I skipped taking bupropion and my skin started to get better. I stayed off it for a month or more and hardly had any acne at all, but then I started to feel very tired and was sleeping a lot during the day. I tried to take the bupropion again (by the way I was taking 75mg of immediate release generic bupropion 2x/day by Mylan) and within a week of starting it again, the bad acne came roaring back, so now I once again have scars that have to heal and the new breakouts have not completely stopped yet.
    I stopped taking it as soon as I realized what was happening again. I seemed to be out of options as far as what to do for energy and stress, so I bought a supplement called Adrenal Support (by Solaray) and when I went to my latest doctors appointment, she looked at me like I was crazy for thinking something natural would work.
    She gave me a prescription for 10mg Adderall 2x/day and I only took one today because I was a bit skeptical about it. All I can say is that I was not physically more stimulated, but mentally, yes. I felt like I could have given a seminar on pretty much anything… I had so many thoughts going through my head that I felt like I could talk someone’s ear off. I don’t know if the doctor thinks that is getting more energy, but it’s not. It’s just getting tons of extra thoughts going through my head. But I am all out of ideas because there was no way I could have continued taking the bupropion and having a face full of acne.
    I believe that it wreaks havoc on hormones, especially to those people who are sensitive and who may already have a history of hormonal issues. So if anybody reading this is taking bupropion and has developed acne, that might be the culprit for you!!!

  9. Shay0414
    Reply

    How are you doing these days I read your article from March? I hope things are better :)

  10. Bamon718
    Reply

    TO TMC-
    I don’t know that the drug being generic or not was what caused the difference. Listen to this.
    I took regular bupropin ( Generic ) 150 in morning, no problem. Had a bout of depression,[ mostly tearfullness for no reason-and not being able to leave the house by myself.]
    Doc put me on bupropin 300 XL, not only did my symptoms contiue-they got worse !
    Doc then tried 2 doses of bupropin 150 2 x a day [I know, same amount!] and it worked fine ! I’m still levelling out, but if anything I am more wound up than depressed.
    I know it doesn’t make sense-but as ong as I am not crying for reasons like ‘the mail was late’-I don’t really care which, what, or why.
    Bamon

  11. Jess
    Reply

    I’ve been on Mylan’s generic (immediate release)for a week and am going to try the brand version, SR or XL because I get a huge rush as the pill breaks up as designed. I have been getting things done and feeling better (Major Dep, PTSD, etc.) I do, however, have to time when I take these carefully so I won’t be driving, having important conversations, or making decisions that have significant consequences, because I’m never sure if the initial flush, itching, anxiety (easily self-talked out of, not like real panic/terror) will strike too hard and skew my judgement, or make me speedy/sleepy.
    I’m not able to pay 300 for the brand. I’m looking into coupons, Canadian pharmacies etc. I get dry mouth and weird breath, but feel sooooo much better. I’m sorry other people have had the same less-than-ideal experience on the generics, but glad to have validation. I would not wish dealing with heartless, ignorant drones while depressed on my worst enemy.
    Some of our most amazing contributions have been made by those who saw the world differently. Invalidation by committee compounds/triggers symptoms and does not fall into the helpful category! Glad not to be alone in this.
    Good luck to all.

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