From the Guidelines
The typical starting dose for Wellbutrin (bupropion) is 150 mg once daily in the morning. This initial dose is usually maintained for 3-7 days before considering any increase. After this initial period, if well tolerated, the dose may be increased to 150 mg twice daily (morning and early afternoon) to reach the standard target dose of 300 mg per day. The gradual titration helps minimize side effects like insomnia, agitation, and seizure risk. Wellbutrin comes in immediate-release (IR), sustained-release (SR), and extended-release (XL) formulations, which affects dosing frequency - IR is typically taken three times daily, SR twice daily, and XL once daily. Patients should take Wellbutrin with food to reduce stomach upset and avoid taking it late in the day as it may cause insomnia. The medication typically takes 2-4 weeks to show therapeutic effects for depression, though some side effects may appear earlier. According to the American College of Physicians guideline 1, it is essential to assess patient status, therapeutic response, and adverse effects of antidepressant therapy on a regular basis beginning within 1 to 2 weeks of initiation of therapy.
Some key points to consider when prescribing Wellbutrin include:
- Monitoring for suicidal thoughts and behaviors, especially during the first 1-2 months of treatment
- Assessing response to treatment and making necessary changes in therapy if the response is not sufficient after adequate treatment
- Considering addition of other therapeutic modalities if the patient does not respond to first- or second-line treatments
- Being aware of potential side effects, such as sexual dysfunction, which may be lower with bupropion compared to other antidepressants like fluoxetine or sertraline 1.
It is crucial to discuss adverse event profiles with patients before selecting a medication and to closely monitor them for any changes in behavior or emergence of agitation, irritability, or unusual changes in behavior.
From the FDA Drug Label
The recommended starting dose for MDD is 150 mg once daily in the morning. After 4 days of dosing, the dose may be increased to the target dose of 300 mg once daily in the morning. The recommended starting dose for SAD is 150 mg once daily. After 7 days of dosing, the dose may be increased to the target dose of 300 mg once daily in the morning.
The typical starting dose for Wellbutrin (bupropion) is 150 mg once daily. This dose can be increased to a target dose of 300 mg once daily after 4 days for Major Depressive Disorder (MDD) or after 7 days for Seasonal Affective Disorder (SAD) 2.
From the Research
Typical Starting Dose for Wellbutrin
- The provided studies do not mention the typical starting dose for Wellbutrin (bupropion) 3, 4, 5, 6, 7.
- The studies focus on the effectiveness of bupropion as an antidepressant, its pharmacology, and potential side effects, but do not provide information on the recommended starting dose.
- Studies 4 and 5 discuss the use of bupropion in various populations and its side effect profile, but do not mention the starting dose.
- Studies 6 and 7 are related to the use of atypical antipsychotics in bipolar disorder and do not provide relevant information on the starting dose of Wellbutrin.
- Therefore, there is no relevant information in the provided studies to determine the typical starting dose for Wellbutrin.