From the Guidelines
Bupropion (Wellbutrin) should be initiated at a dose of 150 mg once daily for the first 3-4 days, then increased to 150 mg twice daily if tolerated, with a maximum recommended dose of 300 mg per day, as indicated in the most recent and highest quality study 1.
Dosing Schedule
The dosing schedule for Bupropion (Wellbutrin) is as follows:
- Initiate dosing 1-2 weeks prior to quitting
- Days 1-3: 150 mg orally, once daily
- Day 4-12 weeks: 150 mg orally, twice daily, if tolerated
- Maximum 300 mg per day
Important Considerations
- Bupropion is contraindicated for patients with seizure risks, those taking MAO inhibitors, or those with closed-angle glaucoma 1
- Patients with hepatic or renal impairment generally require lower doses
- Wellbutrin works by inhibiting the reuptake of dopamine and norepinephrine, which helps improve mood and energy levels
- Full therapeutic effects may take 4-6 weeks to develop, so it's essential to continue the medication even if benefits aren't immediately apparent
- Side effects like dry mouth, headache, and agitation are common initially but often subside with continued use
Additional Information
- The most recent study 1 provides guidance on the use of naltrexone-bupropion ER for weight loss and smoking cessation, but the recommended dosing schedule for Bupropion (Wellbutrin) remains the same as indicated in the study 1
- It's crucial to monitor patients for neuropsychiatric adverse effects, including suicidal thoughts and behaviors, especially in individuals younger than 24 years 1
From the FDA Drug Label
In the first study, the bupropion dose range was 300 mg to 600 mg per day administered in 3 divided doses; 78% of patients were treated with doses of 300 mg to 450 mg per day. The initial bupropion dose was 150 mg once daily for 1 week, followed by up-titration to 300 mg once daily.
The dosing schedule for Bupropion (Wellbutrin) is as follows:
- The dose range is 300 mg to 600 mg per day, administered in 3 divided doses.
- The initial dose can be 150 mg once daily for 1 week, followed by up-titration to 300 mg once daily.
- The majority of patients were treated with doses of 300 mg to 450 mg per day 2 2.
From the Research
Dosing Schedule for Bupropion (Wellbutrin)
- The dosing schedule for Bupropion (Wellbutrin) is not explicitly stated in the provided studies, but the following doses are mentioned:
- 450 mg/day as the maximum recommended dose 3
- 600 mg/day as a dose that may increase the risk of seizures 4
- 100-400 mg/day as the dose range used in a study comparing bupropion SR with topiramate for the treatment of bipolar depression 5
- 250 mg/day as the mean dose of bupropion SR used in the same study 5
- 450 mg/day as the suggested maximum daily dose when treating bipolar depressed patients 6
Special Considerations
- The risk of seizures appears to be higher with bupropion doses above the recommended maximum 3
- Predisposing factors, such as a history of epilepsy or neurological illness, may increase the risk of seizures 4, 3
- Bupropion may interact with other medications, such as anticonvulsants, and affect their plasma levels 7