From the Guidelines
Buproping SR (sustained-release) is preferred over other formulations due to its balanced approach to bupropoin delivery, providing consistent blood levels throughout the day and minimizing side effects. The SR formulation is taken twice daily, which improves medication adherence and reduces the peak-and-trough effect that can lead to side effects like anxiety or insomnia. According to the study 1, bupropion is a dopamine/norepinephrine reuptake inhibitor that has been approved for depression and smoking cessation, and its combination with naltrexone in Contrave has a synergistic effect on weight loss. The SR formulation of bupropion, such as in Wellbutrin SR, provides a more consistent release of the medication, which can help regulate mood and energy levels while minimizing the risk of seizures associated with rapid bupropoin absorption.
Key benefits of Buproping SR include:
- Consistent blood levels throughout the day
- Improved medication adherence due to twice-daily dosing
- Reduced peak-and-trough effect that can lead to side effects
- Less expensive than extended-release formulations like Wellbutrin XL
- Minimized risk of seizures associated with rapid bupropoin absorption
In comparison to other weight loss medications like phentermine, orlistat, and liraglutide, bupropion/naltrexone SR has a unique mechanism of action that targets multiple signaling pathways involved in obesity, making it a preferred option for some patients 1. However, the choice of formulation ultimately depends on individual patient needs and response to treatment.
From the Research
Buproping (Wellbutrin) SR Preference
- Buproping SR is preferred over other formulations due to its efficacy and tolerability in the treatment of major depressive disorder (MDD) 2, 3.
- The sustained-release formulation (SR) is administered twice daily, which may be more convenient for some patients compared to the immediate-release formulation (IR) that is administered three times daily 2, 3.
- Buproping SR has a similar tolerability profile to some selective serotonin reuptake inhibitors (SSRIs), but has the advantage of less somnolence and sexual dysfunction 2, 3.
Formulation Considerations
- All three formulations of buproping (IR, SR, and XR) are bioequivalent in terms of systemic exposure to buproping 2, 3, 4.
- The XR formulation has a prolonged absorption compared to the IR and SR formulations, which may be beneficial for some patients 4.
- The choice of formulation may depend on individual patient factors, such as age, medical illnesses, and potential drug interactions 4.
Clinical Efficacy and Safety
- Buproping SR has been shown to be effective in the treatment of MDD, with a similar efficacy to some SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) 2, 3.
- The safety and tolerability of buproping SR have been established in clinical trials, with common adverse events including insomnia, headache, dry mouth, nausea, and anxiety 5.
- Buproping SR has a low discontinuation rate due to adverse events, and the most common adverse events are generally transient and resolve quickly without therapeutic intervention 5.