What is the best management for xerostomia in an 84-year-old male with major depressive disorder taking bupropion (Wellbutrin)?

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Last updated: March 30, 2025View editorial policy

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From the Research

For an 845-year-old male with major depressive disorder experiencing dry mouth from bupropion, the best management option is to continue the medication while implementing supportive measures to alleviate the side effect, as recommended by the most recent study 1 published in 2025. The management of dry mouth should focus on symptomatic relief while continuing treatment with bupropion, as it can be effective for depression and typically has fewer sexual side effects than many other antidepressants. Some key measures to alleviate dry mouth include:

  • Increasing fluid intake
  • Using sugar-free candies or gum to stimulate saliva production
  • Avoiding alcohol and caffeine which can worsen dry mouth
  • Using alcohol-free mouthwashes
  • Considering over-the-counter artificial saliva products if needed, as they have been shown to reduce symptoms of xerostomia 2. It's essential to note that dry mouth is a common anticholinergic side effect of bupropion that often improves with time as the body adjusts to the medication. If dry mouth becomes severe or intolerable despite these measures, the patient should follow up with their provider to consider dose adjustment or medication alternatives. The importance of managing dry mouth is highlighted by the potential complications, including dental caries, periodontal disease, and infections, as discussed in the study 3 published in 2015. However, the most recent and highest quality study 1 provides the most relevant guidance on the management of dry mouth, and its recommendations should be prioritized. Overall, the goal of management should be to alleviate symptoms, prevent complications, and maintain the patient's quality of life while continuing effective treatment for major depressive disorder.

References

Research

Management of Dry Mouth.

The Senior care pharmacist, 2025

Research

Dry mouth: a critical topic for older adult patients.

Journal of prosthodontic research, 2015

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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