From the FDA Drug Label
2.2 Dosage for Major Depressive Disorder (MDD) 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.
No, a patient should not start Wellbutrin at 300 mg. The recommended starting dose is 150 mg once daily, which may be increased to 300 mg after 4 days of dosing 1.
From the Research
Starting Wellbutrin at 300 mg is not recommended. The standard approach is to begin with 150 mg once daily for 3-7 days, then increase to 150 mg twice daily (300 mg total) if tolerated. This gradual titration helps reduce the risk of side effects, particularly seizures, anxiety, insomnia, and headaches. The body needs time to adjust to bupropion (Wellbutrin's active ingredient), and starting at a lower dose allows the liver enzymes to adapt to metabolizing the medication.
Key Considerations
- For sustained-release (SR) formulations, the typical schedule is 150 mg once daily for 3 days, then 150 mg twice daily.
- For extended-release (XL) formulations, patients usually start with 150 mg once daily in the morning for at least 3 days before increasing to 300 mg once daily.
- Patients with hepatic or renal impairment and elderly patients may require even more conservative dosing.
Evidence-Based Recommendation
According to the most recent and highest quality study 2, bupropion is an effective antidepressant with a good side-effect profile, and the recommended dosing schedule is to start with a lower dose and gradually increase as needed and tolerated. Always take Wellbutrin exactly as prescribed by your healthcare provider.
Important Side Effects to Consider
- Seizures
- Anxiety
- Insomnia
- Headaches It is essential to follow the recommended dosing schedule to minimize the risk of these side effects and ensure the safe and effective use of Wellbutrin.