What are the uses of Wellbutrin (Bupropion)?

From the Guidelines

Wellbutrin (bupropion) is primarily used to treat depression and seasonal affective disorder, and as an aid for smoking cessation, with a recommended dosing for depression starting at 150 mg once daily for 3-4 days, then increasing to 150 mg twice daily, with a maximum dose of 450 mg per day, as supported by the American College of Physicians guidelines 1. The medication works differently from most antidepressants by affecting the neurotransmitters dopamine and norepinephrine rather than serotonin. For smoking cessation (under the brand name Zyban), treatment usually begins 1-2 weeks before the quit date at 150 mg daily for 3 days, then 150 mg twice daily for 7-12 weeks, with studies showing its efficacy in smoking cessation 1. Wellbutrin may also be prescribed off-label for attention deficit hyperactivity disorder (ADHD), bipolar depression, sexual dysfunction caused by other antidepressants, and weight management, with the combination of bupropion and naltrexone being used for weight loss 1. Common side effects include dry mouth, insomnia, headache, nausea, and anxiety, and it carries a risk of seizures, particularly at higher doses, and should be avoided in patients with seizure disorders, eating disorders, or those undergoing abrupt alcohol or sedative withdrawal, as noted in various studies and guidelines 1. It is essential to monitor patients for potential adverse effects and adjust the treatment plan accordingly, considering the patient's medical history and current health status, as recommended by the American College of Physicians and other guidelines 1. The most recent guideline from the AGA on pharmacological interventions for adults with obesity also supports the use of bupropion for weight management, highlighting its efficacy and safety profile 1. Overall, Wellbutrin is a valuable treatment option for various conditions, but its use requires careful consideration of the patient's individual needs and health status, as well as regular monitoring for potential adverse effects, as supported by the evidence from multiple studies and guidelines 1.

From the FDA Drug Label

Bupropion hydrochloride extended-release tablets (XL) are an aminoketone antidepressant, indicated for: • treatment of major depressive disorder (MDD) ( 1.1) • prevention of seasonal affective disorder (SAD) ( 1.2)

The primary uses of Wellbutrin (bupropion) are for the:

• Treatment of major depressive disorder (MDD)
• Prevention of seasonal affective disorder (SAD) 2, 2

From the Research

Wellbutrin Uses

• Wellbutrin, also known as bupropion, is an effective antidepressant used in the management of major depressive disorder (MDD) 3, 4.
• It is available in three oral formulations: immediate release (IR), sustained release (SR), and extended/modified release (XR), all of which are bioequivalent in terms of systemic exposure to bupropion 3, 4.
• Bupropion is also used in the preventive treatment of seasonal affective disorder (SAD) and is probably effective in the acute treatment of SAD 5.
• Additionally, bupropion is used to treat Attention Deficit Hyperactivity Disorder (ADHD) and smoking cessation, although more research is needed to determine its efficacy in these areas 6.
• In the case of smoking cessation, bupropion is found to be an effective anti-smoking drug with synergistic benefits when used as a combination therapy 6, 7.

Efficacy and Safety

• Bupropion has been shown to be as efficacious as some tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) in the treatment of MDD, with the advantage of less somnolence and sexual dysfunction 3, 4.
• The efficacy of bupropion in the treatment of SAD has been established in several trials, although more research is needed to determine its efficacy in the acute treatment of SAD 5.
• Bupropion has been found to be generally safe and well-tolerated in the treatment of MDD, SAD, and smoking cessation, although it may be associated with a higher risk of neuropsychiatric adverse events in individuals with current or past MDD 7.

Formulations and Administration

• The XR formulation of bupropion is recommended for SAD due to its ease of use and is the only formulation currently used as a therapy 5.
• Bupropion can be administered once daily, which may improve patient adherence and outcomes 3, 4.
• The choice of formulation and administration schedule may depend on the individual patient's needs and preferences, as well as the specific indication being treated 3, 4, 5, 6.