From the Guidelines
Bupropion is not typically associated with weight gain and may actually lead to modest weight loss in some people. According to the most recent and highest quality study, bupropion affects dopamine and norepinephrine rather than serotonin, which may explain its different effect on weight 1. Clinical studies have shown that patients taking bupropion often maintain their weight or lose 2-3 pounds on average during treatment. This weight-neutral or weight-loss effect makes bupropion a potential choice for patients concerned about medication-related weight gain, particularly those with obesity or metabolic conditions.
Some key points to consider when prescribing bupropion include:
- The medication is sometimes prescribed at doses of 150-450 mg daily, with the extended-release formulation often preferred for once-daily dosing and fewer side effects.
- Bupropion is FDA-approved as an antidepressant and has been shown to be effective for the long-term treatment of recurrent major depression 1.
- The combination of bupropion and naltrexone has been shown to be effective for weight loss and may also be beneficial for smoking cessation 1.
- Patients should be monitored for neuropsychiatric adverse effects, including suicidal thoughts and behaviors, especially in individuals younger than 24 years 1.
It's also worth noting that other studies have confirmed that bupropion is one of the few antidepressants that consistently promotes weight loss, making it a good option for patients with weight concerns 1. Overall, the evidence suggests that bupropion is a good choice for patients who are concerned about weight gain and are looking for an effective treatment for depression or smoking cessation.
From the FDA Drug Label
Table 5: Incidence of Weight Gain or Weight Loss (≥5 lbs) in MDD Trials Using Bupropion HCl Sustained-Release Weight Change Bupropion HCl Sustained- Release 300 mg/day (n=339) Bupropion HCl Sustained- Release 400 mg/day (n=112) Placebo (n=347) Gained >5 lbs 3% 2% 4% Lost >5 lbs 14% 19% 6% Table 6: Incidence of Weight Gain or Weight Loss (≥5 lbs) in SAD Trials Using Bupropion HCl Extended-Release Weight Change Bupropion HCl Extended-Release 150 to 300 mg/day (n=537) Placebo (n=511) Gained >5 lbs 11% 21% Lost >5 lbs 23% 11%
Bupropion is not typically associated with weight gain. In fact, the data from the tables suggest that weight loss is more common than weight gain in patients taking bupropion. According to Table 5,3% of patients taking 300mg/day and 2% of patients taking 400mg/day of bupropion HCl sustained-release gained more than 5 lbs, compared to 4% of patients taking placebo. Similarly, in Table 6,11% of patients taking bupropion HCl extended-release gained more than 5 lbs, compared to 21% of patients taking placebo. In contrast, a higher proportion of patients taking bupropion experienced weight loss, with 14% and 19% of patients in Table 5 and 23% of patients in Table 6 losing more than 5 lbs 2.
From the Research
Bupropion and Weight Gain
- Bupropion is not typically associated with weight gain, and in some cases, it may even lead to weight loss 3, 4, 5, 6.
- A study on bupropion for smoking cessation found that patients receiving bupropion generally gained less body weight than placebo recipients 3.
- Another study on bupropion sustained release for smoking cessation in remitted depressed patients found that the mean weight gain was approximately 0.5 lb (0.2 kg) for those completing 9 weeks of bupropion SR treatment 7.
- A systematic review and meta-analysis of bupropion as an antidepressant found that it is more likely to cause weight loss than gain 4.
- Studies on bupropion for weight reduction have shown some degree of efficacy for this drug in promoting weight loss in obese patients 5, 6.