From the Guidelines
Developing tolerance to Wellbutrin (bupropion) is not common, and most patients maintain its benefits without needing dose increases due to tolerance. The medication's mechanism of inhibiting the reuptake of dopamine and norepinephrine does not generally become less effective with continued use 1. If a patient feels that Wellbutrin is becoming less effective, it is more likely due to changes in their underlying condition, stress levels, or other factors rather than true pharmacological tolerance.
Some key points to consider:
- Typical dosing ranges from 150mg to 450mg daily, often starting at a lower dose and gradually increasing if needed 1.
- The most common adverse effects associated with bupropion are dry mouth, insomnia, tremor, rash, headache, and urticaria, but these are not typically causes for drug discontinuation 1.
- Bupropion has been associated with a small increased incidence of seizures, particularly among those with a medical history suggesting increased risk, but this is not directly related to tolerance 1.
- If effectiveness seems to decrease, patients should consult their healthcare provider rather than assuming tolerance has developed, as dosage adjustments or complementary treatments might be needed to address changing symptoms.
Overall, the evidence suggests that tolerance to Wellbutrin is not a common issue, and any perceived decrease in effectiveness should be evaluated by a healthcare provider to determine the best course of action 1.
From the Research
Developing Tolerance to Wellbutrin
- Developing a tolerance to Wellbutrin, also known as bupropion, is not directly addressed in the provided studies as a common issue.
- However, the studies do discuss the efficacy and safety of bupropion for smoking cessation and its effects on depression symptoms 2, 3, 4.
- One study mentions that highly nicotine-dependent smokers who receive bupropion are more likely to experience a decrease in depressive symptoms during active treatment but are also more likely to experience a rebound in depressive symptoms when bupropion is discontinued 4.
- Another study discusses the adverse reactions to bupropion, including agitation/excitement and major motor seizure, but does not mention tolerance as a common issue 5.
- A review of antidepressants for smoking cessation found that bupropion increases long-term smoking cessation rates, but also increases the number of adverse events, including psychiatric adverse events, and trial dropouts due to adverse events of the drug 6.
Adverse Events and Tolerance
- The studies suggest that bupropion can cause adverse events, including psychiatric adverse events, and that participants taking bupropion are more likely to discontinue treatment compared with placebo 6.
- However, there is no clear evidence to suggest whether people taking bupropion experience more or fewer serious adverse events than those taking placebo 6.
- The review of antidepressants for smoking cessation found that the safety and tolerability of bupropion are important considerations, and that further studies should measure and report safety and tolerability clearly 6.