Wellbutrin (Bupropion): Uses, Side Effects, Dosage

Key Takeaways

• Wellbutrin (bupropion) is an atypical antidepressant that increases dopamine and norepinephrine levels, making it different from common SSRIs.
• It treats major depression and seasonal affective disorder with a lower risk of sexual side effects and weight gain than other antidepressants.
• Most people notice improvements in energy and mood within 1-2 weeks, though full effects typically develop over 4-6 weeks.

If you're exploring treatment options for depression, you may have come across Wellbutrin. Its generic name is bupropion, and it belongs to the class of norepinephrine-dopamine reuptake inhibitors (NDRIs).

Wellbutrin works differently from many common antidepressants by targeting dopamine and norepinephrine, two brain chemicals linked to energy and motivation. This makes it a popular choice for treating symptoms of major depressive disorder (MDD) and seasonal affective disorder (SAD), among other mental health conditions.

If you're considering taking it, it's important to learn what it is, how it works, its pros and cons, side effects, dosage information, and more.

What is Wellbutrin?

Wellbutrin is an FDA-approved atypical antidepressant medication that's used to treat some types of depression and help with smoking cessation.

It is also sometimes prescribed off-label, meaning it is not FDA-approved for this use, but has been found to help treat symptoms of attention-deficit hyperactivity disorder (ADHD) and other mental health conditions.

Wellbutrin treatment is thought to work by stopping the transport of the neurotransmitters dopamine and norepinephrine back into nerve cells, effectively boosting levels in the brain to improve mood, motivation, stress response, and other things related to depressive symptoms.

What is Wellbutrin Used for?

Wellbutrin comes in two forms: Wellbutrin XL (extended-release, which also comes in the generic bupropion XL) and Wellbutrin SR (sustained-release, also available via bupropion SR).

Although they work the same way and have the same active ingredient, Wellbutrin XL differs in that it's an extended-release drug that's released into the body more slowly and stays in your system longer.

Follow the medical advice of your psychiatrist or healthcare provider to determine which form of Wellbutrin treatment you should take.

What Wellbutrin is used for includes:

• Wellbutrin XL: Treats depression and can help prevent seasonal affective disorder (SAD)
• Wellbutrin SR: Treats depression and can help some people quit smoking by reducing nicotine withdrawal symptoms

Depression

Wellbutrin increases dopamine and norepinephrine levels in the brain by preventing reabsorption. When levels of these neurotransmitters stay elevated, they can effectively reduce or relieve symptoms of depression.

Research published in the Primary Care Companion to The Journal of Clinical Psychiatry supports the efficacy of Wellbutrin in treating major depressive disorder (MDD). One meta-analysis in Therapeutic Advances in Psychopharmacology found that the drug was effective in reducing depression scores in 24 out of 27 trials.

Common depression symptoms often include:

• Feelings of persistent sadness
• Loss of interest in things once found pleasurable
• Change in appetite
• Change in sleep patterns
• Feelings of worthlessness or guilt
• Having difficulty concentrating or making decisions

Seasonal affective disorder

Seasonal affective disorder (SAD) is a type of depression linked to seasonal changes, often starting in the fall or winter. Though symptoms can (and often do) resolve on their own in the spring and summer months, people who have an intense experience might benefit from a drug like Wellbutrin.

Research published in American Family Physician found that extended-release bupropion may help prevent recurring seasonal depression when started before symptoms begin.

Symptoms of SAD may include:

• Low energy
• Increased sleep
• Changes in appetite
• Reduced interest in daily activities

Off-label uses

In some cases, providers may prescribe Wellbutrin for:

• Attention-deficit hyperactivity disorder (ADHD)
• Certain anxiety-related conditions
• Fatigue or low energy
• Sexual side effects from other antidepressants

Pros and Cons of Wellbutrin

Like any antidepressant, Wellbutrin offers specific benefits for some people while carrying risks and limitations that won't fit everyone's needs.

The table below outlines the key trade-offs worth discussing with your prescribing clinician:

What are the Side Effects of Wellbutrin?

Wellbutrin is generally well-tolerated, but side effects can occur. Not everyone will experience them, and many improve over time.

If you begin to experience side effects not listed on the boxed warning label, reach out to a medical professional.

Some potential Wellbutrin side effects include:

• Dry mouth
• Headache
• Insomnia
• Nausea
• Agitation
• Constipation
• Dizziness
• Sweating
• Increased heart rate
• Tremor
• Blurred vision
• Loss of appetite
• Weight loss
• Anxiety
• Irritability
• Seizures (rare but can be more common at higher doses)
• High blood pressure (especially at higher doses or for someone with preexisting hypertension)

What is the Recommended Dosage for Wellbutrin?

Optimal Wellbutrin dosage will vary from person to person depending on factors like age, weight, the condition being treated, other conditions and medications, family history, and more.

You should always discuss dosage with your doctor to ensure you take the appropriate amount for your symptoms and condition.

Take Wellbutrin exactly as directed. Do not chew, crush, or break Wellbutrin extended-release tablets — they should always be swallowed whole.

Forms

Wellbutrin comes in multiple forms – tablets are available in:

• Sustained-release (SR)
• Extended-release (XL)

Dosage

Dose will depend on the condition being treated and symptom severity, among other things.

• Major depressive disorder (MDD): The starting dose is usually 100 – 150 mg 1 – 2 times daily. After a few days, your doctor might increase your dose to 3 times per day. The maximum dose is 300 – 450 mg daily, depending on which form your doctor prescribes.
• Seasonal affective disorder: The starting dose is generally 150 mg per day. After a week (7 days), your dose may be increased to 300 mg once per day. Treatment often begins in the fall, before symptoms start, and is typically discontinued in the early spring.

Additional Considerations

Beyond dosing considerations, there are other factors to keep in mind if you're planning to take Wellbutrin for depression. For example, you should try to take this medication at or around the same time daily. This ensures a stable and consistent level of the drug in your bloodstream, maximizing efficacy.

You can take Wellbutrin with or without food, but it’s generally recommended to avoid alcohol while taking Wellbutrin, as it can increase the risk of seizures or other side effects.

Interactions

All drugs have the risk of interacting with other medications. For this reason, it's essential to inform your doctor of anything else you're taking besides Wellbutrin. This includes natural or over-the-counter (OTC) supplements or vitamins.

Drugs known to interact with Wellbutrin include:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Monoamine oxidase inhibitors (MAOIs)
• Tricyclic antidepressants (TCAs)
• Antipsychotic medications
• Anticonvulsant medications
• Nicotine replacement therapy (NRT)
• Alcohol

Warnings

Wellbutrin can increase your risk for serious health conditions. Warnings when taking this drug can include, but aren't limited to, the following:

• Increased risk of seizure
• Psychiatric symptoms, such as an increase in suicidal thoughts and behaviors
• Neuropsychiatric events, such as hallucinations, increased agitation, paranoia, delusional thinking, and mania, in some people
• Hypertension
• Allergic reactions — while rare, cases of angioedema (extreme swelling) and anaphylaxis (a severe, potentially life-threatening allergic reaction) have been reported in some people who take Wellbutrin

"Wellbutrin is not to be taken in a patient with a history of seizures. If taken, it increases the likelihood of them having another seizure."‍‍‍

-Talkspace psychiatrist, Dr. Dion Metzger, MD

How Does Wellbutrin Make You Feel?

People often notice changes in how they feel after starting bupropion, though experiences can vary.

• Energy levels often improve within the first week or two. You might feel more alert and motivated to engage in activities you've been avoiding. Unlike some antidepressants that can cause sedation, Wellbutrin tends to have an activating effect.
• Mood stabilization typically develops gradually over several weeks. Rather than sudden euphoria, most people describe a subtle lifting of the heavy feeling that depression brings. Daily tasks feel more manageable.
• Anxiety changes can go either way. Some people find that their anxiety decreases as depression lifts. Others may experience increased restlessness or agitation, especially in the first few weeks. This side effect often improves with time.
• Emotional clarity is another common effect. Many people report feeling more like themselves again. Emotions may feel less blunted compared to other antidepressants, which can be both positive and challenging as you readjust.

If you're experiencing concerning changes in how you feel, discuss them with your healthcare provider. They can adjust your dose or timing to optimize your response.

Is Wellbutrin an Antidepressant and How is it Different From Others?

Yes, Wellbutrin or bupropion is classified as an atypical antidepressant. What makes it unique is its mechanism of action compared to more commonly prescribed options.

Dopamine and norepinephrine mechanisms set Wellbutrin apart. While most antidepressants target serotonin, bupropion primarily affects dopamine and norepinephrine. These neurotransmitters play important roles in motivation, energy, focus, and reward processing. By preventing their reabsorption into nerve cells, Wellbutrin keeps these chemicals available in the brain longer.

The difference between SSRIs and SNRIs is significant. Selective serotonin reuptake inhibitors (SSRIs) like Prozac or Zoloft work mainly on serotonin. Serotonin-norepinephrine reuptake inhibitors (SNRIs) affect both serotonin and norepinephrine. Wellbutrin is one of the only commonly prescribed antidepressant medications that doesn't significantly affect serotonin levels.

This difference also explains why Wellbutrin often causes fewer sexual side effects than SSRIs and SNRIs. It's also why some providers prescribe it for people who haven't responded well to serotonin-focused medications.

The dopamine action may particularly help with motivation, concentration, and low energy — symptoms that don't always improve with SSRIs alone.

Sometimes Wellbutrin may be combined with an SSRI or SNRI for comprehensive symptom coverage. This approach targets multiple neurotransmitter systems simultaneously.

What are the Alternatives to Wellbutrin?

Wellbutrin isn't right for everyone. If you're not tolerating it well or you aren't seeing the results you want after taking it for a few months, your doctor may decide to change your dosage or type of antidepressant medication entirely.

Some alternatives to Wellbutrin can include:

• A different antidepressant
• A depression medication in a different class of drugs, like an SSRI or an SNRI
• Psychotherapy (also known as talk therapy)
• Basic lifestyle changes that are known to benefit people living with depression, like working out, eating healthy, and sleeping well

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are considered the gold standard treatment for depression. They improve mood and emotion by upping serotonin levels in the brain. SSRIs are often the first type of drug that's tried because they're generally well-tolerated and have fewer side effects than some other types of antidepressants.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) block the reabsorption of both serotonin and norepinephrine in the brain. These neurotransmitters are important in mood regulation, memory, and the sleep-wake cycle.

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are an older class of drugs and are typically only suggested if SSRIs and SNRIs haven't reduced depression symptoms. TCAs were initially developed for psychotic episodes but were later found to effectively treat depression in some people.

Atypical antidepressants

If Wellbutrin, which is also an atypical antidepressant, doesn't seem to be working, your doctor may decide to start you on a different medication in this same class. Some other atypical antidepressants can be an excellent alternative to Wellbutrin.

"An alternative to Wellbutrin is an SNRI (Serotonin and Norepinephrine Reuptake Inhibitor) such as Pristiq or Effexor XR. SNRIs can boost the neurotransmitter norepinephrine to help with concentration and energy, similarly to Wellbutrin's benefits."

– Talkspace psychiatrist, Dr. Dion Metzger, MD

Getting Wellbutrin Prescribed Online with Talkspace

Before you can get a prescription for Wellbutrin online, you'll need a diagnosis from a licensed doctor or mental health provider like a psychiatrist. Talkspace offers convenient, affordable, and easily accessible online therapy and medication consultations, prescriptions, and management.

With Talkspace, you can connect with licensed professionals from home, receive personalized care, and have your treatment plan monitored securely and conveniently.

You don't have to live with depression or another mental health condition. Talkspace can help you with therapy and, if needed, medication so you can take charge of your mental health and get back to living a healthy, happy, productive life. Connect with an online psychiatrist about Wellbutrin today.

Frequently Asked Questions (FAQs)

How long does Wellbutrin take to start working?

Most people notice improvement in energy and motivation within 1-2 weeks of starting bupropion, though full antidepressant effects typically develop over 4-6 weeks. Your provider may adjust your dose during this time to optimize results.

Can Wellbutrin be taken for anxiety?

Bupropion isn't FDA-approved for anxiety treatment and may actually increase anxiety or agitation in some people. However, it's sometimes prescribed off-label when depression and anxiety occur together, so discuss with your provider whether it's appropriate for your specific situation.

Does Wellbutrin cause weight loss or weight gain?

Wellbutrin is associated with potential weight loss rather than weight gain, unlike many other antidepressants, and some people experience decreased appetite as a side effect. However, weight changes vary significantly between individuals.

Can you drink alcohol while taking Wellbutrin?

You should avoid alcohol while taking bupropion, as it can increase your risk of seizures and worsen depression symptoms. Discuss any alcohol use with your healthcare provider.

Is Wellbutrin safe for long-term use?

Yes, Wellbutrin is generally considered safe for long-term use when monitored by a healthcare provider, and many people take bupropion for years to manage chronic depression. Your provider will periodically review your symptoms and overall health to ensure the medication remains appropriate.

Sources

1. Fava M, Rush AJ, Thase ME, et al. 15 years of clinical experience with bupropion hcl. The Primary Care Companion For CNS Disorders. 2005;7(3). doi:10.4088/pcc.v07n0305. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1163271/. Accessed March 20, 2024.
2. Patel K, Allen S, Haque MN, Angelescu I, Baumeister D, Tracy DK. Bupropion: A systematic review and meta-analysis of effectiveness as an antidepressant. Therapeutic Advances in Psychopharmacology. 2016;6(2):99-144. doi:10.1177/2045125316629071. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837968/. Accessed March 20, 2024.
3. Magovern M, Crawford-Faucher A. Extended-release bupropion for preventing seasonal affective disorder in adults. American Family Physician. January 1, 2017.  https://www.aafp.org/pubs/afp/issues/2017/0101/p10.html. Accessed March 20, 2024.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.