Wellbutrin SR (bupropion hydrochloride sustained-release) is a second-generation antidepressant and aminoketone-class medication approved for the treatment of major depressive disorder (MDD) and seasonal affective disorder (SAD). Unlike many conventional antidepressants that primarily target serotonin systems, Wellbutrin SR functions as a norepinephrine-dopamine reuptake inhibitor (NDRI), offering a distinct pharmacological profile with a favorable side effect spectrum. It is particularly noted for its minimal impact on sexual function and weight neutrality, making it a valuable option for patients who experience undesirable effects with SSRIs or SNRIs. This sustained-release formulation provides stable plasma concentrations over a 12-hour dosing interval, supporting consistent therapeutic effect and patient compliance.

Features

• Active ingredient: Bupropion hydrochloride (150 mg or 100 mg per tablet)
• Pharmacologic class: Aminoketone, norepinephrine-dopamine reuptake inhibitor (NDRI)
• Formulation: Sustained-release (SR) tablets for biphasic absorption
• Dosing frequency: Twice daily, approximately 8 hours apart
• FDA-approved indications: Major depressive disorder (MDD), seasonal affective disorder (SAD)
• Half-life: Approximately 21 hours for bupropion and active metabolites
• Bioavailability: Approximately 87% under fasting conditions
• Excretion: Primarily renal (87%) and fecal (10%)

Benefits

• Provides effective relief from depressive symptoms with a unique mechanism of action
• Low incidence of sexual dysfunction and weight gain compared to SSRIs
• May improve energy, motivation, and focus due to dopaminergic and noradrenergic activity
• Suitable for long-term maintenance therapy in major depression
• Does not typically cause sedation, allowing for daytime use without impairment
• May be used as an adjunct or alternative in treatment-resistant depression

Common use

Wellbutrin SR is primarily prescribed for the management of major depressive disorder in adults. It is also indicated for the prevention of seasonal affective disorder episodes. Off-label uses may include attention-deficit/hyperactivity disorder (ADHD), bipolar depression (with mood stabilizer), and smoking cessation support, though these applications require careful clinical consideration and are not FDA-approved for this formulation. The medication is typically incorporated into a comprehensive treatment plan that may include psychotherapy and lifestyle modifications.

Dosage and direction

The initial recommended dose for Wellbutrin SR is 150 mg once daily in the morning. After at least 3 days, the dose may be increased to 150 mg twice daily, with doses separated by at least 8 hours. The maximum recommended dose is 400 mg per day, given as 200 mg twice daily. Doses should not exceed 150 mg in a single administration. Tablets should be swallowed whole and not crushed, divided, or chewed, as this may alter the release profile and increase seizure risk. Administration with food may minimize potential gastrointestinal discomfort.

Precautions

Patients should be monitored for clinical worsening, suicidality, or unusual changes in behavior, particularly during initial treatment or dose adjustments. Use with caution in patients with hepatic or renal impairment, dose adjustment may be necessary. May lower seizure threshold; caution in patients with history of seizure, head trauma, or eating disorders. May increase blood pressure; regular monitoring recommended. Use caution when operating machinery until response is known. Abrupt discontinuation should be avoided; taper gradually when discontinuing treatment.

Contraindications

Wellbutrin SR is contraindicated in patients with seizure disorder or history of seizures. Concurrent use with monoamine oxidase inhibitors (MAOIs) is contraindicated; allow at least 14 days between discontinuation of an MAOI and initiation of Wellbutrin SR. Contraindicated in patients with current or prior diagnosis of bulimia or anorexia nervosa due to increased seizure risk. Hypersensitivity to bupropion or any component of the formulation prohibits use. Not recommended in patients undergoing abrupt discontinuation of alcohol or sedatives.

Possible side effects

Common adverse reactions (≥5%) include dry mouth, nausea, insomnia, dizziness, headache, constipation, and tremor. Less frequently reported effects include anxiety, agitation, tinnitus, sweating, rash, and taste disturbances. Serious side effects may include seizures (dose-dependent), hypertension, psychotic or manic episodes, angle-closure glaucoma, and severe hypersensitivity reactions. Any unusual mood changes, suicidal thoughts, or allergic reactions should be reported immediately to a healthcare provider.

Drug interaction

MAOIs may potentiate toxicity (contraindicated within 14 days). Drugs that lower seizure threshold (antipsychotics, antidepressants, tramadol) may increase risk. May interact with CYP2B6 inhibitors (e.g., paroxetine, sertraline) or inducers (e.g., carbamazepine). Caution with drugs metabolized by CYP2D6 (beta-blockers, antipsychotics, Type 1C antiarrhythmics). May potentiate levodopa and amantadine effects. Use caution with nicotine replacement therapy. Alcohol consumption may increase seizure risk and should be minimized.

Missed dose

If a dose is missed, it should be skipped if it is close to the next scheduled dose. Doubling doses is not recommended due to increased seizure risk. Patients should maintain the regular dosing schedule and contact their healthcare provider if multiple doses are missed or if unsure about proper administration.

Overdose

Overdose may manifest as seizures, hallucinations, tachycardia, or loss of consciousness. Fatal outcomes have been reported, often involving multiple drug ingestion. Management includes ECG monitoring, supportive care, and seizure control with benzodiazepines. Activated charcoal may be considered if presented early. There is no specific antidote; hemodialysis is not likely to be effective due to large volume of distribution.

Storage

Store at controlled room temperature (20-25°C or 68-77°F). Keep in original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets. Do not use after expiration date printed on packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Wellbutrin SR is available by prescription only and should be used under appropriate medical supervision. Individual response to medication may vary. Patients should consult their healthcare provider for diagnosis, treatment decisions, and personalized medical advice. Never adjust dosage or discontinue medication without professional guidance.

Reviews

Clinical studies demonstrate Wellbutrin SR’s efficacy in reducing depressive symptoms with response rates comparable to other antidepressants. Patient reports often highlight improved energy levels and minimal weight gain compared to alternatives. Some users note initial side effects such as insomnia or headache that often diminish with continued use. Healthcare providers frequently prescribe it as an alternative for patients experiencing sexual side effects with SSRIs. Long-term maintenance therapy data support its sustained effectiveness in preventing depressive relapse.