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Bupropion for depression

Sounds like bue-PROE-pee-on

Key points about bupropion for depression

Bupropion is used to treat depression.
Bupropion is also called Zyban or Wellbutrin.
Find out how to take it safely and possible side effects.

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Bupropion is used to treat moderate-to-severe depression when other antidepressants such as SSRIs have not been effective. Bupropion may be useful in people with depression who have severe tiredness (fatigue) as their main symptom, but it may cause sleep problems and insomnia. Other benefits of bupropion is that it does not cause sexual side effects or weight gain.

Note: In New Zealand bupropion has not been approved by Medsafe for use in depression. It is only approved as an aid to help quit smoking. Read more about bupropion to quit smoking and about the use of unapproved medicines.

In New Zealand bupropion is available as tablets (150 mg).
Take 1 tablet once a day.
Depending on your response, your doctor may increase your dose after a few days to 1 tablet 2 times a day.
Increasing the dose slowly allows your body to get used to the medicine and reduces side effects.
If you are an older adult or have certain liver or kidney diseases, the dose may be different. Your doctor will advise you about this.
Bupropion may take a few weeks to start working and you may initially feel worse at the start of treatment. This could be due to your illness or from side effects (see below for more information).

Swallow the tablets whole with a full glass of water. Do not crush or chew the tablets because if you do that it releases all the medicine at once and can increase your chance of side effects.
Timing: You can take bupropion with or without food. Bupropion can cause sleep problems, so don't take it just before bedtime. Try taking it early in the evening. If you are taking a dose 2 times a day, take the second dose at least 8 hours after your morning dose.
Avoid or limit drinking alcohol while you are taking bupropion. Drinking alcohol while taking bupropion may increase the risk for mood changes.
Missed dose: If you forget to take your dose, take it as soon as you remember that day. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose. Remember there should be at least 8 hours between doses.

Here are some things to know when you're taking bupropion. Other things may be important as well, so ask your healthcare provider what you should know about.

Other medicines. Bupropion interacts with some medications, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting bupropion and before starting any new products.
Be careful when driving or using tools until you know how this medicine affects you.
If you are taking bupropion as an antidepressant, the effects are not immediate. It may take a few weeks before you start to feel better.
Don't stop taking this medicine without talking to your healthcare provider first. The dose of this medicine should be reduced slowly before stopping it completely.

Like all medicines, bupropion can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Increased risk of seizures

Bupropion can increase the risk of seizures. This happens in about 1 in 1,000 people who take bupropion. Although this is rare, it can be serious, especially if it occurs when you are driving or operating machinery. The risk of a seizure is increased if you:

take more than 2 tablets per day
have had a head injury
drink a lot of alcohol
are taking medicines that can cause fits, such as antipsychotics, antidepressants, anti-malarials, tramadol, theophylline, corticosteroids and some antihistamines
have diabetes and are being treated with insulin or other medicines.

Other side effects

Side effects	What should I do?
Dry mouth Sore throat Feeling sick (nausea) Loss of appetite – not wanting to eat because food tastes different Headache	These are quite common when you first start taking bupropion and usually go away with time. Tell your doctor if you are finding them troublesome.
Sleep problems, difficulty falling asleep	These are common when you first start taking bupropion but go away with time. Avoid taking your dose at bedtime. If you are taking a dose 2 times a day, take the second dose at least 8 hours after your morning dose.
Feeling sleepy, drowsy or tired during the day Poor concentration	Be careful when driving or using tools until you know how this medicine affects you. You will have a greater risk of falls and injuries, especially if you are an older adult. Tell your doctor if you are concerned. Do not drink alcohol.
Signs of a severe allergic reaction, such skin rash, itching, swelling of your lips, face and mouth, or difficulty breathing	Stop using bupropion. Tell your doctor immediately or phone Healthline 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product(external link)

Note: In September 2020, Medsafe highlighted a possible risk of psoriasis worsening with the use of bupropion. If you have psoriasis and notice it getting worse, or if you develop psoriasis when starting bupropion, you or your doctor can read more about medicines and side effects and reporting a reaction you think might be a side effect.

Depression topics | Mate pāpouri
Antidepressants

Zyban(external link) Medsafe Consumer Information Sheet, NZ