Bupropion (Wellbutrin/Zyban): Everything You Need to Know

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    Kristin Hall, FNP
    Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 8/09/2020

    If you’re interested in quitting smoking, you’ve likely heard of bupropion, the active ingredient in the medications Zyban® and Wellbutrin®. 

    Bupropion is an antidepressant medication that was originally designed to treat depression. It’s also a very effective smoking cessation aid that can reduce nicotine withdrawal symptoms and make it easier to stop smoking.

    If you currently smoke and want to quit, using bupropion may increase your likelihood of quitting successfully. 

    Below, we’ve covered what bupropion is and how it works, both as a smoking cessation aid and as an antidepressant. We’ve also listed bupropion’s common side effects, interactions and more to provide everything you need to know before you use this medication. 

    What is Bupropion?

    Bupropion is a prescription antidepressant. It was first approved by the FDA in the mid-1980s as a treatment for depression. 

    After trials showed that bupropion made it easier for smokers to quit, the FDA also approved it in 1997 for use as a smoking cessation aid.

    As an antidepressant, bupropion is commonly marketed under the brand name Wellbutrin. As a smoking cessation aid, it’s marketed as Zyban. Today, bupropion is also available as a generic depression and smoking cessation medication under a variety of different brand names. 

    Bupropion is a common medication, with tens of millions of prescriptions written for it in the U.S. annually. 

    How Bupropion Works

    Bupropion works by changing the levels of certain neurotransmitters in your brain, including the neurotransmitters that are affected when you consume nicotine by smoking a cigarette or using any other type of tobacco product.

    To explain how bupropion works as a smoking cessation aid, we need to briefly explain how the nicotine inside each cigarette affects your brain and body. 

    When you smoke a cigarette, your body rapidly absorbs nicotine from the tobacco. The nicotine in cigarettes enters your bloodstream quickly — for most people, in around eight seconds — after which it travels to your brain. 

    In your brain, nicotine causes an increase in the production of certain neurotransmitters. These are a type of chemical messenger used by your body to send messages between neurons and manage your brain and body’s biological processes.

    More specifically, nicotine triggers a sudden increase in the production of the neurotransmitters dopamine and norepinephrine

    You may have heard of dopamine as the “pleasure” or “feel good” neurotransmitter. While this is an oversimplification of its role in your body, it is responsible for making you feel motivated to do certain things. 

    Dopamine is also responsible for managing your ability to learn, your mood, level of motivation, attention, satisfaction and more. Your brain naturally releases dopamine after you eat food that you’ve been craving, as well as when you have sex. 

    Norepinephrine, on the other hand, is responsible for managing your level of alertness. It’s one of several chemicals responsible for keeping you awake, alert, focused and mentally prepared for daily life. 

    When you quit smoking, your body no longer gets the dopamine and norepinephrine boosts it used to get every time you smoked a cigarette. Your dopamine levels drop, leading to nicotine withdrawal symptoms that can last for several months. 

    Dealing with the nicotine withdrawal is very difficult — one of several reasons why smokers who quit without a cessation program return to smoking 95 percent of the time

    Enter bupropion. 

    As a norepinephrine–dopamine reuptake inhibitor, or NDRI, bupropion works by raising dopamine and norepinephrine levels in your brain. 

    This may reduce the effects of nicotine withdrawal and make it easier to avoid nicotine cravings after you decide to quit.

    Bupropion works similarly to treat depression. People with depression often have low levels of dopamine and norepinephrine. By increasing levels of these neurotransmitters, bupropion can help to treat certain depression symptoms. 

    Is Bupropion Effective? 

    Studies show that people who use bupropion are more likely to successfully quit smoking than people who attempt to quit without smoking cessation medication. 

    In one study from 1997, smokers who used bupropion daily at a dosage of 150mg or 300mg were more successful in quitting smoking than those who used a non-therapeutic placebo, with 22.9 percent to 23.1 percent of the 150mg and 300mg bupropion users remaining smoke-free after one year. 

    A separate scientific review from 2014 concluded that bupropion significantly increases the rate of long-term smoking cessation compared to quitting without the use of medication. 

    Finally, another scientific review from 2003 noted that studies of bupropion show it “consistently produces a positive effect on smoking cessation outcomes.”

    In short, bupropion works well for many smokers that want to quit. It can decrease cravings and make dealing with withdrawal symptoms easier. 

    However, using bupropion is no guarantee that you’ll remain smoke-free. To truly quit long term, you’ll also need to change your habits, stay focused and make a serious, ongoing effort to stay away from cigarettes and other tobacco products. 

    Using Bupropion to Quit Smoking

    Bupropion is an easy medication to use. It comes in tablet form and is designed for use either one or two times per day. You can use bupropion on its own as a smoking cessation aid, or in combination with nicotine replacement therapy (NRT). 

    Research shows that using bupropion with nicotine replacement therapy could make it easier for you to successfully abstain from smoking. 

    Bupropion is a prescription medication, meaning you’ll speak to talk to a healthcare professional before you can use it as a smoking cessation aid. We offer bupropion with convenient home delivery, following an online consultation with a physician who will determine if a prescription is appropriate. 

    If you’re prescribed bupropion, your healthcare provider may recommend that you start taking it while you’re still smoking. It’s best to set a quit date, at which point you’ll stop smoking, during your second week of using bupropion. 

    Bupropion is typically prescribed at a starting dosage of 150mg per day. After using bupropion for three days, this dosage typically increases to 300mg (150mg taken twice daily, at least eight hours apart). Of course, and as always, be sure to follow the dosage provided by your healthcare provider when using this medication. 

    If you forget to take bupropion and it’s close to the time for your next tablet, take the next tablet as normal and skip the missed dose. Taking a double dose of bupropion may increase your risk of experiencing side effects and should not be done. 

    Most people continue to use bupropion for a total of seven to 12 weeks. If you don’t notice any effects from bupropion and haven’t managed to quit by week three, your healthcare provider may suggest a different medication, or recommend that you stop using bupropion.

    If you’d like to use bupropion with nicotine replacement therapy products, such as gum, patches or lozenges, make sure that you talk to your healthcare provider first. 

    Does Bupropion Have Side Effects?

    Like many other prescription medications, bupropion can cause side effects. The most common side effects of bupropion tend to be minor and temporary. However, bupropion may also cause more severe or longer-lasting side effects.

    Common side effects of bupropion include:

    • Abnormal dreams
    • Agitation
    • Blurred vision
    • Constipation
    • Dizziness
    • Dry mouth
    • Edema (swelling)
    • Excessive sweating
    • Headache
    • Insomnia
    • Migraine
    • Nasopharyngitis, rhinitis and other cold-like symptoms
    • Nausea
    • Sedation
    • Tachycardia (fast heart beat)
    • Tremor
    • Vomiting
    • Weight fluctuation

    These side effects may resolve during the first one to two weeks of treatment with bupropion. If you experience persistent side effects, or notice your side effects worsening over time, contact your healthcare provider. 

    Bupropion is an antidepressant. In general, it’s less likely to cause sexual side effects than most other antidepressant medications. If you notice any changes in your sex drive, ability to become aroused or enjoyment from sex, it’s best to talk to your healthcare provider. 

    Although uncommon, bupropion may cause other, more severe side effects. These side effects may be more likely or severe if you’re a heavy smoker, or have other health conditions. Serious side effects of bupropion include:

    • Hypertension. Bupropion can contribute to hypertension (high blood pressure). If you’ve been diagnosed with hypertension or have an existing heart condition, it’s important that you tell your healthcare provider before using bupropion for smoking cessation or other conditions.

    • Vision problems. In rare cases, bupropion may cause vision-related problems such as swelling and redness of the eyes and surrounding area.
    • Mental health issues. Bupropion may cause changes in your mood, impulsive behavior, panic attacks or feeling of anxiety and/or depression.
    • Seizures. A very small percentage of bupropion users (approximately 0.1 percent) are at risk of experiencing seizures while using this medication.

      Your risk of experiencing seizures after using bupropion may be higher if you have brain tumors, a history of epilepsy or other seizure-causing conditions, a head injury, previous use of drugs that may cause seizures or withdrawal from certain drugs or alcohol. 

    Using bupropion for smoking cessation or other conditions may not be safe if you have a history of eating disorders, such as bulimia or anorexia. You may also have an elevated risk for certain side effects if you have liver or kidney issues, mental health issues or diabetes. 

    To reduce your risk of experiencing side effects from bupropion, inform your healthcare provider of any health conditions you currently have or have recently had, as well as all medications you currently use or have recently used before discussing bupropion.  

    FDA “Black Box” Warning: Suicidal Thoughts and/or Behavior

    Bupropion is used as a smoking cessation aid and as an antidepressant. Like many other drugs in the antidepressant class, certain medications containing bupropion carry a “black box” safety warning from the FDA.

    This warning provides information about an increased risk of suicidal thoughts and/or behavior when this medication is used by people under the age of 24. 

    By law, smoking cessation medications containing bupropion such as Zyban are not required to carry this warning. However, you should still seek help from your healthcare provider if you experience any sudden changes in behavior, thoughts or feelings while using bupropion. 

    Can Bupropion Interact With Other Medications?

    Bupropion can interact with other medications, including over-the-counter drugs, supplements and herbal products. Tell your healthcare provider about any other medications you use before discussing using bupropion.

    Some interactions between bupropion and other drugs may increase the amount or effects of bupropion in your body. Others may potentially be dangerous or harmful. 

    Bupropion may cause dangerous effects when used with antidepressants in the monoamine oxidase inhibitor (MAOI) class. Commonly prescribed MAOI medications include phenelzine, selegiline tranylcypromine and isocarboxazid.

    Do not use bupropion if you currently use any MAOI medication, or if you have used a MAOI during the last 14 days.

    Other antidepressants that can interact with bupropion include many SSRIs, SNRIs, tricyclic antidepressants (TCAs) and other drugs in this class. If you’re currently being treated for any depression or anxiety condition, inform your healthcare provider before using bupropion. 

    Bupropion may also interact with other medications, including common antipsychotic drugs, beta-blockers, blood thinners and other drugs used to treat heart issues. Some medications, including antiviral and anti-seizure drugs, may make bupropion less effective.

    Inform your healthcare provider about all medications, supplements and herbal products that you currently use or have recently used before using bupropion. 

    Bupropion and Pregnancy

    Bupropion has a category C rating from the FDA. This means that animal studies have shown that it may have adverse effects on fetuses during pregnancy. However, there is currently not enough human study data to be certain about how the medication may affect a human fetus.

    If you think that you’re pregnant or are planning to become pregnant in the near future, inform your healthcare provider before using bupropion. If you become pregnant after starting bupropion, contact your healthcare provider as soon as possible.

    The big issue is that small quantities of bupropion may pass into breast milk. If you’re currently breastfeeding, talk to your healthcare provider about the safety of using bupropion while you breastfeed. 

    Your healthcare provider will provide an expert opinion on the safety of using bupropion during pregnancy based on your symptoms, health history and other factors.

    Frequently Asked Questions About Bupropion

    How Long Does it Take for Bupropion to Work?

    If you’re prescribed bupropion as a smoking cessation aid, you should start taking it at least one week before you plan to quit. This gives the medication enough time to start working effectively, reducing your cravings for nicotine and easing withdrawal symptoms associated with quitting. 

    If you’re prescribed bupropion for depression, it may take several weeks before you notice any effects. Some improvement in your sleep and energy levels may be noticeable during the first two weeks of treatment, with improvements in mood noticeable after four to six weeks.

    Can You Stop Taking Bupropion?

    It’s best to talk to your healthcare provider if you want to stop taking bupropion. While it’s normally okay to stop using bupropion if you’re prescribed it as a smoking cessation aid, you may experience withdrawal effects if you suddenly stop using bupropion as a treatment for depression. 

    Before making any changes to your usage of bupropion, make sure you talk to your healthcare provider. Do not adjust your dosage or stop using the medication by yourself. 

    Can You Use Bupropion With Birth Control?

    It’s normally okay to take bupropion with your regular form of hormonal birth control, such as the pill, patch or ring. However, if you smoke and want to use bupropion to quit, your healthcare provider may not recommend using the hormonal birth control pill due to an elevated risk of side effects

    Before using bupropion, make sure you tell your healthcare provider about any medications you currently use or have used within the last few weeks, including hormonal birth control.

    Does Bupropion Contain Nicotine?

    Bupropion does not contain nicotine. Instead, it works by increasing the production of certain neurotransmitters in your brain, including those that are stimulated when you take in nicotine from a cigarette, vaporizer or other nicotine-containing product.

    This can help to reduce the severity of nicotine withdrawal symptoms. As bupropion doesn’t contain any nicotine itself, it’s usually okay to use it with nicotine replacement therapy (NRT) products such as gum, lozenges, sprays and adhesive patches.

    Do Bupropion Users Have a 100 Percent Quit Rate?

    No. Using bupropion does not guarantee that you’ll successfully quit smoking. In clinical trials, 27 percent to 36 percent of people who used bupropion at a normal dosage successfully quit smoking by week seven of treatment, compared to 17 percent of non-users.

    By week 26, almost twice as many bupropion users (19 percent vs. 11 percent for non-users) remained smoke-free. 

    Bupropion is more effective when used with nicotine replacement therapy (NRT). Clinical trials have found that 51 percent of smokers who used bupropion in combination with nicotine transdermal patches remained smoke-free after 10 weeks of treatment.

    As the saying goes, quitting smoking is more like a marathon than a sprint. Smoking cessation aids like bupropion can make the process easier, but successfully quitting requires a continual, ongoing commitment to resisting temptation and avoiding cigarettes.

    Is Bupropion a Selective Serotonin Reuptake Inhibitor (SSRI)?

    Although it’s often listed alongside SSRIs as a treatment for depression, bupropion isn’t actually an SSRI. Instead, it’s a norepinephrine-dopamine-reuptake inhibitor, or NDRI.

    NDRIs such as bupropion are sometimes used to treat depression in people who don’t respond to SSRIs, SNRIs, tricyclic antidepressants and other more widely-used antidepressants. They’re also occasionally used to treat people who experience sexual side effects from SSRIs. 

    Does Bupropion Cause Weight Gain?

    Unlike other antidepressants, which are commonly associated with weight gain, bupropion may cause you to lose weight. 

    In a 2002 study, researchers found that bupropion was significantly more effective at promoting weight loss in obese adults than a placebo. 

    Over the course of 24 weeks, the participants who used bupropion with a calorie-restrictive diet and exercise lost an average of 7.2 percent to 10.1 percent of their body weight, depending on the dosage of bupropion they received. 

    A separate study of bupropion from 2001 found that overweight women who used bupropion in combination with a balanced diet lost more weight than those given a placebo. Another study from 2002 also found that bupropion can cause mild weight loss over the long term. 

    Along with naltrexone, bupropion is also an ingredient in Contrave®, an FDA-approved weight loss medication. However, bupropion is not approved on its own for use as a weight loss aid or dietary supplement. 

    It’s worth noting that not everyone loses weight after starting bupropion. Many users maintain a similar weight, while others may gain or lose a small, insignificant amount of weight. 

    Put simply, it’s possible to either gain or lose weight while using bupropion, depending on your diet and activity level. In general, bupropion is associated with mild weight loss when used for the long term and doesn’t seem to cause typical antidepressant-related weight gain. 

    Is it Safe to Drink Alcohol While Using Bupropion? 

    Drinking alcohol with bupropion is not recommended. If you drink alcohol while you’re taking bupropion, you may have an increased risk of experiencing certain side effects, ranging from drowsiness and dizziness to serious side effects such as seizures.

    Alcohol and bupropion can both cause drowsiness and dizziness. When used together, these effects may be stronger than normal, creating a risk of injury.

    If you regularly drink alcohol, talk to your healthcare provider about the best way to stay safe while you use bupropion. Depending on your general health and other factors, your healthcare provider may recommend limiting your alcohol consumption or avoiding alcohol completely. 

    What’s the Difference Between Wellbutrin and Zyban?

    Wellbutrin and Zyban are different brand names used for bupropion. Both medications contain the same active ingredient. Wellbutrin is prescribed to treat depression and seasonal affective disorder (along with Wellbutrin XL®), while Zyban is used for smoking cessation. 

    Talk to a Healthcare Professional About Bupropion

    If you want to quit smoking for good, smoking cessation medication like bupropion may make the process of quitting easier. 

    Bupropion is a prescription medication, meaning you’ll need to talk to a healthcare professional before you can purchase and use it. We offer bupropion with discreet, convenient home delivery following an online consultation with a physician who will determine if a prescription is appropriate. 

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.