Mental health medication

Provided by You Health for patients

Generic for Wellbutrin XL® (Bupropion XL)

In this medication overview
  1. Usage

    How to get the most out of your treatment

  2. Warnings

    Important safety information

  3. Side Effects

    What to look out for when using your treatment

Bupropion (bupropion hydrochloride) is a prescription medicine used to treat major depressive disorder (MDD), seasonal affective disorder (SAD), and to help people quit smoking (smoking cessation). (May also be helpful when prescribed “off-label” for bipolar disorder, attention deficit hyperactivity disorder (ADHD, and sexual dysfunction due to SSRI antidepressants).

Usage

  1. To get started, follow your provider's dosing instructions
    If you are not already taking bupropion, your provider will likely want you to begin by taking a starting dose (150mg) for the first 7 days before increasing your dose. Be sure to follow the instructions your provider sent to help your body safely adjust to Bupropion.
  2. Swallow the tablet whole
    Swallow the tablet whole. Do not break, crush or chew it.
  3. Avoid insomnia
    If you have trouble sleeping, it is best to take this medication in the morning to avoid insomnia.
  4. Missed a dose?
    If you miss a dose of this medicine, for the XL form, do not take an extra tablet to make up for the dose you forgot. Wait and take your next dose at your regular time the next day. Do not double doses.
Do not abruptly stop taking bupropion or change your dose without talking with your healthcare provider first, even when you feel better. Studies have shown that a taper can reduce possible side-effects caused by stopping the medication abruptly.
  • If you are taking bupropion XL 150mg, you may stop taking your medication without tapering.
  • If you are taking bupropion XL 300mg, take one tablet every other day for two weeks then you may stop medication.
  • If you are taking bupropion XL 450mg (equivalent to three 150mg tablets), take two 150mg tablets for one week, then one 150mg tablet for one week, then you may stop medication.
  • Your healthcare provider can also provide individualized guidance for tapering your medication.
While depressed mood and lack of interest in activities may need up to 4-6 weeks to improve, disturbances in sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working.
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.

Warnings

SUICIDALITY AND ANTIDEPRESSANT DRUGS
Bupropion ER XL and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. Watch for these changes and inform your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Pay particular attention to such changes when Bupropion ER XL is started or when the dose is changed.

IMPORTANT SAFETY INFORMATION

Do not take Bupropion XL (bupropion hydrochloride) if you:
  • Are allergic to Bupropion, as contained in bupropion hydrochloride, or any of the ingredients in Bupropion
  • Take any medicines called monoamine oxidase inhibitor (MAOI), or if you have stopped taking an MAOI in the last 14 days
  • Are already taking a medication containing bupropion
  • Taking tamoxifen
  • Have a medical history of a seizure disorder, anorexia nervosa, or bulimia nervosa
  • Drink large amounts of alcohol, use recreational drugs or abuse prescription medications - or suddenly stop substance abuse habits
Before you take Bupropion, tell your healthcare provider if you:
  • Have thoughts of suicide or harming yourself
  • Have a history of psychiatric or medical problems, including bipolar disorder
  • Have taken any medication in the past for your condition, whether effective or not
  • Have suffered adverse or side effects from previous medication therapies
  • Are receiving any non-medication treatment, such as talk therapy
  • Are pregnant, plan to become pregnant, or are breastfeeding
  • Drink alcohol or use/abuse recreational or prescription drugs
Inform your healthcare provider
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Bupropion may affect the way other medicines work, and other medicines may affect the way Bupropion works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Take any medicines called monoamine oxidase inhibitor (MAOI), or if you have stopped taking and MAOI in the last 14 days
The safety of this medication during pregnancy has not been evaluated. If you become pregnant or decide to try to conceive, please alert your provider who will direct you to follow up with your primary care provider or OBGYN for continued management.
Avoid alcohol
Drinking alcohol while taking mental health medication is not advised because alcohol can worsen depression. It can also increase the side effects of some medications, such as drowsiness, dizziness and coordination problems. It is recommended to avoid drinking alcohol while taking your medication, especially if you will be driving, operating dangerous machinery, or participating in dangerous activities.
Avoid cannabis use
Using cannabis products can worsen depression and increase the side effects of some medications, such as drowsiness, dizziness and coordination problems. It is recommended to avoid cannabis use while taking your medication, especially if you will be driving, operating dangerous machinery, or participating in dangerous activities.
Medication disposal

If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.


If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can visit FDA- Disposal of Unused Medicines for more information or follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Side effects

Bupropion can cause serious side effects and should be reported to your provider immediately. Rarely reported side effects include:
  • Confusion
  • Fainting
  • Seizures
  • Inability to concentrate
  • Auditory or visual hallucinations
  • Paranoia
During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication.
  • Constipation
  • Decrease in appetite
  • Dizziness
  • Increased sweating
  • Stomach pain
  • Trembling
  • Unusual weight loss
Bupropion may also worsen anxiety symptoms so if you experience any worsening, reach out to your provider.
Where to find more side effects information
For more information, read the drug information that comes with your medication, ask your healthcare provider, or ask your pharmacist.