Wellbutrin in the treatment of bipolar disorder: risks and benefits

Wellbutrin, also known by its generic name bupropion, is an antidepressant and can also be used to treat depression in bipolar disorder. It has immediate release 75 and 100 mg tablets, extended release 100 and 150 mg and 200 mg Wellbutrin SR tablets, and extended release 150 mg, 300 mg and 450 mg Wellbutrin XL formulations.

Wellbutrin treats bipolar disorder

Bipolar disorder is an unbearable disease because it is characterized by two opposite emotions, mania and depression, both of which can be very extreme and neither are optimal.

Antidepressants including Wellbutrin are widely used to treat depression in bipolar disorder. There are concerns about antidepressants and bipolar disorder.One of the problems is called phase shift, which is the transition of mood from depression to mania.This can be a serious problem because mania can lead to impulsive or dangerous behavior. Studies have shown that when Wellbutrin is used for bipolar disorder, it has the same risk of inducing phase shifts as most other antidepressants.

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Wellbutrin may reduce the symptoms of depression by inhibiting the reuptake of the neurotransmitters serotonin, dopamine and norepinephrine and prolonging their effects, thereby preventing depression.

General guidelines for starting Wellbutrin

If you start taking Wellbutrin for the first time, your doctor will first start your medication at a low dose and then gradually increase your dose due to the risk of side effects.

When you start taking Wellbutrin for the first time, your initial dose should not exceed 200 mg/day. Take 100 mg doses twice a day, preferably about 12 hours apart. This may increase to the target dose of 300 mg/day on the fourth day, taking 100 mg doses at least 6 hours apart. The maximum dose is 450 mg per day, 150 mg can be taken 3 times a day.

If you feel irritable, irritable, or insomnia, you should take a lower dose for a longer period of time and/or gradually increase the dose. These are common side effects that sometimes occur when you start taking the medicine and then resolve when you adapt.

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Don’t expect your depression to improve immediately. It may take two to three months for you to feel the antidepressant effects of the medicine.

Precautions and side effects of Wellbutrin

The following points should be noted when taking this drug:

side effect

  • The most common side effects of Wellbutrin include headache, dry mouth, nausea and insomnia. If you experience these symptoms, be sure to tell your doctor if they are severe or if they worsen suddenly.
  • A small number of people suffer from anorexia (loss of appetite) when taking bupropion, so patients with a history of anorexia nervosa (deliberate restriction of food) or bulimia should not take this drug. If you cannot afford to lose more than 5% of your current body weight, you should not take Wellbutrin.
  • Studies have shown that bupropion is harmless during pregnancy, but of course, your obstetrician should always be aware of all the medicines you are taking.
  • At a dose of 400-450 mg/day, your risk of seizures increases threefold, although it is still very, very small: four out of 1,000 people have seizures while taking such high doses of Wellbutrin.
  • If you miss a dose, skip it. The risk of seizures is related to the dose, and doubling is more likely to cause seizures.
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Drug and alcohol interaction

  • If you are taking MAOI antidepressants, you should wait at least two weeks after taking the last dose of the drug before starting Wellbutrin because these drugs can interact.
  • Do not take Wellbutrin and Zyban at the same time, the latter is also bupropion. Zyban is used to quit smoking, but taking these two drugs at the same time can dangerously increase the dose of the same chemical.
  • If you take bupropion, drinking alcohol can increase the risk of seizures.

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