If you or a loved one is interested in the antidepressant Wellbutrin, you may have some questions about what to expect when starting the medication. During the first few weeks, many people experience changes in their mood, energy, sleep and appetite. These experiences vary from person to person. Your prescriber can help you know what is expected and what may require attention.
Wellbutrin is the brand name for bupropion, a prescription medication used to treat certain mental health conditions. Understanding how the medication works, its potential side effects and what to talk about with your doctor can help you make informed decisions about your treatment.
This article provides general information about Wellbutrin. It isn’t a substitute for medical advice, diagnosis or treatment from a qualified healthcare professional.
What Is Wellbutrin and What Is It Used For?
Wellbutrin is a prescription antidepressant commonly used to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). Bupropion is also used to help people quit smoking. Compared with many other antidepressants, it’s less likely to cause sexual side effects.
Doctors may prescribe Wellbutrin for several off-label, non-FDA-approved uses. These include treatment for attention deficit hyperactivity disorder (ADHD), depression associated with bipolar disorder, antidepressant-induced sexual dysfunction and obesity.
What to Expect the First Few Weeks
Wellbutrin’s side effects in the first week can include mild dizziness, dry mouth or headache. These effects are common and often ease as your body adjusts to the medication. Your doctor should monitor your response and can help you determine which symptoms are expected.
You may also feel agitated, anxious, restless or more energized. It may be harder to fall asleep, your appetite may decrease and you may experience some nausea.
Side effects often level off or start to decrease within a few weeks. If you have lingering sleeplessness, irritability or other symptoms that cause distress, let your doctor know. Also contact your doctor if you begin to experience problems with concentration or memory.
How Wellbutrin Works
The drug works by blocking the brain from absorbing two key neurotransmitters: norepinephrine and dopamine. Norepinephrine can increase alertness, arousal and attention. Dopamine is a chemical that the brain releases to make you feel good. As a dual norepinephrine and dopamine reuptake inhibitor, Wellbutrin works to increase these neurotransmitters in the brain to combat the symptoms of depression. This inhibiting action represents the Wellbutrin MOA, or mechanism of action.
How Long Does It Take for Wellbutrin to Work?
If you’re wondering how long it takes for Wellbutrin to work, the answer can vary from person to person. Typically, individuals who begin taking Wellbutrin can expect to see a reduction in symptoms over several weeks. In the first two weeks, individuals might notice that they’re sleeping better and their appetite and energy levels have improved. However, overall improvement in mood and a complete reduction in depression symptoms can take a bit longer, often as long as 6 to 8 weeks.
Wellbutrin can also be used to help people quit smoking. For this purpose, the drug can take several weeks to start working, so people are typically advised not to completely quit smoking when they start the drug. Your doctor can determine when it’s time to stop smoking, but people usually start the medication one to two weeks before their quit date and continue it for 7 to 12 weeks.
Several factors can impact Wellbutrin’s timeline for effectiveness. The drug is available in three formulations, and the type of Wellbutrin you take can impact how long it takes for the drug to work. Your doctor may prescribe an immediate-release dose that’s taken two to three times per day at regular intervals. A sustained-release dose is taken twice daily. Or you may be prescribed Wellbutrin XL, an extended-release dose that’s taken once a day in the morning. While all types of Wellbutrin can positively affect your mental health, the dosage you’re prescribed can determine when it takes effect.
Managing Expectations
Reducing depressive symptoms after starting Wellbutrin is gradual, so it’s important to manage your expectations and look for signs the drug is working. Rather than expecting to wake up free of all your symptoms, you want to identify small steps toward improved mental health.
Like other antidepressants, Wellbutrin doesn’t start working instantly. However, you might be able to recognize some improvements as early as the second week of taking the drug. Look for improvements in your sleep habits, instances where you had a more positive outlook or a better mood and enhanced focus while you’re working. You may also be able to identify a reduction in physical symptoms of depression, which may include aches, joint and muscle pain or digestive issues.
By looking for these gradual improvements, you can build a more positive outlook on your new Wellbutrin regimen.
Risks and Side Effects of Wellbutrin
No prescription drug is without side effects. Most common side effects decrease or subside after your body gets used to the medication. If they keep occurring or get worse, however, let your doctor know.
What Are the Common Side Effects of Taking Wellbutrin?
People who take Wellbutrin may experience side effects such as:
- Digestive issues
- Changes in sleep patterns or energy levels
- Mood changes
- Changes in thinking or concentration
- Flu-like symptoms
- Changes in sexual function
- Changes in hearing or vision
- Other changes, such as urinary problems, changes in appetite or weight, or changes in heart rate or blood pressure
Serious Side Effects
Bupropion, the active ingredient in Wellbutrin, may cause uncommon or rare side effects that can be serious. Tell your doctor right away if you experience any of the following, and seek emergency care for a seizure, a severe allergic reaction or chest pain.
- Chest pain
- Severe allergic reaction, such as rash, swelling, itching or trouble breathing
- Eye pain, swelling or significant changes in vision
- Fainting
- Fever with rash or other delayed hypersensitivity symptoms
- Hearing difficulties
- Liver problems, including hepatitis or jaundice
- High blood pressure, including when bupropion is combined with nicotine replacement therapy
- Seizures, which appear to be dose-related
Precautions and Considerations When Taking Wellbutrin
What is the downside of Wellbutrin? The following precautions and considerations are worth knowing.
High Blood Pressure
Wellbutrin may raise blood pressure. Check your blood pressure regularly and tell your doctor if it’s consistently high.
Insomnia
Insomnia may occur while taking Wellbutrin. Taking it too close to bedtime can make sleep problems worse. If you’re having trouble sleeping, ask your doctor whether to adjust your dose or the time of day you take it.
Persistent or Worsening Symptoms
Talk with your doctor or pharmacist as soon as possible if any of these symptoms persist or get worse:
- Achy joints
- Blurry vision
- Constipation
- Diarrhea
- Dizziness
- Dry mouth
- Headache
- Increased sweating
- Nausea
- Sore throat
- Strange taste in your mouth
- Vomiting
Seizures and Alcohol
Rarely, Wellbutrin may cause seizures. If you have a seizure, get emergency medical care and stop taking Wellbutrin. Don’t restart it unless your doctor tells you to.
Alcohol can make bupropion’s side effects worse, and suddenly stopping heavy drinking while taking bupropion raises the risk of seizures. The same is true for abruptly stopping sedatives or seizure medications. Tell your doctor about your drinking before you start Wellbutrin. If you’re living with an alcohol use disorder, your doctor may recommend a different medication.
Mood Changes and Bipolar Disorder
Antidepressants, including Wellbutrin, can trigger manic or hypomanic symptoms in some people, particularly those with bipolar disorder. Contact your doctor right away if you notice greatly increased energy, racing thoughts or reckless behavior.
Suicidality
Wellbutrin and other antidepressants may increase the risk of suicidal thoughts and behaviors in children, teens and young adults, especially during the first few months of treatment or after a dose change. Anyone beginning antidepressant therapy with Wellbutrin should be monitored carefully for new or worsening suicidal thoughts or behaviors.
If you or someone you know is in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911 in an emergency.
Wellbutrin Dosage and Administration
Wellbutrin (bupropion hydrochloride) is available as Wellbutrin SR and Wellbutrin XL. SR is indicated for MDD, while doctors may prescribe Wellbutrin XL to treat MDD and to help prevent depressive episodes in people with SAD. Extended-release and sustained-release tablets should be swallowed whole, not crushed or chewed.
The exact dosage of Wellbutrin varies depending on your condition, the formulation your doctor prescribes and how your body responds. Your doctor will determine the appropriate dose and may adjust it depending on how you respond and whether you experience side effects.
What is the best time to take Wellbutrin? Discuss this with your doctor. Prescribing information indicates you can take it with or without food.
Treatment Duration and Discontinuation
When your doctor prescribes Wellbutrin as part of your treatment, you’ll likely discuss how long to take it.
Discontinuing Wellbutrin
When it’s time to stop, talk with your doctor about the best way to do it. Avoid stopping suddenly, particularly after long-term use or at higher doses. Your doctor can guide you through the process to reduce the risk of side effects or a return of symptoms.
Drug Interactions
Wellbutrin can interact with other medications. Before starting it, give your doctor a complete list of the prescription drugs, over-the-counter medications and supplements you take.
- Don’t take Wellbutrin with a monoamine oxidase inhibitor (MAOI), or within 14 days of stopping one.
- Don’t take Wellbutrin with other medications that contain bupropion.
- Wellbutrin may increase levels of the beta-blocker metoprolol, which can lead to low blood pressure and a slower heart rate.
- Certain HIV medications can lower bupropion levels in the bloodstream, which may reduce its effectiveness.
- Taking Wellbutrin with amantadine, used to treat some types of influenza and Parkinson’s disease, may increase the risk of side effects such as restlessness, tremor and dizziness.
Wellbutrin and Co-Occurring Mental Health Conditions
For people living with mental health conditions, medication can be one part of a comprehensive treatment plan. A doctor may prescribe Wellbutrin for MDD and, in some cases, for depression associated with bipolar disorder. Depending on your needs, your treatment may also include therapy and other forms of support. Combining medication with therapy and lifestyle changes can help address both your symptoms and the factors underlying them.
Frequently Asked Questions
Getting Support at Restore
If you have questions about Wellbutrin or other mental health treatment options, Restore Mental Health is here to help. Our team in Deerfield Beach provides psychiatric care, medication management and therapy as part of residential and outpatient mental health treatment. Call (877) 810-2074 or contact us online to request that a member of our team reach out to you.
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