Bupropion

Why people buy bupropion

Bupropion is an antidepressant used for depression — low mood lasting weeks or months and getting in the way of daily life — and it is just as well known for helping people stop smoking. Nothing about the tablet changes with the reason for taking it. Paired with naltrexone, bupropion is also used for weight management: Contrave combines naltrexone 8mg with bupropion 90mg in one tablet. For quitting cigarettes, quit-smoking medicines covers the other options, and antidepressants covers the wider group bupropion belongs to.

How bupropion works

It is not an SSRI, the serotonin-based group most modern antidepressants belong to. Bupropion acts on dopamine and noradrenaline, two chemical messengers in the brain, slowing the rate at which nerve cells clear them away so each signal lasts longer. That difference is why the same tablet can take the edge off cigarette cravings and the withdrawal that follows a quit date. The lift in mood comes on gradually rather than in a day or two.

Sustained-release or standard: the single-ingredient tablets

Bupropion is a 150mg tablet and Wellbutrin comes as 150mg or 300mg, the one single-ingredient choice here with two strengths. The other three 150mg tablets, Bupron SR, Wellbutrin SR and Zyban, release the drug slowly. Zyban is sold for stopping smoking only; the rest appear under depression and smoking both. Zyban and Wellbutrin are brand names, and every tablet contains the same active ingredient, written on packs as bupropion hydrochloride.

Fitting bupropion into the day

Anyone starting on a once-daily tablet should take it in the morning: bupropion is mildly stimulating, and a late dose often costs sleep. The SR tablets are different. They are taken twice a day, at least eight hours apart, which usually means one in the morning and one in the afternoon, and each is swallowed whole rather than split or chewed. If they leave you queasy, take them with food.

For quitting cigarettes, treatment often starts with 150mg once a day for the first few days and then moves to 150mg twice a day. The quit date falls in the second week, and a course usually runs seven to twelve weeks.

Side effects and interactions worth knowing

Dry mouth, headache, nausea, dizziness, sweating, shaky hands and broken sleep are the usual early complaints, and blood pressure can rise during treatment. The serious risk is a seizure: uncommon at usual doses, more likely at higher daily doses, in anyone with a seizure disorder or an eating disorder such as bulimia or anorexia, and after heavy drinking or a sudden stop to alcohol or benzodiazepines. A monoamine oxidase inhibitor (MAOI), an older kind of antidepressant, must not be taken with bupropion, or within 14 days of stopping one. Rarely, the lips, face or throat swell, and that needs urgent treatment; new or worsening thoughts of harming yourself need urgent help too.