Bupropion

Bupropion treats depression. Certain XL formulations help prevent seasonal depression, and SR is used to help adults stop smoking.

Providers may also prescribe it off-label for ADHD or sexual side effects from another antidepressant. Off-label means the FDA has not approved that specific use.

Bupropion slows the reuptake of dopamine and norepinephrine, allowing more of these chemical messengers to remain available between nerve cells. They help regulate mood, attention, and motivation.

IR: Immediate-release, usually 2–3 times daily.
SR: Sustained-release, usually twice daily.
XL: Extended-release, usually each morning.

During the first few weeks: Sleep, appetite, or energy may improve before your mood does. Side effects can appear before you notice a benefit.

Over the following weeks: Mood and interest in activities may improve gradually. Full benefit often takes 4–8 weeks or longer.

Keep scheduled follow-up appointments. Schedule an earlier appointment if your mood gets worse.

• Follow your prescribed dose and schedule. Your provider may increase the dose gradually.
• Swallow SR and XL tablets whole. Do not cut, crush, or chew them.
• If you miss a dose, skip it. Take your next dose at the usual time. Extra doses or doses taken too close together increase seizure risk.
• Take with food if you have nausea. If you have trouble sleeping, discuss dose timing with your provider.

• Dry mouth, nausea, or constipation
• Headache or dizziness
• Trouble sleeping, anxiety, or feeling jittery
• Decreased appetite or weight loss
• Sweating or a mild tremor

Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.

Pay attention to your mood, sleep, anxiety, appetite, and ability to manage daily activities. Bring any changes or concerns to your follow-up appointments.

Have your blood pressure checked before starting treatment and periodically while taking bupropion.

Antidepressants can increase suicidal thoughts in people under 25. Watch for mood or behavior changes at any age, especially after starting treatment or changing a dose.

For an overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for collapse, a seizure, trouble breathing, or inability to wake.

Do not take bupropion if you have a seizure disorder, current or past anorexia or bulimia, or an allergy to it.

Discuss bipolar symptoms, head injury, high blood pressure, kidney or liver problems, pregnancy, pregnancy plans, and breastfeeding with your provider.

Do not drive until you know how bupropion affects you.

Review all your medications with your provider, including over-the-counter medicines and supplements.

• Other bupropion medications: Do not combine bupropion with other bupropion-containing medications, including Auvelity or Contrave.
• MAOIs: MAOI antidepressants generally require a 14-day gap before or after bupropion. Linezolid and IV methylene blue also need special precautions.
• Alcohol and sedatives: Limit or avoid alcohol. Heavy drinking or suddenly stopping alcohol, benzodiazepines, or seizure medications can increase seizure risk. Consult with your provider.
• Other prescriptions: Bupropion can change levels of certain medications. Some combinations also increase seizure risk. Your provider or pharmacist can check your specific medications.

Use a dose reminder and arrange refills before you run out.

An empty shell from some XL tablets may appear in your stool. The medication has already been released.

Bupropion can cause a false-positive amphetamine result on some urine drug screens. Tell the testing clinician so a confirmatory test can be used.

Keep tablets in their labeled container at room temperature, away from excess heat and moisture and out of reach of children and pets. Do not share medication.