Bupropion, commonly known by its brand name Wellbutrin, ranks among the most frequently prescribed antidepressants. It is effective in alleviating symptoms associated with major depressive disorder (MDD) and seasonal affective disorder (SAD), and it can be used alongside other antidepressants that may not have provided sufficient relief on their own. However, a notable drawback of this medication is the potential for bupropion withdrawal symptoms when stopping the medication. Furthermore, there has been an increase in reported cases of bupropion misuse and overdose, especially when combined with substances like alcohol.
Withdrawal from bupropion occurs when the medication is abruptly stopped and the brain and body undergo a temporary state of imbalance. While these withdrawal symptoms are generally milder compared to those associated with medications like benzodiazepines or opioids, they typically manifest within two to four days after stopping the medication and can last from one to two weeks. The symptoms can vary in both duration and intensity and may include:
- Mood swings and irritability
- Headaches
- Fatigue
- Dizziness
- Flu-like sensations
- Insomnia or hypersomnia
- Difficulty concentrating
- Memory lapses
- Nausea, vomiting, and digestive discomfort
- Trouble balancing
- Sensations described as “brain zaps”
- Suicidal ideation
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What Does Bupropion Do for a Person?
Bupropion is an antidepressant that has been approved for the treatment of major depressive disorder (MDD), and seasonal affective disorder (SAD), and as a smoking cessation aid, as noted by the National Alliance on Mental Illness. It falls under the category of norepinephrine and dopamine reuptake inhibitors (NDRIs), functioning by enhancing mood through the elevation of norepinephrine and dopamine levels in the brain by preventing their reabsorption. Some healthcare professionals may also prescribe bupropion off-label for conditions like anxiety and attention deficit hyperactivity disorder (ADHD). Additionally, it is sometimes used in combination with serotonin reuptake inhibitors (SSRIs) for patients whose depression does not improve with SSRIs alone.
For individuals diagnosed with major depressive disorder (MDD) taking bupropion, the increased dopamine and norepinephrine levels can significantly improve mood and energy, alleviating depressive symptoms. A notable advantage of bupropion is that it does not impact sexual desire or lead to weight gain, common side effects associated with many other antidepressants. It is frequently prescribed alongside other antidepressants to mitigate the sexual side effects they may cause.
Beyond its role as an antidepressant, bupropion acts as an antagonist to nicotinic receptors, effectively blocking the sites where nicotine attaches, which aids individuals in quitting smoking and managing withdrawal symptoms. Its mild stimulating properties can also benefit those with anxiety and ADHD by enhancing focus and reducing impulsivity.
What Is a Major Side Effect of Bupropion?
As with any medication, bupropion can lead to various side effects that range from mild to severe. Bupropion comes with a black box warning, the most serious type of warning from the U.S. Food and Drug Administration, aimed at informing both healthcare providers and patients about the potential risks of suicidal thoughts and behaviors associated with the drug. Users may experience mood and behavioral changes, such as agitation, irritability, worsening depression, anxiety, panic attacks, insomnia, hostility, and aggression. The risk of developing suicidal thoughts and behaviors is particularly heightened in children, adolescents, and young adults.
In rare cases, bupropion can trigger seizures, which can be severe and even life-threatening. Certain individuals are at a higher risk for seizures, especially those with a history of seizures, eating disorders (due to electrolyte imbalances), withdrawal from alcohol or drugs, head injuries, or neurological disorders. The likelihood of experiencing seizures increases with higher doses of bupropion. While the most serious side effects include suicidal thoughts and seizures, other potential side effects may include:
- Insomnia
- Dry mouth
- Dizziness
- Headaches
- Nausea
- Increased anxiety
Abruptly stopping or significantly reducing dosage can lead to bupropion withdrawal symptoms as well. These drug withdrawal symptoms include brain zaps, insomnia, suicidal ideation, vomiting, dizziness, and tremors. It is crucial to consult a healthcare provider about a tapering plan to minimize withdrawal effects when discontinuing the medication.
Moreover, a study published in the National Library of Medicine highlights bupropion’s potential for abuse and overdose. The article notes a rise in case reports of bupropion misuse, including recreational use, snorting crushed tablets, and intravenous administration. Although bupropion shares some structural and pharmacological similarities with amphetamines, early studies indicate that it does not produce psychostimulant effects. However, individuals who misuse bupropion report experiencing euphoric highs similar to cocaine, but less than intense.
Can Bupropion Cause Weight Gain?
Bupropion is generally not linked to weight gain, but some individuals may experience fluctuations in their weight. In contrast, other antidepressants and antianxiety medications, like Prozac, Paxil, and Celexa, are more frequently associated with weight gain. These SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors) can disrupt serotonin levels in the brain, potentially leading to increased cravings for carbohydrate-rich foods, which may contribute to weight gain over time.
Similarly, bupropion can cause weight gain as it affects levels of both dopamine and norepinephrine, which play an important role in controlling appetite and eating. Another factor is that people with depression may have lost weight and now return to a healthier weight as their appetite has returned from taking an antidepressant. Furthermore, some people may lose weight while on bupropion and gain it back as one of the effects of stopping bupropion. Some individuals may return to emotional eating as well when stopping the medication.
Why Do Doctors Not Prescribe Bupropion?
Bupropion stands out among antidepressants for its lower likelihood of causing weight gain and sexual dysfunction—two side effects that often concern patients and significantly affect their long-term adherence to treatment. While these advantages make it a preferable option for many, healthcare providers may hesitate to prescribe it, especially for patients dealing with depression accompanied by high anxiety levels. Research from the National Library of Medicine at Brown University School of Medicine indicates that its mild stimulating properties can worsen anxiety and agitation. Additionally, bupropion may trigger manic episodes in individuals with bipolar disorder, making it unsuitable for those patients. Its potential to induce seizures also leads doctors to avoid prescribing it to individuals with a history of seizures or eating disorders.
Moreover, although bupropion is not classified as addictive when taken as directed, there have been numerous reports of misuse. The risk of serious side effects, including seizures, increases significantly when the medication is abused, particularly through higher doses or non-oral methods like snorting or injecting. Such misuse raises the potential for developing an addiction to bupropion. Even patients who follow their prescribed regimen may face withdrawal symptoms, which can result in prolonged use of the medication beyond what is necessary.
How Muse Treatment Can Help You Overcome Bupropion Withdrawal
Many people envision drug rehab centers like Muse Treatment as solely focused on addiction recovery. However, these facilities also provide essential support for individuals looking to discontinue certain medications. At Muse Treatment in Los Angeles, we offer thorough detox programs designed to assist individuals in managing bupropion withdrawal safely and comfortably. Our tailored programs cater to each patient’s unique needs, providing expert guidance and evidence-based therapies to help them stop Wellbutrin while also addressing depression through non-medication therapies. For those facing more severe challenges with bupropion abuse and addiction, we also offer more intensive treatment options.
If you’re finding it difficult to stop bupropion or any other antidepressant on your own, reach out to Muse Treatment at 800-426-1818 to explore your treatment options.
External Sources
- National Alliance on Mental Illness – Bupropion (Wellbutrin)
- National Library of Medicine – Bupropion abuse and overdose
- National Library of Medicine – Why isn’t bupropion the most frequently prescribed antidepressant?
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