What is Wellbutrin Approved to Treat?
Drug licensing can be complicated. Wellbutrin is approved to treat MDD, or major depressive disorder, but not approved to treat depression in bipolar patients. It is not approved for quitting smoking. Its sister drug “Zyban” is bupropion that has been approved for smoking cessation, but not for treating depression. Wellbutrin comes in immediate release and slow-release versions. 
(Wellbutrin XR, extended release, and Wellbutrin SR, or sustained release)
Generic bupropion is approved for quitting smoking, and seasonal affective disorder, but is not approved for treating MDD. Nonetheless, it is possible any of these versions could be prescribed for MDD, seasonal affective disorder, or smoking cessation. The FDA label has been modified to include various uses, noting that the side effects for either version of the drug could, of course, be identical.
Off-label uses also occur when a prescriber chooses Wellbutrin or generic bupropion, or a drug combination such as naltrexone-bupropion (XR) to treat obesity. Other conditions that are not FDA-approved include OCD, ADHD, antidepressant-induced sexual dysfunction, and even though the label expressly states it is not approved for treating depressive episodes of bipolar disorder, this sometimes has occurred off-label. The American Society of Addiction Medicine has recommended prescribing bupropion to assist with quitting cocaine or other stimulant drugs.
There are likely other off label uses that are not well documented.
Anyone taking any prescription drug deserves to be closely monitored for adverse effects so they can be handled before they become disabling.2-4
How is Wellbutrin/bupropion Classified?
Bupropion marketed as Wellbutrin or Zyban is a unique antidepressant. It is classed as an atypical antidepressant and though its mechanisms are not completely understood, animal studies suggest it inhibits the normal reuptake of 2 neurotransmitters, norepinephrine and dopamine. Just as an SSRI (selective serotonin reuptake inhibitor) is thought to inhibit the reuptake of the neurotransmitter serotonin, Wellbutrin inhibits the reuptake of both norepinephrine (a precursor to adrenaline) and dopamine, another excitatory neurotransmitter. The higher the dose the more norepinephrine and dopamine are potentially made available.
Wellbutrin does not act on serotonin transmission like an SSRI does. Wellbutrin differs from SSRIs in that it does not cause weight gain, does not cause sedation, and does not cause sexual side effects associated with SSRI medications.
Bupropion’s unique neurochemical mechanisms of action also are thought to be what give it its unique side effect profile.6
Drug Interactions to Know About
If certain other drugs are taken concurrently with bupropion side effects may arise from the chemical interaction that occurs. Some drug interactions reduce the effectiveness of a drug, while other combinations may increase a drug’s effects. Below is a list compiled from the drug’s label and other sources where noted of drug combinations that should be avoided for safety reasons.1,4
Drug interactions with safety concerns include:
- Wellbutrin/bupropion taken with other dopaminergic drugs (opioids, levodopa, amantadine) can lead to CNS toxicity
- MAOIs & Wellbutrin should not be taken together. A 14 day washout period is required to switch from MAOIs to bupropion, or from bupropion to an MAOI.
- Intravenous methylene blue and bupropion should not be taken concurrently
- Zyvox (an antibacterial drug) should not be taken at the same time as Wellbutrin, Zyban, or bupropion
- Bupropion products should not be taken concurrently with any other class of antidepressants, anticonvulsants, or antipsychotics as concentrations of the active ingredients can occur (venlafaxine, sertraline, paroxetine, antipsychotics, beta blockers, and others)
- Bupropion drugs should not be taken concurrently with cessation of alcohol, benzodiazepines, barbiturates, or cessation of antiepileptic drugs.
- Avoid taking bupropion at the same time as other CNS stimulants.
- FDA advises alcohol should be avoided while taking bupropion products.
These may not be all the drug interactions relating to Wellbutrin and bupropion products. Polypharmacy is becoming more common which means one must take care to always let your prescriber know all the drugs you are or have been recently taking to avoid drug interaction safety issues.
Paradoxical Bupropion Side Effects
Although bupropion has a structure similar to amphetamines, and acts more like a stimulant than a sedative, clinical reports of a side effect called somnambulism have been reported. Somnambulism is sleep-walking, with amnesia. The episodes are not remembered upon waking.7-9
Impaired decision making and reduced awareness of one’s environment are associated with somnambulism, as are daytime fatigue and problem-solving skills. These are side effects that may be overlooked due to the associated decrease in awareness, but should be known for anyone taking bupropion or for their loved one’s safety.
How to Avoid Side Effects and Still Get Symptom Relief?
Holistic, drug-free methods can be extremely effective for treating the symptoms that a drug like bupropion is prescribed for. ATMC specializes in implementing strategies and protocols that are specifically designed to address unwanted symptoms without the liability of adverse reactions to drugs, like the Wellbutrin side-effects listed above.
The origin of symptoms can seem quite mysterious, can come on gradually or suddenly, and can be perplexing to understand why they present. So, prior to starting a prescription to a drug like Wellbutrin, lab testing can be used to help isolate causative factors and their primary and secondary effects that may have been overlooked completely.
A body’s burden of toxicity can lead to unwanted symptoms including depression, anxiety, insomnia and many others.10 The best approach is to remove the neurotoxic load from the body, allowing the CNS to function as it was intended. In the modern world, we are living in a soup of chemicals that we are exposed to on a near daily basis, in the air, in our water supply, in our work environments, and even in our commercial food industry.
Orthomolecular medicine approaches nutrition in therapeutic ways, that include choosing clean, organic food that is unprocessed as much as possible. Daily consumptions of probiotics such as sauerkraut, kimchi, pickled foods, yogurt can support a healthy gut microbiome. This is vital, as it is the gut microbiome that produces and distributes the bulk of neurochemicals throughout the body.11
Nutritional deficiencies are another area that can be overlooked entirely, but can be easily determined through lab testing. These problems can be transformative once corrected. This is another benefit of orthomolecular approaches to both mental and physical health concerns.
Safe Drug Tapering is Possible Without Harsh Side Effects, and Without Returning Symptoms
Alternative to Meds Center uses a safe, proven set of protocols to enable safe tapering for the relief of untenable Wellbutrin side effects. And just as importantly, there is really no point in coming off a drug if the original symptoms are just going to return. So we do the investigative work to isolate the factors that are contributing to unwanted symptoms. And, using our vast array of treatment methods, make sure these are no longer present, and no longer problematic.
Our clients’ success shows how effective our approach is for regaining natural mental health without suffering the liabilities and side effects of harsh or intrusive drugs. Please feel free to contact us directly for more information and find out how we could be the missing link in your recovery or that of your loved one. We can also refer you to other resources if coming to an inpatient facility is not possible for you at this time. In any case, call today. We are here to help.
Seizures
