Wellbutrin SR (bupropion hydrochloride) is a second-generation antidepressant and aminoketone-class medication specifically formulated with a sustained-release delivery system. This pharmaceutical product represents a distinct therapeutic approach to managing major depressive disorder through its unique noradrenergic and dopaminergic activity profile. Unlike many conventional antidepressants that primarily affect serotonin, Wellbutrin SR offers an alternative mechanism of action, making it particularly valuable for patients who experience undesirable side effects with other antidepressant classes. The sustained-release formulation provides stable plasma concentrations over a 12-hour period, allowing for twice-daily dosing while minimizing peak-trough fluctuations that can impact both efficacy and tolerability.

Features

• Contains bupropion hydrochloride as the active pharmaceutical ingredient
• Sustained-release matrix formulation for controlled drug delivery
• Available in 100 mg and 150 mg tablet strengths
• White to off-white, round, bi-convex tablets with functional score line
• 12-hour controlled release profile for consistent therapeutic effect
• Minimal impact on serotonin pathways compared to SSRIs/SNRIs
• Manufactured under current Good Manufacturing Practices (cGMP)
• Bioequivalent to the reference listed drug
• Packaged in light-resistant, high-density polyethylene bottles
• Includes desiccant canister for moisture protection

Benefits

• Provides effective relief from depressive symptoms with a different mechanism than SSRIs
• Lower incidence of sexual dysfunction compared to serotonergic antidepressants
• Not associated with weight gain commonly seen with other antidepressants
• May improve energy levels, motivation, and concentration in depressed patients
• Sustained-release formulation reduces dosing frequency and improves compliance
• May be particularly beneficial for patients with SSRI-induced sexual dysfunction

Common use

Wellbutrin SR is primarily indicated for the treatment of major depressive disorder (MDD) in adults. The medication is approved for managing the symptoms of depression, including depressed mood, loss of interest in usual activities, changes in appetite and sleep patterns, decreased energy, feelings of guilt or worthlessness, difficulty concentrating, and suicidal thoughts. Clinicians may also consider Wellbutrin SR for patients who have not responded adequately to other antidepressant therapies or who experience problematic side effects with serotonin-based medications. Some healthcare providers may prescribe it off-label for seasonal affective disorder, attention deficit hyperactivity disorder (ADHD), and as an aid for smoking cessation, though the SR formulation is not specifically FDA-approved for these uses.

Dosage and direction

The initial recommended dosage for Wellbutrin SR is 150 mg administered once daily in the morning. After a minimum of three days, the dosage may be increased to the target dose of 150 mg twice daily, with doses separated by at least 8 hours. The maximum recommended dose is 400 mg per day, given as 200 mg twice daily. Doses should be swallowed whole and not crushed, divided, or chewed, as this would compromise the sustained-release properties and could lead to rapid drug release. Administration with food may decrease the incidence of gastrointestinal side effects. Dosage adjustments are necessary in patients with hepatic impairment, and the drug should be used with caution in patients with renal impairment. Treatment should be initiated under close medical supervision, with regular monitoring of therapeutic response and potential adverse effects.

Precautions

Patients should be monitored for worsening depression, suicidality, or unusual changes in behavior, particularly during the initial months of therapy or during dosage adjustments. Wellbutrin SR may lower the seizure threshold; therefore, caution is advised in patients with a history of seizure disorder, head trauma, or other predisposing conditions. The medication should be used cautiously in patients with hepatic or renal impairment, and dosage adjustment may be necessary. Patients should avoid alcohol consumption during treatment, as alcohol may increase the risk of seizures. Abrupt discontinuation should be avoided; dosage should be tapered gradually when discontinuing treatment. Wellbutrin SR may impair mental or physical abilities required for performing hazardous tasks; patients should exercise caution when operating machinery or driving until they know how the medication affects them.

Contraindications

Wellbutrin SR is contraindicated in patients with a known hypersensitivity to bupropion or any component of the formulation. It must not be used in patients with a current or prior diagnosis of bulimia or anorexia nervosa due to the increased risk of seizures. The medication is contraindicated in patients undergoing abrupt discontinuation of alcohol or sedatives (including benzodiazepines). Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated; at least 14 days should elapse between discontinuation of an MAOI and initiation of Wellbutrin SR therapy. Wellbutrin SR is also contraindicated in patients who have experienced a seizure disorder, and in those taking other medications containing bupropion due to the additive seizure risk.

Possible side effect

Common adverse reactions (≥5% incidence) include dry mouth, nausea, insomnia, dizziness, headache, constipation, anxiety, agitation, and tremor. Less frequently, patients may experience sweating, rash, tinnitus, blurred vision, tachycardia, hypertension, weight loss, or taste disturbance. Serious side effects requiring immediate medical attention include seizures (incidence approximately 0.1% at 300-400 mg/day), allergic reactions, angle-closure glaucoma, severe hypertension, hepatotoxicity, and neuropsychiatric symptoms including hallucinations, paranoia, or suicidal ideation. The incidence of sexual dysfunction is notably lower than with SSRIs, though some patients may experience changes in libido.

Drug interaction

Wellbutrin SR demonstrates several clinically significant drug interactions. It inhibits the CYP2D6 isoenzyme and may increase plasma concentrations of drugs metabolized by this pathway, including certain antidepressants (SSRIs, TCAs), antipsychotics, beta-blockers, and type 1C antiarrhythmics. Concomitant use with other drugs that lower seizure threshold (other antidepressants, antipsychotics, systemic corticosteroids, theophylline, tramadol) may increase seizure risk. MAOIs are contraindicated due to the risk of hypertensive crisis. Medications that induce CYP2B6 (carbamazepine, phenobarbital, phenytoin) may decrease bupropion exposure, while inhibitors of CYP2B6 may increase bupropion concentrations. Caution is advised when co-administering with drugs affecting dopamine or norepinephrine pathways.

Missed dose

If a dose is missed, the patient should take it as soon as remembered, unless it is close to the time of the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not take double or extra doses to make up for a missed dose, as this increases the risk of adverse effects, including seizures. If multiple doses are missed, patients should contact their healthcare provider for guidance on resuming therapy, as dosage adjustment or re-titration may be necessary. Maintaining a consistent dosing schedule is important for optimal therapeutic effect.

Overdose

Wellbutrin overdose is a medical emergency that requires immediate attention. Symptoms may include seizures, hallucinations, loss of consciousness, sinus tachycardia, ECG changes (prolonged QRS or QTc interval), heart block, hypotension, respiratory failure, and fever. Fatal outcomes have been reported, particularly with large overdoses or in combination with other drugs. Management includes securing the airway, ensuring adequate oxygenation, and implementing cardiac monitoring. Gastric lavage may be considered if performed soon after ingestion. Activated charcoal may be administered. Seizures should be treated with benzodiazepines; status epilepticus may require additional anticonvulsants. There is no specific antidote for bupropion overdose; treatment is supportive and symptomatic.

Storage

Wellbutrin SR tablets should be stored at room temperature, between 20°C and 25°C (68°F and 77°F), with excursions permitted between 15°C and 30°C (59°F and 86°F). The medication must be kept in the original container with the lid tightly closed to protect from light and moisture. The desiccant canister should remain in the bottle and not be removed. Tablets should be kept out of reach of children and pets. Unused medication should be properly disposed of according to local regulations or through drug take-back programs. The tablets should not be stored in bathroom cabinets or other areas subject to high humidity or temperature fluctuations.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Wellbutrin SR is available by prescription only and should be used under the supervision of a qualified healthcare professional. Individual response to medication may vary, and only a healthcare provider can determine the appropriate treatment based on a patient’s specific medical condition, history, and concurrent medications. Patients should not alter their dosage or discontinue treatment without consulting their healthcare provider. The complete prescribing information should be consulted before initiating therapy.

Reviews

Clinical studies demonstrate that Wellbutrin SR is effective in the treatment of major depressive disorder, with response rates comparable to other antidepressants. Many patients report particular satisfaction with the side effect profile, especially the lower incidence of weight gain and sexual dysfunction compared to SSRIs. Some patients note initial side effects such as insomnia or agitation that often diminish with continued treatment. Healthcare providers appreciate the alternative mechanism of action when patients have not responded to or tolerated first-line antidepressants. The twice-daily dosing regimen is generally considered convenient, though some patients report difficulty remembering the second dose. Overall, Wellbutrin SR represents a valuable option in the antidepressant arsenal, particularly for patients who experience problematic side effects with serotonin-based medications.