Bupropion
Bupropion is an aminoketone medicine used to help people stop smoking and to treat depression. Its action centres on dopamine and noradrenaline rather than mainly on serotonin, so its effects differ from those of many other antidepressants. It comes as a prolonged-release tablet, either on its own or combined with naltrexone for weight management.
Medicines containing Bupropion
Wellbutrin
Major Depressive Disorder, Tobacco Dependence
150 · 300mg
Wellbutrin contains bupropion as modified-release tablets for major depressive disorder and tobacco dependence. It is supplied in several strengths and pack sizes. You can compare the price per tablet across options.
Key points
- Bupropion is a non-competitive antagonist of the nicotinic acetylcholine receptor, and it also inhibits the neuronal reuptake of norepinephrine and dopamine.
- Effects are usually noticed within 1–2 weeks.
- It is not recommended for anyone under 18 years.
What bupropion is used for
Bupropion is indicated for major depressive disorder, as defined by diagnostic criteria. It is also indicated for preventing seasonal major depressive episodes in people with a diagnosis of seasonal affective disorder. Both uses sit within major depressive disorder care. It is taken on its own or alongside other agents, and the choice between it and another antidepressant comes down to individual history and tolerability.
Its profile is often described as activating, which can suit people who feel slowed down or tired on other antidepressants.
A separate role is smoking cessation and tobacco dependence. The aim is to ease the craving and withdrawal that make stopping difficult. Treatment begins before the planned quit date and carries on through the early weeks without cigarettes.
With naltrexone added, the same medicine is used in obesity under specialist input, where the same pathways are linked to appetite regulation. Both ingredients come in one tablet.
One active substance sits behind all three uses. Products differ in strength and, for weight management, in the second ingredient.
How bupropion works
Bupropion acts at the nicotinic acetylcholine receptor as a non-competitive antagonist. Separately, it inhibits the neuronal reuptake of norepinephrine and dopamine, so more of both messengers remain available between nerve cells. These two chemicals are involved in mood, motivation, reward and alertness. With more of them available, the reduced drive that can come with depression may lift, and the pull of an established smoking habit can weaken.
Why it helps people stop smoking is not fully settled. Product information links the effect to the medicine’s noradrenergic and dopaminergic activity.
The prolonged-release design spreads the medicine across the day rather than delivering it all at once, which helps blunt the ups and downs that uneven levels can bring.
Forms and brands
Bupropion is supplied as prolonged-release tablets, and both the strength and the companion ingredients vary by product.
- Wellbutrin: bupropion 150 mg and 300 mg tablets, for major depressive disorder and tobacco dependence.
- Zyban: bupropion 150 mg tablets, for smoking cessation.
- Contrave: bupropion with naltrexone, 8/90 mg tablets, for obesity.
Strength, and in one case a second ingredient, is what separates these products. Deliveries to Malaysia are made by pharmacy partners in India in discreet packaging.
Who should not take it
Bupropion is contraindicated in people with a seizure disorder, in anyone with an eating disorder, in people taking MAO inhibitors and in those with hypersensitivity to bupropion. Seizure risk is the reason a seizure disorder rules it out entirely.
Caution is needed for people with a history of head trauma. A history of heavy alcohol use, or stopping alcohol abruptly, also needs closer review.
In pregnancy, bupropion is used only if necessary, and a physician should be consulted. Before breastfeeding, suitability should be confirmed with a qualified clinician or pharmacist.
Side effects and interactions
Minor effects include insomnia, dry mouth and nausea. Anxiety, tremor, dizziness and fever are listed as moderate effects.
Seizures and anaphylaxis are serious reactions and require immediate medical attention.
Alcohol, MAO inhibitors and citalopram are listed interactions.
What the sources say
- Bupropion is contraindicated for anyone with a current or prior diagnosis of bulimia or anorexia nervosa, so a history of either condition counts. (DailyMed)
- Doses are built up gradually so that the risk of seizures is reduced. (DailyMed)
- Antidepressant trials found no increase in suicidal thoughts or behaviour among people aged 65 and over. (DailyMed)
Further reading
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