Wellbutrin XL and SR side effects and use for depression, benefits - Interactions with nutritional supplements and proper dosage by Ray Sahelian, M.D.
September 15 2016

Wellbutrin is an antidepressant prescription medication. Wellbutrin is used to treat major depressive disorder and seasonal affective disorder. Wellbutrin is made by GlaxoSmithKline. The generic name of Wellbutrin is bupropion.

No serotonin effect
Bupropion hydrochloride is a norepinephrine-dopamine disinhibitor (NDDI) approved for the treatment of depression and smoking cessation. Bupropion is a second-generation antidepressant, which differs structurally from most antidepressants, and resides in a novel mechanistic class that has no direct action on the serotonin system.

How Wellbutrin works in the body and brain
Wellbutrin is an antidepressant medication that affects neurotransmitters. Wellbutrin is unrelated to other antidepressants. It works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine, an action which results in more dopamine, serotonin, and norepinephrine to transmit messages to other nerves. Bupropion is unique in that its major effect is on dopamine, an effect which is not shared by the selective serotonin reuptake inhibitors or SSRIs (e.g. paroxetine, Paxil; fluoxetine, Prozac; sertraline, Zoloft) or the tricyclic antidepressants or TCAs (e.g. amitriptyline, Elavil; imipramine, Tofranil; desipramine, Norpramin).

Side effects of Wellbutrin, safety, danger, risk
In rare cases Wellbutrin side effects could be of an allergic nature such as hives; difficulty breathing; swelling of the face, lips, tongue, or throat. Another potential serious adverse reaction is seizure (convulsions). And thirdly, an additional serious Wellbutrin side effect is heart palpitations or irregular heartbeats. Less serious adverse reactions include headache or migraine, difficulty with sleep, gastrointestinal symptoms such as nausea and vomiting, neurological symptoms such as confusion, agitation, restlessness, tremors and dizziness; changes in appetite such as weight loss or weight gain. Additional adverse reactions could occur such as changes in libido.

Addict Sci Clin Pract. Dec 12 2013. A case of hypomania during nicotine cessation treatment with bupropion. Antidepressants can increase the spontaneous risk of hypomania or mania when used for treatment in affective disorders. When prescribed as an antidepressant, bupropion is generally considered to have a lower relative risk of inducing mood shifts. We describe the case of a 67-year-old man known for dysthymic disorder in remission on quetiapine and venlafaxine who experienced a first lifetime episode of hypomania with the introduction of bupropion SR for smoking cessation. To the best of our knowledge, this is the first case report of bupropion-induced mood shift when used specifically for nicotine cessation in a nonbipolar patient. This case highlights the need for clinicians who prescribe bupropion for smoking cessation to perform regular and systematic mood follow-ups during treatment. These follow-ups could even be more important when bupropion is selected to quit smoking in a patient already taking an antidepressant.

Use with 5HTP supplement
Q. Hi there. I didn't know who else to email but I don't trust just anyone on any old blog. I have been using 5-HTP for about a month and a half now. I was doing 100mg two times a day and then increased to 100 mg 3 times a day. What a difference. I was on Wellbutrin for years and just didn't want to put that junk in my body any more. I can't believe how amazing this stuff is. My eating has gotten better. I am think but have suffered from eating disorders for years, not extreme but I am just feeling so much more "light" and balanced. My question for you is: how long can I take 5-HTP before a) it becomes bad for me or b) I become used to it. I can't imagine not being able to use this now. The Wellbutrin was the only chemical anti depressant that didn't make me feel like I wasn't even me and also gain weight but it did make me rather snippy and aggressive which I got tired of (not to mention those around me).
   A. The website mentions all of our knowledge with 5-HTP and the potential cautions and side effects. Each person is unique on the amount that helps them and the potential problems with long term use.

Q. Enjoyed your site, very informative. Can you at least tell me where I can find info on any possible interactions between 5HTP and Wellbutrin. Since I have started taking Wellbutrin in the morning I stopped my 5-HTP at night. Have not had a good nights sleep in weeks but am afraid to combine the two. I would love to ask my Dr. but he has no idea what 5-HTP even is. So I'm on my own. Could you at least refer me to someone who can help and knows about Wellbutrin and 5HTP information. I even contacted Glaxo Smith Kline and they were no help.
     A. Wellbutrin mostly influences dopamine levels while 5-HTP influences serotonin levels. It is difficult to predict the reaction of taking Wellbutrin and 5-HTP the same day. Sometimes lowering the dose of the medication improves sleep patterns.

Q. I just purchased a 5-htp supplement. I am currently taking 75 mg of Wellbutrin but have stopped Lexapro. i know there are no interactions between the two. just wondering how long i should wait since stopping Lexapro and starting 5-htp. also, should I start at lowest possible dose and titrate higher? i think I can open 50 mg capsule? pill? Can St. John's wort be added to the mix. I have heard it is a mild maoi and maois don't mix with Wellbutrin, however, i have read it is not a big deal.
   A. 5HTP, SAM-e, St. John's wort, and other natural supplements used for depression should be used as cautiously as a prescription medication. If your doctor approves you can begin with a portion of a capsule. It is preferable to learn how each supplement and medication works by itself before combining. A few days off the Lexapro should be sufficient before beginning a supplement such as 5HTP that converts into serotonin.

Use with mucuna pruriens
Currently I take 450mg of Wellbutrin SR daily for depression its the only antidepressant thats ever worked for me. I want to try mucuna puriens for a couple of reasons: Id rather take a natural substance than a synthetic one, and Im wondering if mucuna can substitute to any degree for the prescription antidepressant. Id also like to take it for the sexual enhancement effects, given that Im almost 65. If it helps my eyesight, all the better. Does mucuna have enough dopamine and of the right kind (bioavailable) to mimic the effects of this antidepressant drug?
   This is very difficult to predict. If your doctor approves you could try a little less of the medication while starting a low dose of mucuna.

Questions
Q. I am currently reducing my Wellbutrin 300 mg which is way too much as it caused severe panic attacks and necessitated OTC sleeping pills every night. I want to eventually get off the Wellbutrin (which worked wonders at 200mg for bad post-partum depression but my son is almost 2 years old now and I think 300mg is too high) but my questions are this: a) I want to switch to sam-e and am wondering will Sam-e cause the same inability to sleep and panic attacks or is that be dose related in both? b) Should a person avoid light therapy when using either Wellbutrin or SAM-e or simply reduce dose when using?
   A. The side effects of SAM-e are dose related. Many people prefer to use 50 mg to 100 mg as opposed to the full 200 mg tablet. This may necessitate breaking the SAM-e tablet in half or less. Reducing dosage with light therapy works well for most people.

Q. Does Wellbutrin help libido?
   A. Wellbutrin could influence libido since it increases levels of dopamine which is one of the important neurotransmitters involved in libido enhancement.

Q. My husband takes Wellbutrin everyday. His Dr. said he should try Horny goat weed, which didn't work, so now we would like to try Passion Rx. Are there any herbs in Passion Rx shouldn't be taken with Wellbutrin?
   A. Many herbal sexual products don't work as well or have unpredictable effects when combined with antidepressants since antidepressant drugs alter brain chemistry. We don't suggest using Passion Rx the same day as an antidepressant.

Q. Can I take two Wellbutrin SR tablets (150mg each) at the same time of day? My doctor here in Hong Kong says yes I can, however the instructions for Wellbutrin say to take them one at a time with at least four hours between. I prefer to take them together in the morning, since I often forget to take the second one later. If I take the second one too late in the day, I have trouble sleeping. I'm an American living in Hong Kong, and they don't allow Wellbutrin XL (extended release) on the market. I used to take that and it was perfect, but now I don't have that option.
   A. Sorry but this is a treatment question your doctor would need to answer since he or she knows your condition best.

I have been reviewing the information you provide on 5 HTP and its benefits / side effects. I suffered from severe postpartum depression after the birth of my first child in 1992. After 10 months of not realizing what was wrong with me I was diagnosed and prescribed Zoloft. I hated the void and numb like feeling or state it put me in but with the combination of the drug (for 6 months) and therapy, I was able to get my life back to normal. Since then I have gone through occasional bouts of mild depression but I am usually able to work through them with regular exercise and nutrition. Last year, the bout that came on was more severe and I was prescribed Wellbutrin (300 mg). I don't feel void or numb on the Wellbutrin but I don't feel great or better which troubles me because I have so much to feel happy
about - great life, fantastic husband, four amazing children! I have been doing the research on 5 HTP and can't get much advice from my practitioner. I was curious if I can take the low dosage of 5 HTP combined with the Wellbutrin or if I should switch to see if there is benefit solely from the 5 HTP or as a result of the combination.
Is it safe to take this antidepressant medication and 5 HTP?
    It is not easy to give such answers since different users respond differently. As a general rule it is best to learn how each supplement or medication works by itself.

I have had chronic issues with depression my whole life and possibly ADD (w/o hyperactivity) plus other labels to many to list. When I was put on Wellbutrin to treat possible ADD I found rather than getting agitated (as was the norm I was told) it tended to make me sleepy and could take it at bedtime. Later on I took Adderall for a brief period of time. A couple of years ago I had to stop taking Wellbutrin because my tinnitus had gotten worse and this drug seemed to really aggravate it.