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Dec 19, 2022

Blood Pressure

Antidepressant

6 Interesting Facts About Bupropion

1. Bupropion has Two FDA-Approved Indications

Bupropion is an interesting medication, as it has two very different medical indications. It is most well-known for its role as an antidepressant, but the two indications for bupropion are:

  • Major depressive disorder (MDD) (under the brand name Wellbutrin)
  • Smoking cessation (under the brand name Zyban)

While both Wellbutrin and Zyban have the same active ingredient, bupropion, they are approved for different uses. The main difference in management of these two conditions with bupropion is the dosages. It is also important to note that you cannot take both Zyban and Wellbutrin at the same time, because the additive doses of bupropion will exceed the safe concentration.

2. Bupropion works by Increasing Dopamine and Norepinephrine

Bupropion is known to weakly inhibit the reuptake of norepinephrine and dopamine. However, the mechanism of exactly how bupropion does this is not fully established. It’s clear that it does not inhibit the reuptake of serotonin like most antidepressants and also does not inhibit monoamine oxidase, like monoamine oxidase inhibitors (MAOIs).

Dopamine is often called the “reward” chemical, and therefore an increase in dopamine allows you to feel more pleasure and gives you motivation to seek out activities that give you that pleasure. Norepinephrine is an excitation chemical, and therefore an increase in norepinephrine allows you to feel more motivated and alert.

In terms of improving MDD symptoms, the increase in dopamine and norepinephrine both work to improve your attentiveness and drive to go about your daily tasks and seek out activities that typically bring you joy. The increased feelings of reward you get from dopamine then allow you to continue feeling good about completing tasks and get you back into a habit of normal, content, daily living.

The mechanism of action for smoking cessation is the same as with MDD but is more focused on the reward system. The increased dopamine is thought to lessen the reward signal that usually comes from smoking a cigarette, therefore reducing your drive to continue smoking.

3. There are 6 Common Side Effects of Bupropion

The side effects of bupropion are slightly different than many other antidepressants. For example, bupropion does not cause the same sexual dysfunction that many antidepressants do. That is thought to be because many antidepressants work to increase serotonin signalling, while bupropion does not.

Most side effects of bupropion improve or resolve within the first few weeks, while your body adjusts to the new medication. Because of this, it is important to stay on the medication for at least 2 weeks (or however long your healthcare provider has specified) before determining if the side effects are bothersome enough to warrant stopping the medication.

Learn about the changes that occur during the first few weeks on antidepressants.

The most common side effects of bupropion include:

  • Agitation
  • Dry mouth
  • Difficulty sleeping
  • Headache/migraine
  • Nausea/vomiting
  • *Increased thoughts of hurting yourself or of suicide

*If you have any thoughts of hurting yourself or suicide, seek medical attention immediately as it is a medical emergency.

4. Bupropion Should Not Be Taken by Certain Populations

There are certain populations in which taking bupropion could do more harm than good. Much of this comes from the slightly increased possibility for you to experience a seizure while taking this medication. Therefore, any population that already has an increased risk of seizures should avoid bupropion to avoid increasing this risk. The main medical conditions that come with any increased risk of adverse events while taking bupropion include:

  • Seizure disorders
    • Bupropion lowers the threshold for seizures to occur, so it should therefore not be used in individuals that are likely to experience seizures
  • Current or prior diagnosis of bulimia nervosa or anorexia nervosa
    • Those with a current or past history of anorexia nervosa or bulimia nervosa have a greater likelihood of experiencing seizures and therefore the additionally lowered threshold with bupropion use can lead to seizures.
  • Those undergoing recent abrupt discontinuation of alcohol and/or benzodiazepines
    • Taking bupropion while abruptly discontinuing alcohol or benzodiazepine use can lead to seizures.
  • Liver or kidney impairment
    • Dosage of bupropion may be adjusted in those with kidney or liver impairment.
  • Pregnancy or breastfeeding
    • Bupropion crosses from the bloodstream of a pregnant individual to the fetal bloodstream. It is potentially unlikely that bupropion poses a risk to the fetus, but because there have not been adequate studies in humans, it is advised to avoid bupropion if possible while pregnant. Bupropion also crosses into the breastmilk, and therefore to the infant. As the risk to the baby is not well known, it’s generally recommended to avoid bupropion while breastfeeding.

5. There are Several Drug Interactions with Bupropion

The way that bupropion works in your body allows for there to be many medications that interact with it, as they compete for certain bodily processes and pathways. This then leads to a potential for something to go wrong when there isn’t enough “room” for both medications. Some of these interactions are minor and just call for extra monitoring, while others have potential to be life threatening and therefore must be strictly avoided in combination. Some of the more serious drug interactions with bupropion include:

  • MAOIs
    • The combination of MOAIs and bupropion can lead to very serious adverse effects, including the potential for sudden death.
  • Levodopa and amantadine
  • Medications that lower the threshold for seizures (antipsychotics, antidepressants, etc)
  • Any other medication containing bupropion
  • Alcohol
  • Pimozide
  • Thioridazine

It is very important to ensure your healthcare provider is aware of all medication, prescription and over the counter, that you are taking so you have the best possible medication safety.

6. You Can Buy Bupropion for Less When You Buy In Longer Supply

At Marley Drug, bupropion is part of our wholesale medication list. This means that you can get a longer supply of the medication for less. A 6-month supply of bupropion would cost you $37, while a full 12-month supply costs only $70.

We are able to price our medications so low because we cut out the insurance “middle-men”. Typically, insurance companies work with medication wholesalers to negotiate and increase the prices of medications with their service fees. Many pharmacies then buy their medications from these insurance companies, which leads to an increased cost of medications for the consumer.

If you would like to learn more about how you can get your bupropion prescription from Marley Drug, call us at 800-810-7790.

Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of August 24, 2022.

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