Wellbutrin XL, SR Medication

Wellbutrin XL (extended-release) is used to relieve mental depression. This medication effectively treats depression with a low risk of sexual side effects and a low risk of weight gain.

This antidepressant is often prescribed for depression when selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) are not able to be used or are not effective.

Dosing: The starting dose is 150 mg per day, which your doctor may increase to the usual adult dose of 300 mg per day. The maximum dosage for this drug is 450 mg per day. Always make sure that you take Wellbutrin XL as prescribed by your doctor.

Although not an approved indication, the combination of bupropion and either an SSRI or an SNRI is generally well tolerated and can boost antidepressant response. Augmenting antidepressants with bupropion has become a common strategy in the treatment of resistant depression. The results of clinical study have shown that Wellbutrin SR added to the SSRI or venlafaxine (Effexor) in patients failed to response to an SSRI or venlafaxine can increase the number of responders [5].

The drug appears to significantly affect dopaminergic neurotransmission and may help with fatigue and sexual dysfunction induced by SSRIs of SNRIs (Effexor). A study by Papakostas and associates examined the impact of bupropion vs SSRIs on sleepiness and fatigue in patients with deprssion. The investigators pooled data from 6 double-blind, randomized clinical trials and found greater improvements in fatigue scores among both bupropion-treated and SSRI-treated groups than placebo-treated patients, and greater improvements in fatigue scores among bupropion-treated than SSRI-treated patients [6].

Wellbutrin may reverse SSRI-induced sexual dysfunction due to its dopaminergic effect. In addition to the SSRI produces produces an increase in desire to engage in sexual activity and frequency of engaging in sexual activity [7].

• Metabolism: Extensively metabolized by hydroxylation or oxidation in the liver. CYP2B6 is involved in formation of hydroxybupropion (50% as potent as bupropion). The other 2 main metabolites are threohydrobupropion and erythrohydrobupropion, which are 20% as potent as bupropion.
• Elimination half-life: about 21 hr (bupropion), about 20 hr (hydroxybupropion), about 37 hr (threohydrobupropion), and about 33 hr (erythrohydrobupropion).
• Excretion: 87% excreted in urine, 10% in feces, and 0.5% as unchanged drug;

• once a day dosage regimen
• low risk of sexual dysfunction [2]: does not lower libido, produce impotence or impair orgasms
• low risk of weight gain
• decreased appetite and weight loss (however, may be a harmful effect for anorectic persons)
• low potential for triggering mania in the bipolar disorder

• frequently cause agitation, anxiety, and insomnia (treatment with a sedative/hypnotic agent or discontinuation of therapy may be required; gradual escalation of dose may minimize symptoms)
• risk of seizures
• risk of hypertension
• high potential for drug interactions

Wellbutrin XL contains the same active ingredient as Wellbutrin SR (bupropion sr), but XL is formulated in an extended-release, once-daily tablet. This means that with XL formulation, you can take one tablet in the morning, continue with your daily activities, and not worry about remembering to take a second dose.

• attention-deficit/hyperactivity disorder (ADHD)
• depression associated with bipolar disorder
• neuropathic pain
• enhancement of weight loss
• augmenting a partial response to SSRIs

The mechanism of bupropion's activity is not fully understood. It is a relatively weak inhibitor of the neuronal uptake of norepinephrine and dopamine, and does not inhibit monoamine oxidase or the reuptake of serotonin. Metabolite inhibits the reuptake of norepinephrine. The primary mechanism of action is thought to be dopaminergic and/or noradrenergic.

• Wellbutrin Reviews, Ratings, Comments by Patients on DrugLib.com
• Psych Central Reviews - Recommended by 74% of reviewers
• Wellbutrin user reviews on DailyStrength, for the treatment of depression - 66% success rate; for the treatment of bipolar disorder - 63% success rate; as smoking cessation - 52% success rate.
• User Reviews on Drugs.com
• Need Wellbutrin good experiences! on Drugs.com

• 1. U.S. Food and Drug Administration. Wellbutrin XL U.S. Prescribing Information. Available at (PDF format): Prescribing Information
• 2. Coleman CC, King BR, Bolden-Watson C, Book MJ, Segraves RT, Richard N, Ascher J, Batey S, Jamerson B, Metz A A placebo-controlled comparison of the effects on sexual functioning of bupropion sustained release and fluoxetine. Clin Ther. 2001 Jul;23(7):1040-58. PubMed