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The Drugs
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Bupropion
Brand Name: Wellbutrin

Overview
Wellbutrin is the brand name for Bupropion, a type of antidepressant (aminoketone class) that also acts as a stimulant. Wellbutrin raises the amounts of the neurotransmitters dopamine and norepinephrine in the brain to more normal levels.

Wellbutrin's effects can usually be felt in one to four weeks.

Why is this drug prescribed?
Wellbutrin is used to treat:

  1. Attention Deficit Hyperactivity Disorder (ADHD)
  2. Major depression
  3. Bipolar disorder (depressive phase)
  4. Chronic fatigue syndrome
  5. Cocaine craving
  6. Lower back pain
Bupropion is also used to help people stop smoking. When it is prescribed for this reason, it is marketed under the brand name Zyban, which contains a different dosage of Bupropion than drugs used to treat mental disorders, and is prescribed differently.

Warnings and Precautions
The safety and effects of Wellbutrin in children under 18 years old are not known.

Wellbutrin causes significant weight loss (more than 5 pounds) in 28% of people who take it. It should be not be used when such weight loss might be dangerous to the patient.

Wellbutrin may impair coordination or mental abilities: patients should not drive or operate heavy machinery until it is known that Wellbutrin does not affect the ability to safely engage in such activities.

For Pregnant or Nursing Mothers: Wellbutrin's effects during pregnancy are not well understood; Wellbutrin is not recommended for pregnant women. Wellbutrin does pass into breast milk and could cause a serious reaction in the infant; women should not breast-feed while taking this medication.

Contraindications
Bupropion should Not be used for people with the following medical conditions:

  1. a history of seizures (such as epilepsy) or of brain damage - Wellbutrin can lower the seizure threshold, especially with high doses
  2. a history of anorexia or bulimia - risk of seizures is increased in these individuals

Precautions
Wellbutrin may be used with caution in people with the following conditions:

  1. weight loss associated with depression - Wellbutrin often causes weight loss
  2. liver or kidney disease - dosage may need to be reduced
  3. patients over 60 - lower doses are used
  4. bipolar disorder - Wellbutrin may cause a rapid swing to the manic phase
  5. addicted to narcotics, cocaine, stimulants, or using over-the-counter stimulants or diet pills - risk of seizures is increased
  6. diabetes - risk of seizures is greater in individuals taking insulin or oral diabetes medication.

Adverse Reactions
Bupropion may cause the following reactions:

  1. weight loss
  2. decreased appetite
  3. restlessness
  4. agitation
  5. insomnia
  6. anxiety
  7. constipation
  8. dry mouth
  9. diarrhea
  10. dizziness
  11. nausea / vomiting
  12. headache
  13. increased libido
  14. skin problems
  15. tremors
  16. excessive sweating
  17. hypomania
  18. seizures
  19. ringing in the ears
  20. decreased white blood cell count

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Bupropion include:

  1. MAO Inhibitors (within 14 days) - can increase bupropion levels and lead to drug toxicity
  2. alcohol - risk of seizures may be increased
  3. marijuana - when used with Wellbutrin has been known to induce psychotic behavior
  4. major tranquilizers such as thorazine
  5. antidepressants or anti-psychotics such as Clozaril, Dilantan, Haldol, Maprotiline, Phenobarbital, Prozac, Tagamet, and Tegretol
  6. Tricyclic antidepressants (TCAs) - increases risk of seizures
  7. Carbamazepine - may increase the effects of Carbamazepine and increases risk of seizures
  8. Levodopa - may increase the effects of Levodopa, and increases the risk of seizures
  9. Cimetidine - may increase bupropion's effects
  10. Clozapine, Fluoxetine, Haloperidol, Lithium, Loxapine, Molindone, Thioxanthenes, and Trazodone - increase the risk of seizures 1
  11. All Phenothiazines - increases the risk of seizures
  12. Phenytoin - may increase the effects of Phenytoin, and increases the risk of seizures

Sources

http://www.health-center.com/db/PageReq?SessionID=2972&
TopicID=406&PageID=2152&Action=view

http://www.psyweb.com/Drughtm/buprop.html

http://www.mentalhealth.com/drug/

http://www.healthsquare.com/newrx/WEL1488.HTM

 
   
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