Bupropion (Wellbutrin SR® or Wellbutrin XL®) is sometimes referred to as a norepinephrine/dopamine reuptake inhibitor or NDRI. I do not favor this term because the mechanism of action of bupropion is actually not clear. Here is more information about this medication.
Buproprion Sustained-Release (Wellbutrin SR®)
FDA-approved indications
Major depressive disorder (MDD)
Dosage
Starting: 150 mg/day (single dose)
Target: 300 mg/day (150 mg twice daily)
Maximum: 400 mg/day (200 mg twice daily)
General Instructions: No single dose should exceed 200 mg
Dosage forms and strengths (USA)
Tablets: 100 mg, 150 mg, 200 mg.
Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Bupropion Extended-Release (Wellbutrin XL®)
FDA-approved indications
Major depressive disorder (MDD)
Prevention of seasonal affective disorder (SAD)
Dosage
Major Depressive Disorder
Starting: 150 mg/day (once daily)
Target: 300 mg/day (once daily)
Seasonal Affective Disorder
Starting: 150 mg/day (once daily)
Target: 300 mg/day (once daily)
General Instructions: Start medication in the autumn prior to the onset of symptoms and continue the treatment through the winter season
Dosage forms and strengths (USA)
Tablets: 150 mg, 300 mg
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Related Pages
Bupropion and seizures (part 1): what the clinician needs to know
Bupropion and seizures (part 2): What factors can increase risk of seizures with bupropion?
Bupropion (Wellbutrin XL®) versus the SSRIs
Bupropion Preparations (Wellbutrin XL® and others)
Key information about seizures with clozapine
Antidepressants: Pharmacological effect and Category names
References
Buproprion sustained-release (Wellbutrin SR®) Prescribing Information
Bupropion extended-release (Wellbutrin XL®) Prescribing Information
Hewett K, Chrzanowski W, Jokinen R, Felgentreff R, Shrivastava RK, Gee MD, Wightman DS, O’Leary MC, Millen LS, Leon MC, Briggs MA, Krishen A, Modell JG. Double-blind, placebo-controlled evaluation of extended-release bupropion in elderly patients with major depressive disorder. J Psychopharmacol. 2010 Apr;24(4):521-9. doi: 10.1177/0269881108100254. Epub 2009 Jan 22. PMID: 19164492.
Stahl SM, Pradko JF, Haight BR, Modell JG, Rockett CB, Learned-Coughlin S. A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. Prim Care Companion J Clin Psychiatry. 2004;6(4):159-166. doi: 10.4088/pcc.v06n0403. PMID: 15361919; PMCID: PMC514842.
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Hello,
I often see psychiatrists prescribing just am dosing of the SR formulation instead of bid and it still seems to help well – what are the pros/cons of this and would this affect consistency with blood levels – makes sense for off label ADHD but how does this still seem to work fine in depression?
Thanks,
KF
Thanks for your question.
1. Up to 200 mg of bupropion SR can be prescribed as a morning dose only. If the dose is more than that, it MUST be given in a twice-daily regimen.
2. Antidepressants, including bupropion, work based on their effects on the brain over several weeks and not based on their presence in the blood. That is why bupropion SR 200 mg given once in the morning is fine for the treatment of depression.
3. That said, I think it is probably better to use bupropion XL. Since it is now generic, I personally don’t usually prescribe bupropion SR.