Wellbutrin / Zyban for Bipolar (Bupropion)

by Sarah from Bipolar-Lives
(FL, US)

US BRAND NAME: Wellbutrin

GENERIC NAME: Bupropion

TYPE: Atypical antidepressant

USE: An antidepressant that is also effective in helping people quit smoking. Wellbutrin is not a "typical" antidepressant in that it primarily acts as a dopamine reuptake inhibitor. It also acts on norepinephrine.

COMMENTS: As an effective antidepressant it can be a good add-on to a mood stabilizer that has mainly anti-manic properties. Also, many of anti-manic drugs are anticonvulsants, reducing the risk of seizures, the most feared side effect of Wellbutrin. Some people prefer to an SSRI such as Prozac or Zoloft beause it does not cause weight gain or sexual dysfunction. I have used Wellbutrin and loved the improvement I experienced in mood, energy and motivation. It is my preferred antidepressant and always pulls me "out of the hole". As with the other antidepressants, there is debate about people with bipolar disorder using Wellbutrin in case it promotes a switch into mania. However, recent data has shown that the addition of newer antidepressants, including Wellbutrin, to a mood stabilizer does not cause the switch to mania more often than the addition of placebo. Moreover, when added to a mood stabilizer, Wellbutrin is less likely to induce mania than Effexor. The main risk wold be for people using ONLY Wellbutrin to treat their bipolar disorder, just as with with any other antidepressant such as Lexapro, etc.

EVIDENCE: Placebo-controlled double-blind clinical studies have confirmed Wellbutrin is an effective antidepressant, equivalent to Prozac, Paxil and Zoloft in antidepressant potency. A recent study showed Wellbutrin to be more effective than Effexor (venlafaxine).

SIDE EFFECTS: Include but not limited to: drowsiness, excitement, dry mouth, dizziness, headache, nausea, vomiting, uncontrollable shaking of a part of the body, weight loss, constipation, excessive sweating.

CAUTIONS: Some people are wary of Wellbutrin as it lowers the lowers seizure threshold, and has the potential to cause seizures, even in people who have no prior history of any. However, at the recommended dose the risk of seizures is actually no greater to that found for other antidepressants.