[Paracelsus]

Taking medications at the right time of day is imperative to achieve correct therapeutic levels in plasma concentration. Wellbutrin or bupropion, a dopamine reuptake inhibitor, can provide great relief to those suffering from depression when one to two trials of conventional serotonergic antidepressants fail to adequately address underlying symptoms. wellbutrin is especially useful in depressed patients who smoke have co-occurring ADD and ADHD. It may also be used as an adjunct with other antidepressants to combat unwanted sexual side effects.

since wellbutrin comes in immediate release, sustained release (SR) and extended release (XL). Often times even pharmacy techs or even pharmacists may mistakenly think your referring to SR or XL if your talking about immediate release. So, be sure to specifically state immediate release if you are taking that one to avoid confusion. It is this reason I have decided to write what I know on the topic of wellbutrin dosing for the patients' perspective. You know your body more than your psychiatrist or nurse practitioner. It is imperative that you pay attention to side effects especially during a dose change. Often times providers rely on the patient to report how the medication is working or not working and whether there are side effects.

The most common side effect that leads to discontinuation of wellbutrin is a general anxious state. Depending on your provider they may add an anxiolitic such as the benzodiazapine class of drugs (Klonopin, Ativan, Xanax, Valium, etc.) the second most common side effect that leads to discontinuation is insomnia.

correct dosing is imperative because of the associated with a dose dependent seizure risk with wellbutriin. always check for drug interactions yourself and ask a pharmacist if still unsure. Wellbutrin can be a great antidepressant for some if you find the correct dose.

typically mono-therapy using immediate release is started at 75mg - 100mg every 12 hours. after 4 days 100 mg can be given every 8 hours. maximum dose for immediate release is 150 mg every 8 hours. with SR wellbutrin is initially given at 150 mg once a day than after three days may be given 2x a day. the dose may be raised to 200 mg 2x daily after 4 weeks.

wellbutrin xr is initiated at 150 mg once daily and after 3 days can be raised to 300 mg. 450 mg once daily after 4 weeks may be considered.

within these dose ranges wellbutrin is cardiovascular safe and seizure risk is minimal, but it's good to be aware of it. two additional cautions about seizure risk. people taking 450 mg XL 1x daily, 200 mg SR 2x daily and immediate release given at 100 mg 3x daily while taking benzodiazapines and or serotonergic antidepressants should be extra cautious. Avoid alcohol and take the benzodiazapines directly as prescribed. Typically if your taking a benzo for mono-therapy you can safely cut your dose in half, but not while your on wellbutrin. rapid discontinuation of benzos increase siezure threshold and so do certain antidepressants.

do not take more wellbutrin than prescribed. it is a chemical that has been studied and approved at a certain dose range. any medicine, if given in large amounts, becomes a poison. increasing wellbutrin dose above clinicians guidelines is stupid and dangerous. I repeat, don't do it.

it's important to be aware of your dose to tell new providers. PO simply means the medication is taken orally. so, if you take wellbutrin SR 100 mg 2x daily, you would write down or say:

wellbutrin IR PO q8hrs

another example, if your taking wellbutrin 100mg immediate release 1x a day you would write:

wellbutrin immediate release PO qDay

the q stands for quaque octa hora, a latin term meaning ", and rushes on the eighth hour that." it's just one of the fancy ways pharmacists and providers write it out.

HERE'S A FUN TRIVIA QUESTION FOR YOU ALL

if a patient is regularly taking wellbutrin instant release 100 mg once a day and after 8 hours takes an additional 50 mg of instant release wellbutrin, is this dose equivalent to wellbutrin XL 150 mg PO qDay? What about wellbutrin SR qDay? Why or why not.

As a final note. It is always wise to be aware of what your putting into your body and knowing that you are in charge of your health decisions. Your provider can't force you to take anything you don't want to. Do not use alcohol or recreational drugs while on antidepressants.