bupropion

Adjunctive therapy

Brands: WELLBUTRIN

Last reviewed 2026-02-12

Reviewed by PsychMed Editorial Team.

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Quick answers

What is bupropion?
Bupropion is an atypical antidepressant (NDRI) used for major depressive disorder, bipolar depression augmentation, and smoking cessation, valued for weight neutrality and low sexual side effects.
What is WELLBUTRIN?
WELLBUTRIN is a brand name for bupropion.
What is WELLBUTRIN (bupropion) used for?
Label indications include: MDD; seasonal affective disorder; smoking cessation (SR).
What drug class is WELLBUTRIN (bupropion)?
Norepinephrine–dopamine reuptake inhibitor (NDRI).
What strengths does WELLBUTRIN (bupropion) come in?
SR tablets 100–200 mg (BID) and XL tablets 150–450 mg (QD).

Snapshot

Class: Adjunctive therapy
Common US brands: WELLBUTRIN
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-12

Label indications

MDD; seasonal affective disorder; smoking cessation (SR).

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Clinical Highlights

Bupropion is an atypical antidepressant (NDRI) used for major depressive disorder, bipolar depression augmentation, and smoking cessation, valued for weight neutrality and low sexual side effects. Activating profile useful for patients with fatigue and weight gain; contraindicated in seizure disorders and in current/prior eating disorders (e.g., bulimia or anorexia nervosa).

Because bupropion is not serotonergic, sexual dysfunction and emotional blunting are typically less prominent than with SSRIs/SNRIs; however, anxiety, jitteriness, and insomnia can be more noticeable during early titration.
The compare tool can help contrast activation, weight change, and sexual side-effect profiles against common alternatives; the bupropion evidence feed collects key sources for augmentation and cessation decisions.
The bipolar disorder hub can help coordinate mood-stabiliser coverage when treating bipolar depression, and the bupropion print page provides counselling materials.
Major depressive disorder (FDA 1985)
Smoking cessation (SR) (FDA 1997)
Generic: All formulations available generically.

Dosing & Formulations

SR tablets 100–200 mg (BID) and XL tablets 150–450 mg (QD). XL: start 150 mg qAM for 3–7 days, increase to 300 mg qAM; may increase to 450 mg qAM if needed.

SR: 150 mg qAM ×3 days then 150 mg BID (≥8 h apart).
SR/XL tablets should not be crushed, split, or chewed; dose dumping can increase adverse effects and seizure risk.

Monitoring & Risks

Boxed warning: Antidepressants increase risk of suicidality in young adults; monitor during initiation. Insomnia: Morning dosing can help reduce.

Dry mouth: Hydration counsel helpful.
Headache: Often transient.
Nausea: Often improves with food.
Hypertension can occur, particularly when combined with nicotine replacement; blood pressure monitoring is especially important during titration and when nicotine replacement is used.
Seizure risk (0.1% ≤450 mg/day); contraindicated in seizure/eating disorders or abrupt sedative withdrawal.
Mania/hypomania: mood stabiliser coverage and monitoring plans are typically addressed when treating bipolar depression; see the bipolar disorder hub.

Drug Interactions

CYP2B6 inhibitors (clopidogrel, ticlopidine) raise levels; CYP2B6 inducers (carbamazepine, ritonavir) lower levels. As a strong CYP2D6 inhibitor, bupropion can increase concentrations of coadministered CYP2D6 substrates (antidepressants, antipsychotics).

Contraindicated with MAO inhibitors; a 14-day washout is used to reduce hypertensive crisis.

Practice Notes

Combination with SSRIs for augmentation is sometimes used; anxiety and insomnia are common early tolerability issues to watch. Augmentation is sometimes used to target residual fatigue or SSRI/SNRI sexual side effects; anxiety/insomnia and blood pressure monitoring are often emphasized as dose increases, and seizure risk factors are revisited at follow-up visits.

Alcohol moderation can reduce seizure risk.
If used for smoking cessation, pair medication with behavioral support; blood pressure monitoring is especially important when nicotine replacement is co-prescribed.
Weight and blood pressure monitoring, and attention to emerging mania/hypomania, support safer use; printable materials from the bupropion print page can reinforce key points between visits.

References

WELLBUTRIN XL (bupropion hydrochloride) prescribing information — DailyMed (2026)
Clinical efficacy of bupropion in the management of smoking cessation — Drugs (2002)
Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL — Biological Psychiatry (2005)
APA Clinical Practice Guideline for the Treatment of Depression — American Psychiatric Association (2023)Guidelinedepressionclinical
Comparative efficacy and acceptability of 21 antidepressant drugs for major depressive disorder — The Lancet (2018)Meta-analysisdepressionefficacy