Bupropion

A good friend of mine is on this drug

Description

WELLBUTRIN SR (bupropion hydrochloride), an antidepressant of the aminoketone class, is chemically unrelated to tricyclic, tetracyclic, selective serotonin re-uptake inhibitor, or other known antidepressant agents. Its structure closely resembles that of diethylpropion; it is related to phenylethylamines.

It is (±)-1-(3-chlorophenyl)-2-((1,1-dimethylethyl)amino)-1-propanone hydrochloride. The molecular weight is 276.2. The molecular formula is C13H18ClNOoHCl. Bupropion hydrochloride powder is white, crystalline, and highly soluble in water. It has a bitter taste and produces the sensation of local anesthesia on the oral mucosa.

WELLBUTRIN SR Tablets are supplied for oral administration as 100-mg (blue) and 150-mg (purple), film-coated, sustained-release tablets. Each tablet contains the labeled amount of bupropion hydrochloride and the inactive ingredients: carnauba wax, cysteine hydrochloride, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, and titanium dioxide and is printed with edible black ink. In addition, the 100-mg tablet contains FD& C Blue No. 1 Lake and polysorbate 80, and the 150-mg tablet contains FD&C Blue No. 2 Lake, FD& C Red No. 40 Lake, and polysorbate 80.

Wellbutrin is not, as some commonly think, an SSRI (Selective Serotonin Reuptake Inhibitor, like Prozac), nor is it an MAOI. GlaxoSmithKline's info on the drug(1) mentions that, while Wellbutrin does slightly affect serotonin reuptake, its effects probably derive from its effects on dopamine reuptake.

An interesting note: Wellbutrin was briefly pulled from the market due to a study that indicated it may cause more seizures than SSRI's (on the order of 4 per 1000 patients, as opposed to 2). This result has been called into question, and in any case the seizures mostly occurred among patients who were already seizure-prone. Still, the risk appears on the warning label.

A word about interactions with psychotropic drugs: It's well-known that Wellbutrin doesn't always play well with other antidepressants, and that it may reduce tolerance to alcohol, but risks with respect to other psychotropic drugs are not well documented. GlaxoSmithKline's documentation, as well as some evidence floating around the 'net(2), suggests a few rough guidelines. NOTE! If you are doing to do recreational drugs, read up extensively. Information herein may be inaccurate, and it's certainly incomplete. IANA MD.

• Wellbutrin has been linked to seizures in a small portion of patients. Of course, you probably shouldn't take it if you're seizure prone. Cocaine, other stimulants, and depressants (including alcohol, opiates, etc.) appear to increase the risk. Heavy usage of any of the previous indicates you may need rehab, not antidepressants.
• Don't go through alcohol withdrawal while on Wellbutrin. (Hangovers aren't withdrawal, I'm talking delirium tremens.) Again, seizures.
• A number of folks have reported that Wellbutrin, as well as SSRIs, decrease the effectiveness of Ecstacy. This does NOT mean that you should take more; bear in mind that Ecstacy often has chemicals other than MDMA in it, many of which might cause trouble in large doses (or at all). Let the buyer beware. (Also note: It sucks to come down from MDMA if you're depressed.)
• While I haven't heard of many negative reports regarding LSD and Wellbutrin, many claim the latter inhibits the former somewhat. Again, don't run and take 3x the normal dose, lest you act like a moron for a week straight. If you happen to also be using lithium or another tricyclic, do not take LSD.
• Marijuana (and, presumably, hashish) does not appear to cause problems. You may, however, wish to be cautious with dosages.

The moral of the story: Don't do all the crap you usually shouldn't do, like coke or oxycontin or entire bottles of Jack Daniels.

Bupronin was released as a smoking-cessation aide under the name Zyban thanks to Wellbutrin's mostly unfounded reputation as seizure-inducing. GlaxoWellcome panicked somewhat after inconclusive studies claimed that Wellbutrin caused more seizures than other antidepressants; as it turns out, the seizures occurred among .4% of patients, most of them already seizure-prone. But the reputation stuck with many physicians, so Glaxo "re-branded" bupronin.

Many HMO's, including BlueCross BlueShield, do cover Zyban and other drugs to combat nicotine addiction. This makes sense financially, since non-smoking customers tend to have lower rates of costly diseases like lung cancer.

Trouble is, some of those companies only cover Zyban for a few months, as there's little point to suppressing nicotine cravings when one hasn't smoked in months. Wellbutrin, on the other hand, is often covered indefinitely, as bouts of depression can last a great while.

Zyban is supposed to take 2 weeks to "kick in"; during that period, you may wish to use some type of nicotine (the patch, the gum, the inhaler, or the new smokable nicotine sticks) to stave off cravings. I've been on Zyban (actually, Wellbutrin -- screw you, HMO) for 2 weeks and have had a very easy time not smoking--in fact, I ditched the patch the other day--but this may be the placebo effect. YMMV. Just take it on a full stomach, because even placebos can upset your tummy.

Oh, and if you plan on using non-medicinal (read: illegal) psychotropic drugs, please read whatever else you can find, as there exist some bad combinations.

Bupropion Hydrochloride is the generic name for a drug that is also known as Amfebutamone, Wellbutrin or Zyban.

It is usually used to treat depression, but it is also used to treat ADHD (Attention Deficit Hyperactivity Disorder), manic depression, chronic fatigue syndrome, and as a smoking cessation tool (when it's called Zyban).

Bupropion is a monocyclic aminoketone. This is one of the things that distiguishes it from other antidepressants, whose usual classifications are Tricyclic, SSRI (Selective Serotonin Reuptake Inhibitor), or MAOI (Monoamine Oxidase Inhibitor). It works by increasing the levels of norepinephrine and dopamine in the brain.

Many people taking bupropion notice a change in appetite. 28% of the people taking the drug will lose 5 pounds or more.

One of its effects is the lowering of the seizure threshold, so in combination with other drugs (alcohol, speed, certain antidepressants) that have the same effect, it can induce seizures. It does in about 0.04% of people taking it. That number seems small, but one of those people could be you. Please don't mix. It's dangerous.

Other common side effects are agitation, constipation, diarrhea, dizziness, dry mouth, headache, increased perspiration, insomnia, nausea, or vomiting. But at least you won't be depressed! (Ha ha, little joke. You are not likely to get more than two or three of these, and the duration is short, however long it takes your body to adjust to the drug.)

Contraindications for bupropion include epilepsy, heart/liver/kidney problems, alcoholism, a history of anorexia/bulimia, pregnancy.

Also, it is never prescribed to anyone under the age of 18—it has the slight side effect of encouraging adolescents to commit suicide. Uh oh, spaghetti-o's! For a few years in the late 1990s, it was also deemed to be responsible for the suicides of a number of bulimic women, so it is typically not prescribed to people with bulimia anymore.

Fainting, seizures and skin rash indicate a very bad reaction to the drug. Go to your doctor immediately.

It makes your coffee taste bad. How? By blocking the pleasure pathways in your brain. You will not get the same enjoyment out of cigarettes, coffee and chocolate that you used to.

Doctors prescribe Zyban to people who are having trouble quitting smoking. Apparently, it helps reduce the cravings, irratibility, and sluggishness that often afflict people trying to quit. Intriguingly, Zyban is chemically identical to Wellbutrin, a common antidepressant drug; they're both bupropion hydrochloride. Buproprion is actually an atypical antidepressant; instead of acting on serotonin and norepinephrine, it blocks the reuptake of dopamine.

Why market the same drug under two different names? Pure psychology, I think. If you asked your doctor to help you stop smoking, and he prescribed you an antidepressant, you might think he was implying that you were mentally ill. Given the stigma associated with psychiatric illness and psychiatric medicine, you might be less likely to take the drug. You might even say, "Geez, what the hell is this quack doing? I'm not depressed; I'm trying to stop smoking!" This way, if you check up on your doctor, you'll see he's prescribed you an antismoking drug, and all will be well.

Now, I'm not saying that you shouldn't take Zyban--it seems to work, which is what's important. I'm just saying that the placebo effect rocks.

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Interesting point by whizkid...I hadn't thought of that possibility but it seems quite plausible (heck, my own insurance company covers antidepressants but not antismoking drugs). One problem, though: Wellbutrin (the antidepressant that most health insurance plans cover) was introduced before Zyban (the antismoking drug that most plans won't cover). Why then create Zyban at all, given that it would be less lucrative? (I'm not aware of any insurance programs that cover smoking-cessation drugs but not antidepressants). I suppose it's possible that some insurance companies might get upset that you're using a drug for something other than its express purpose, but off-label prescriptions are relatively common and it's possible to get an existing drug approved for a second purpose.

The reason for marketing the same drug under two different names may actually have nothing to do with psychology.

Many insurance companies do not cover prescription drugs to aid one in quitting smoking (which is silly considering that quitting improves your health and reduces their costs) but they do cover prescription drugs used against depression.

Using two different names for the same drug allows the insurance company to determine whether to pay for the prescription or not.

For that reason some smokers ask their doctor to prescribe Wellbutrin instead of Zyban. Of course, technically, they are committing insurance fraud.