Bupropion XL: Dual-Action Relief for Depression

For major depressive disorder, the FDA-approved dosing schedule for bupropion XL is:

• Starting dose: 150 mg once daily in the morning
• Usual recommended dose: May increase to 300 mg once daily after at least four days. Your healthcare provider may adjust the dose further based on how you respond, up to a maximum of 450 mg per day.

It’s important to take bupropion consistently and at the same time each day. Avoid taking it too close to bedtime, as it may cause insomnia in some people.

For seasonal affective disorder, bupropion typically starts in the fall before symptoms appear. The FDA-approved dosing schedule is:

• Starting dose: 150 mg once daily in the morning for the first 7 days
• Maintenance dose: Increase to 300 mg once daily after the first week

It’s important to take bupropion consistently and at the same time each day. Avoid taking it too close to bedtime, as it may cause insomnia in some people.

A small number of people have noted mood changes and reduced tolerance for alcohol while taking bupropion XL. To play it safe, it’s best to limit or avoid alcohol while you’re on this medication.

Before you start bupropion, share every prescription you are taking with your doctor. Bupropion can interact with:

• CYP2B6 inhibitors (ticlopidine and clopidogrel): These can raise your bupropion levels. Your doctor may adjust your dosage if you are taking these medications.
• CYP2B6 inducers (ritonavir, lopinavir, efavirenz): These may reduce how much bupropion gets into your system. Your doctor may adjust your dosage if you are taking these medications.
• Drugs metabolized by CYP2D6 (e.g., venlafaxine, paroxetine, fluoxetine, sertraline, metoprolol): Because bupropion inhibits CYP2D6, levels of these medications can rise. Your provider may decrease their dosages accordingly.
• Medications that lower the seizure threshold: Combining them with bupropion XL can increase seizure risk. In this case, bupropion treatment typically starts at a lower dose with gradual increases under close supervision.
• Dopaminergic drugs (levodopa and amantadine): Taking these medications with bupropion can cause central nervous system (CNS) toxicity, which can lead to restlessness, agitation, muscle tremors, loss of body control, vertigo, and dizziness.
• MAO inhibitors: Coadministration is contraindicated. You must wait at least 14 days after stopping an MAOI before starting bupropion XL.

Yes, as long as you choose a reputable online service that meets strict safety standards. Look for LegitScript verification, which means the company has passed rigorous quality and safety checks. ScriptsMD is LegitScript-approved, so you can trust that your bupropion XL is authentic and dispensed safely.

Studies of women who took bupropion in their first trimester haven’t shown an increased risk of birth defects overall. Bupropion does pass into breast milk at low levels, and there have been a few reports of seizures in breastfed babies. However, it’s not clear if bupropion was the cause.

If you’re pregnant or planning to breastfeed, discuss the potential benefits and risks with your healthcare provider.

In a short-term study of people taking bupropion 300 mg once daily, 3% gained more than 5 pounds, while 14% lost over 5 pounds. If you see any significant weight changes, be sure to discuss them with your doctor.