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Buproprion is a unique antidepressant which is often chosen
when side effects need to be avoided.
Buproprion does not cause weight gain,
drowsiness, or sexual side effects.
It works as well for depression as other antidepressants and, like
the others, takes 3-6 weeks to work (although some people respond
earlier).
It
does not change who you are, although it may allow you freedom to develop
in ways that depression had prevented.
Some people say that they feel more like their usual self, or are better
able to deal with stress, after taking it.
Buproprion seems to help concentration and energy, and has been
effective in attention-deficit disorder (ADD), though not as effective as
stimulant medication. Buproprion is often used to
treat bipolar depression, since it may cause fewer problems in bipolar
disorder than other antidepressants. It is sometimes added to other
antidepressants to help restore sex drive. Many people take buproprion, under the brand name Zyban,
to help stop smoking.
Unlike many other
antidepressants, buproprion is not very effective
for anxiety disorders (including panic attacks and obsessive-compulsive
disorder). Anxiety, in fact, can be a side effect of buproprion.
How does it work?
Buproprion is the only antidepressant which works by enhancing
both dopamine and norepinephrine in the brain.
These chemicals are involved in motivation, mood, energy and concentration.
What types are available and how is it taken?
Buproprion is now available in a once a day form (150mg or
300mg XL). This capsule should not be crushed or chewed, as that can break
the extended-release coating. It is
best to take it in the morning to prevent the side effect of insomnia.
Taking it with food may help reduce stomach discomfort.
It is important not to double-up
on your doses, since taking too much can cause seizures. If you miss a
dose, ask yourself if you are closer to the dose you missed or to your next
dose. If you are closer to your next
dose, just wait and take it then, otherwise it’s ok to take the dose
you missed.
Buproprion is also available as a twice a day (SR form) and a
three times a day medicine. These
forms are available as generics, but the once-a-day (XL) form is
brand-name.
How long do I
need to take it?
There
are two reasons to take buproprion: to treat current symptoms and to
prevent the return of symptoms.
These two reasons will be different in each condition, and in many
cases the decision to continue or stop it will be a personal one.
What side effects can I expect?
Most people who take buproprion have no side effects. However, a few people
feel uncomfortably activated soon after starting it. This feeling can
include anxiety, insomnia, headache, stomach discomfort, tremor and
agitation. Although not dangerous,
it usually makes people stop the medicine.
Buproprion can lower appetite and increase
energy. Generally, there are no
serious side effects, although it can increase the risk of seizures in
higher doses and, rarely, can raise blood pressure.
It is important to let me know
if you habits of binging and purging (i.e. vomiting) food, since this can
increase the risk of seizures with buproprion.
Can it cause
harm? Should children take it?
Buproprion may worsen certain psychiatric conditions,
such as bipolar disorders (“manic-depression”). If you notice
these signs while taking them, call me:
•
Feeling “high”, speeded up, giddy or “too happy”;
decreased need for sleep, paranoid feelings, hyperactivity, racing
thoughts, high anxiety or irritability, talking fast.
There is currently controversy about whether children
and teenagers should take antidepressants due to concern about suicide on
them. Click here to learn more.
Precautions
Pregnancy and Breast-feeding:
Buproprion passes into breast milk. It has
not been studied in pregnancy.
Although no problems have been reported with it, it is probably best
to plan pregnancy and breast feeding so as to avoid any exposure to
medication.
Children: There are a few studies in
children ages 6-16.
Older adults: Buproprion appears to pose no special risks to older
adults.
Medical conditions which require caution
with buproprion:
- Liver
or kidney disease
- Epilepsy,
seizures, or serious neurologic illness
Drug Interactions
Buproprion may
increase levels of:
Atomoxetine (Strattera), fluvoxamine (Luvox), paroxetine (Paxil), fluoxetine (Prozac), valproate
(Depakote), risperidone
(Risperdal), haloperidol (Haldol), perphenazine, thioridazine, tricyclinc antidepressants, warfarin
(Coumadin), meperidine,
metoprolol, propafenone,
flecainide.
Medicines
that can lower buproprion levels:
Tegretol (Carbamazepine), phenytoin (Dilantin), rifampin.
Medicines
that can increase buproprion levels:
Cimetidine, protease inhibitors.
Medicines
that should be avoided with buproprion:
MAOIs (phenelzine, nardil, parnate, tranylcypromine)
Storage
- Keep
out of the reach of children.
- Store
away from heat and direct light.
- Do
not store in the bathroom, near the kitchen sink, or in other damp
places. Heat or moisture may cause the medicine to break down.
- Do
not keep outdated medicine or medicine no longer needed. Be sure that
any discarded medicine is out of the reach of children.
Updated 6/1/4 by Chris Aiken,
M.D.
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