Bupropion SR (sustained-release) is a prescription antidepressant medication belonging to the class of norepinephrine-dopamine reuptake inhibitors (NDRIs). It is specifically formulated to alleviate symptoms of major depressive disorder by modulating key neurotransmitters in the brain, distinct from many other antidepressants that primarily target serotonin. The sustained-release mechanism ensures a steady concentration of the active ingredient over time, reducing peak-trough fluctuations and potentially minimizing side effects. Clinical use is supported by extensive research demonstrating efficacy in improving mood, energy, and focus in adult patients.

Features

• Active ingredient: Bupropion hydrochloride
• Dosage form: Sustained-release (SR) oral tablets
• Available strengths: 100 mg, 150 mg, 200 mg
• Mechanism of action: Norepinephrine-dopamine reuptake inhibitor (NDRI)
• Administration: Oral, usually twice daily
• Prescription status: Rx-only medication

Benefits

• Reduces symptoms of depression such as low mood, loss of interest, and fatigue
• Does not commonly cause sexual dysfunction or significant weight gain, unlike many SSRIs
• May improve concentration and energy levels due to its dopaminergic activity
• Sustained-release formulation supports consistent therapeutic levels and dosing convenience
• Non-serotonergic mechanism offers an alternative for patients intolerant of or unresponsive to SSRIs/SNRIs

Common use

Bupropion SR is indicated for the treatment of major depressive disorder (MDD) in adults. It is also used off-label for seasonal affective disorder (SAD) and as an aid to smoking cessation. Unlike many first-line antidepressants, it does not inhibit serotonin reuptake, making it a preferred option for patients who experience undesirable effects with serotonergic agents, such as emotional blunting or sexual dysfunction. It is not approved for use in pediatric populations.

Dosage and direction

The initial recommended dose for Bupropion SR is 150 mg once daily in the morning. After at least three days, the dose may be increased to 150 mg twice daily, with at least 8 hours between doses. The maximum recommended dose is 400 mg per day, given as 200 mg twice daily. Tablets should be swallowed whole and not crushed, chewed, or divided, as this may alter the release profile and increase the risk of adverse effects, including seizure. Dosage adjustments may be necessary in patients with hepatic or renal impairment.

Precautions

Bupropion SR carries a boxed warning regarding the increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during initial treatment or dose adjustments. Patients should be monitored closely for clinical worsening, suicidality, or unusual changes in behavior. Use with caution in patients with a history of seizure disorder, cranial trauma, or conditions that lower seizure threshold. May elevate blood pressure; periodic monitoring is advised. Avoid use in patients with eating disorders due to increased seizure risk.

Contraindications

Bupropion SR is contraindicated in patients with a seizure disorder or history of seizures. It must not be used in individuals with a current or prior diagnosis of bulimia or anorexia nervosa due to a higher incidence of seizures in these populations. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated; a 14-day washout period is required when switching from an MAOI to bupropion. Hypersensitivity to bupropion or any component of the formulation is also a contraindication.

Possible side effects

Common side effects include dry mouth, nausea, headache, insomnia, and dizziness. Less frequently, patients may experience tremor, agitation, anxiety, sweating, or tinnitus. Serious side effects can include seizures (dose-related), hypertension, allergic reactions, angle-closure glaucoma, and severe skin reactions. Any new or worsening psychiatric symptoms, such as anxiety, panic attacks, or hostility, should be reported immediately to a healthcare provider.

Drug interaction

Bupropion SR is metabolized primarily by CYP2B6 and may interact with inhibitors or inducers of this enzyme. Concomitant use with other drugs that lower seizure threshold (e.g., antipsychotics, antidepressants, theophylline, systemic corticosteroids) should be avoided. May increase levels of drugs metabolized by CYP2D6, such as certain antidepressants, antipsychotics, beta-blockers, and Type 1C antiarrhythmics. Use caution with drugs that affect dopamine or norepinephrine. Do not combine with MAOIs.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one, as this increases the risk of adverse effects, including seizure.

Overdose

Overdose of Bupropion SR may lead to seizures, hallucinations, loss of consciousness, tachycardia, and cardiac arrest. Fatal outcomes have been reported. Symptoms can be delayed; medical observation is required even in initially asymptomatic cases. Management is supportive and may include activated charcoal, anticonvulsants, and ECG monitoring. There is no specific antidote.

Storage

Store at room temperature (20–25°C or 68–77°F), in a tightly closed container, away from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Dispose of unused medication through a drug take-back program or according to FDA guidelines.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

Clinical studies and patient reports generally indicate that Bupropion SR is effective in reducing depressive symptoms with a favorable side effect profile regarding weight and sexual function. Some users note initial side effects like jitteriness or insomnia, which often subside with continued use. Adherence to dosing instructions is critical to minimize risks. Individual responses vary; a healthcare provider should guide treatment decisions.