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A Class of Its Own
Most common antidepressants fall into one of several classes of medications: SSRi’s, TCAs, MAOIs and the newer class, SNRIs. However, Wellbutrin, also known by its generic name bupropion, is chemically unrelated to these classes and falls into the “other antidepressants" category. Unlike SSRIs and SNRIs, Wellbutrin does not inhibit the reuptake of serotonin. Instead, it works as a weak inhibitor of the reuptake of norepinephrine and dopamine, two brain chemicals that may play a role in mood regulation.
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Understanding the Mechanism Behind Wellbutrin
While scientists are not exactly certain how the brain's chemistry affects depression, they believe certain brain chemicals play a large role. When reading about antidepressants, you may notice the term “reuptake" appearing frequently. For example, "Wellbutrin acts as a dopamine and norepinephrine inhibitor." In layman's terms, neurotransmitters such as serotonin, dopamine and norepinephrine are chemicals used by nerve cells in the brain to communicate with each other. One cell produces the chemical and releases it into the surrounding area. From there, the chemical will travel to a nearby cell and be taken in, or it will reattach itself to the cell that produced it and be reabsorbed, recycled and sent back out. This process is called "reuptake," according to MedicineNet.
When your brain contains an abundance of the necessary neurotransmitters, the reuptake process works in a constant state of balance. However, when you have a shortage, or when the process happens to quickly, your brain doesn’t have enough of what it needs to carry out certain functions, including regulating moods. By inhibiting, or slowing down, the reuptake process, more chemicals are available for use by the brain. In addition to slowing down the reabsorption of dopamine and norepinephrine, Wellbutrin also acts as a mild central nervous system stimulant.
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Uses and Usage
Wellbutrin is typically used to treat major depressive disorder, or depression that interferes with daily activities at on most days for at least a two-week period. In addition to this disruption of daily life, those with major depressive disorder also have at least four of the following symptoms: changes in appetite, sleep changes, agitation, feelings of worthlessness or guilt, loss of interest in daily activities, increase fatigue, difficulty concentration, and thoughts of suicide. Wellbutrin XL, an extended-release form of the medication, is used for treatment of seasonal affective disorder.
If your physician prescribes Wellbutrin for depression, it is extremely important to follow the dosing directions supplied. For major depression, dosage typically starts out at 100 mg taken twice a day. Your physician may increase the dosage after three days, maxing out at 150 mg per dose or 450 mg per day. If you are taking an extended-release form, do not crush, chew or break the tablet. Do not change your dosage or stop taking suddenly without talking to your doctor.
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What to Expect While Taking Wellbutrin for Depression
Side effects vary from person to person, but common side effects include: dry mouth, constipation, headache, nausea, dizziness, sweating, ringing in the ears, appetite loss, anxiety and blurred vision. Less common, serious reactions include: worsening of depression, psychosis, hallucinations, paranoia, mania, migraines and thoughts of suicide. Wellbutrin can also cause seizures in certain people, especially those with preexisiting medical conditions such as epilepsy and eating disorders, or those taking other medications. Be sure to tell your doctor about any other medications or supplements that you are using. Drinking alcohol also increases your risk of seizures.
If side effects become unbearable, you notice a worsening of certain reactions or new effects crop up, contact your physician immediately. If you miss a dose of Wellbutrin, do not double-up during the next dose.
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Wellbutrin Prescribing Information
MedicineNet: Definition of Reuptake
Epocrates Online: Wellbutrin