Coping with depression can feel overwhelming. Depression is most commonly known for feelings of sadness, but it can also bring on other symptoms that can interfere with your moods, physical well-being, and relationships. That’s why it is critical that people with depression seek support.

While there are many ways to treat depression, some choose to take antidepressants. Wellbutrin SR and Wellbutrin XL are examples of prescription medications that treat symptoms of depression. Almost 25 million Americans use Wellbutrin to improve their mood and energy.

What Is Wellbutrin?

Wellbutrin SR and Wellbutrin XL are two prescription antidepressant medications. Both drugs contain the active ingredient, bupropion hydrochloride (HCl). Although they are similar, they cannot be taken interchangeably.

Wellbutrin SR is the sustained-release version that is taken more frequently while Wellbutrin XL is the extended-release version. The main difference is that the XL version stays in your system longer meaning you don’t have to take it as often.

Is Wellbutrin an SSRI?

Wellbutrin SR and Wellbutrin XL are atypical antidepressants that are not selective serotonin reuptake inhibitors (SSRIs). Wellbutrin medications belong to the drug class called norepinephrine-dopamine reuptake inhibitors (NDRIs). They are also known as aminoketone antidepressants. They act to balance chemicals in the brain to help improve symptoms of depression.

Wellbutrin Generic Name

Wellbutrin SR is the brand name for bupropion HCl sustained-release tablets. It was approved by the U.S Food and Drug Administration (FDA) for the treatment of major depressive disorder (MDD) in 1996.

Wellbutrin XL is the brand name for bupropion HCl extended-release tablets. It was FDA approved in 2003 for both major depressive disorder and seasonal affective disorder (SAD). Wellbutrin XL is absorbed in the body more slowly. Compared to sustained-release bupropion, the XL form releases the drug over a longer period of time.

Both Wellbutrin SR and Wellbutrin XL are available as generic bupropion tablets.

Bupropion Uses

Both Wellbutrin SR and Wellbutrin XL are prescription medications that are FDA approved to treat adults with major depressive disorder. Wellbutrin XL is also used to treat adults with seasonal affective disorder.

Major depressive disorder

Major depressive disorder is a serious mood disorder which most commonly affects young adults between the ages of 18-25. More women than men have clinical depression and over 7% of American adults have at least one major depressive episode a year.

If you have MDD, you continually feel sadness and a loss of interest in your previously enjoyable daily activities. These symptoms persist to the extent that you may feel as if life isn’t worth living. You find it difficult to function in your daily tasks and may also suffer from physical symptoms such as chronic pain or digestive issues.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), to be diagnosed with major depressive disorder, you will have at least five of the following symptoms Including either a depressed mood or a loss of interest/pleasure:

• Depressed mood
• Noticeable loss of interest or pleasure in your usual activities
• Significant/noticable change in weight and/or appetite
• Slower thoughts and movements, and physical and emotional reactions (psychomotor retardation)
• Fatigue or lack of energy
• Feelings of excessive or inappropriate guilt or worthlessness
• Difficulty thinking and concentrating, or indecisiveness
• Suicidal thoughts, recurrent suicidal ideation, or a suicide plan or attempt

People with MDD have these symptoms persistently nearly every day for a minimum of two weeks.

Seasonal affective disorder

Seasonal affective disorder (SAD) is seasonal depression or sometimes called winter depression. It is important to realize that SAD is not simply a case of ‘winter blues’ but a form of major depression with distressing symptoms that can feel overwhelming and interfere with your daily activities. The symptoms usually happen during the fall and winter months and improve with the arrival of spring and more sunlight. In the U.S. most people with SAD find that January and February are the most difficult months.

SAD affects up to 10% of people in the U.S. and approximately 70% of people with depression feel worse during the winter and better in the summer. Women are four times as likely as men to be diagnosed with SAD.

The causes of SAD have been linked to a biochemical imbalance in the brain triggered by less sunlight and shorter daylight hours in the winter. With the change in seasons, your internal biological clock or circadian rhythm is shifted resulting in you being out of step with your normal daily schedule. Indeed, people living far from the equator where there are fewer daylight hours in the winter more commonly impacted by SAD.

According to the DSM-5, to be diagnosed with seasonal affective disorder:

• Depression should be present only at a specific time of the year (such as fall and winter)
• Full remission occurs at a characteristic time of the year (such as spring)
• There have been at least two episodes of clinical depression in the previous two years
• Seasonal depressive episodes should substantially outnumber nonseasonal episodes

If you experience SAD, you will have symptoms of MDD and also further symptoms not typical of MDD including:

• Hypersomnia or excessive sleeping
• Increased appetite
• A craving for carbohydrates

How Does Bupropion Work?

Bupropion is a norepinephrine-dopamine reuptake inhibitor which acts to inhibit the reuptake or absorption of chemicals or neurotransmitters in the brain. These neurotransmitters include dopamine, serotonin, and norepinephrine. Depression is thought to occur due to an imbalance in the amounts of neurotransmitters released from neurons on brain cells. Bupropion therefore works to allow more dopamine, serotonin and norepinephrine to be available and improve your mood.

Before You Take Bupropion

Bupropion should only be taken for its FDA approved uses—MDD or SAD. Any off-label usage should not be considered without consulting your doctor. Bupropion cannot be taken without a prescription from your doctor.

You cannot take bupropion if you have an allergy or hypersensitivity to bupropion.

Other medical conditions

Before you start taking medication to treat your depression, you will need to discuss with your doctor your medical history including any existing medical conditions you may have. Wellbutrin may cause seizures, especially if you have certain medical conditions or use certain drugs. To make sure bupropion is safe for you, let your doctor know if you have any of the following medical conditions:

• Bipolar depression or bipolar mania or other mental illness
• A seizure disorder, head injury, or brain or spinal cord tumor
• An eating disorder such as as anorexia or bulimia
• Angle closure glaucoma
• Kidney or liver disease since this can affect how well you can break down and eliminate bupropion from your body
• Heart disease, high blood pressure, of if you’ve had a heart attack
• Diabetes

Pregnancy and Wellbutrin

If you are pregnant, notify your provider right away. There is limited data on the safety of Wellbutrin during pregnancy. It may also not be safe to nurse your baby while on Wellbutrin since the drug can enter your breast milk. There are other medications that may be better suited for use during pregnancy while still treating mental health conditions.

Bupropion interactions

Bupropion can interact with various other medications and affect how well other drugs work. Such drug interactions may also result in some serious side effects which are preventable if you let your doctor know all the medications you are currently taking or have recently taken. These include all over-the-counter (OTC) medications or off-the-counter supplements. Once you are taking bupropion, let your doctor know whether you start or stop taking supplements.

It is important that you have not taken a monoamine oxidase inhibitor (MAOI) in the last 14 days or are about to take an MAOI within the next 14 days when starting bupropion. This is because an MAOI can interact with bupropion and cause your blood pressure to rise dangerously and lead to a serious condition called serotonin syndrome.

St. John’s wort is an herbal supplement used to treat depression and it should not be combined with bupropion or any other depression or anxiety medications. Other medications that may interact with bupropion include:

• Aripiprazole (Abilify)
• Alprazolam (Xanax)
• Amphetamine/dextroamphetamine (Adderall)
• Buspirone (Buspar)
• Citalopram (Celexa)
• Cholecalciferol (Vitamin D3)
• Clonazepam (Klonopin)
• Duloxetine (Cymbalta)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac)
• Gabapentin
• Lamotrigine (Lamictal)
• Levothyroxine (Synthroid)
• Lisdexamfetamine (Vyvanse)
• Lisinopril
• Melatonin
• Metformin
• Omeprazole
• Paroxetine (Paxil)
• Phentermine
• Quetiapine (Seroquel)
• Sertraline (Zoloft)
• Tramadol
• Trazodone
• Varenicline (Chantix)
• Venlafaxine (Effexor)
• Zolpidem (Ambien)

Wellbutrin and alcohol

Avoid drinking alcohol with bupropion as this can increase the risk of uncommon side effects such as seizures, hallucinations, delusions, paranoia, mood and behavioral changes, depression, suicidal thoughts, anxiety, and panic attacks.

Make sure that your doctor knows if you drink a lot of alcohol normally because if you stop drinking suddenly this can also increase your risk of seizures while on bupropion.

Bupropion can reduce your mental alertness so avoid driving and carrying out other activities where you need to be alert until you know how bupropion affects you.