Wellbutrin has a boxed warning, the most serious type of warning from the Food and Drug Administration (FDA). Wellbutrin’s active ingredient bupropion has an increased risk of suicidal thoughts and behavior. Remember to discuss the risks with your healthcare provider.
Highlights
- Wellbutrin is available in three forms: Wellbutrin IR (immediate-release), Wellbutrin SR (sustained-release), and Wellbutrin XL (extended-release). Each is FDA-approved for its own set of uses.
- Wellbutrin dosage varies based on the form prescribed, the condition being treated, and the response to the medication. Typically, the treatment starts with low bupropion doses that are gradually increased until a maintenance dose is reached.
- Certain medical conditions, such as kidney or liver problems, can affect the dosage of Wellbutrin that is prescribed and the period of time before adjustments are made.
- Finding the ideal dosage of Wellbutrin is a process that requires medical monitoring.
Wellbutrin is an antidepressant medication. It is FDA-approved to treat major depressive disorder and seasonal affective disorder, and its off-label uses include treating ADHD and anxiety. Its active ingredient
Wellbutrin comes in three forms, each capable of treating varying combinations of these conditions, and the dosage guidelines differ accordingly. This medication requires adjustments, overseen by your healthcare provider, to find the ideal dose and dosing schedule. It’s a process, but the end goal is an improvement in your symptoms while keeping side effects at bay.
Standard Wellbutrin Dosages
There are three forms of this antidepressant medication: Wellbutrin IR (immediate-release), Wellbutrin SR (sustained-release), and Wellbutrin XL (extended-release). Each form is FDA-approved for different uses and has different dosages, as noted in the Wellbutrin dosage chart below.
The starting dose of Wellbutrin refers to the dose that is recommended to begin with. How long you remain on this starting dose depends on the condition being treated, but it can be as little as 3–7 days. After this point, the dosage is often increased until the maintenance dose is reached, which is the dose that you will then remain on for the rest of the time that you take Wellbutrin, as prescribed by your healthcare provider.
The maintenance dose in the chart below is the standard one, and it can vary based on your reaction to Wellbutrin and the severity of your condition. The highest dose of Wellbutrin varies by form, as shown below. Note that when Wellbutrin is prescribed off-label for ADHD or anxiety, the dosage may vary as well.
Dosage Form | Approved Uses | Doses | Starting Dose | Maintenance Dose | Maximum Daily Dose |
Wellbutrin IR | Major depressive disorder | 75 mg
100 mg | 100 mg twice a day | 100 mg three times a day | 450 mg |
Wellbutrin SR | Major depressive disorder | 100 mg
150 mg
200 mg | 150 mg once a day | 150 mg twice a day | 400 mg |
Wellbutrin XL | Major depressive disorder
Seasonal affective disorder | 150 mg
300 mg | 150 mg once a day | 300 mg once a day | 450 mg |
Typical dosages are provided for informational purposes only. Please consult your healthcare provider and follow their instructions.
Wellbutrin Dosage Adjustments
When prescribed Wellbutrin, you are typically given a starting dose that is lower than the maintenance dose you will eventually have. This is because it is your doctor’s goal to have you on the lowest dosage of Wellbutrin while still seeing a therapeutic effect. Additionally, starting with a lower dose allows your body to ease into its usage, helping to minimize side effects.
Most people do not remain on the starting dose. After a few days, your healthcare provider may increase it, depending on your condition and symptoms. In addition to the above-mentioned reasons, they wait before increasing the dose to allow the placebo effect to wear off, which is a phenomenon where your brain tricks you into feeling better simply because you’re taking medication and not necessarily because the medication is helping. Waiting a few days allows your doctor to determine if your symptoms are genuinely improving or if a higher dosage is needed.
Finding the therapeutic dose of Wellbutrin takes time. It can
Wellbutrin has a black box warning, which is the highest safety-related warning that the FDA can give. It is given because the medication may worsen depression and increase the risk of suicidal thoughts in adolescents and young adults. This risk is greatest in the first few months of treatment—when the body is still getting used to it—or after the dosage has been adjusted.
If your Wellbutrin dosage has been increased but you experience severe or unpleasant side effects, your doctor may decide to lower it. Always discuss this option with your healthcare provider; do not attempt to adjust your Wellbutrin dosage without medical help.
Special Considerations for Dosing
One of the primary factors that will influence the form of
Dosage for Depression
To treat depression, the Wellbutrin IR dosage usually starts at 100 mg, taken twice a day. After a few days, this same dosage is taken three times a day, with at least 6 hours separating each dose. At this point, a healthcare provider will monitor your progress, and if your symptoms have not improved after several weeks, the Wellbutrin dosage may increase to a 100 mg tablet taken four times a day.
As for Wellbutrin sustained-release tablets (Wellbutrin SR), the starting dose is typically 150 mg once a day, and then it can be increased to 150 mg twice a day, at least 8 hours apart. If your symptoms do not improve after several weeks, your doctor may increase your dosage to 200 mg twice a day.
Finally, the starting dosage of Wellbutrin XL is 150 mg in the morning, and then it typically increases to 300 mg once a day.
Dosage for Seasonal Affective Disorder
When it comes to treating seasonal affective disorder (SAD) with Wellbutrin, only
For some cases, a prescriber may have you start taking bupropion in the fall and then gradually ease off it in the early spring so that you only take the medication when it is needed in the winter season. This schedule can help to prevent seasonal affective disorder, but it’s always necessary to follow your doctor’s orders.
Factors That Can Affect Your Bupropion Dosage
Having various health conditions may affect your Wellbutrin dosage.
Having Kidney Problems
Since the body primarily gets rid of bupropion through the kidneys, individuals with kidney problems may not be able to clear out bupropion as quickly. If you follow a standard dosing guide but cannot clear out bupropion in the same way that those with healthy kidneys can, a build-up of bupropion can occur. The more bupropion in your system, the greater your risk of side effects.
To combat this, individuals with kidney problems may need a lower dosage of Wellbutrin or less frequent doses.
Having Liver Problems
Your liver also plays a crucial role in breaking down bupropion so that it can be cleared from the body. Similar to those with kidney problems, if your liver does not function at its maximum capacity, it can take longer for bupropion to be cleared from your system. As a result, those with liver problems may need a lower dosage or less frequent doses. Doctors may also wait for a longer amount of time before increasing the dose.
For those with moderate or severe liver problems, the maximum recommended dosages are:
- 75 mg per day for Wellbutrin IR
- 100 mg per day or 150 mg every other day for Wellbutrin SR
- 150 mg every other day for Wellbutrin XL
Wellbutrin Dosing Considerations
While having a co-existing medical condition can affect your dosage amount of Wellbutrin, there are other considerations that can affect the dosage.
First, the type and severity of the condition that Wellbutrin is used to treat can affect the dosage; some people may need to increase their dosage twice before they find their ideal maintenance dose. Furthermore, some conditions can only be treated with one form of Wellbutrin—for example, only Wellbutrin extended-release tablets are approved for the treatment of seasonal affective disorder. As such, the dosage will depend on the available options for this one type.
Along these same lines, those with less severe conditions may not need as high of a dose. They may find that a lower dose offers the symptom relief they need, while those with more severe conditions require higher doses. Since someone’s response to Wellbutrin is highly individualized, finding the right dose is a process that often requires adjustments.
The prescribed form of Wellbutrin may also affect the dosage. The different forms last for varying times in the body, which is why some are taken less frequently than others. You may be able to get by with a smaller amount of Wellbutrin depending on the form that you are prescribed and how your body responds to it.
What to Expect When Increasing Wellbutrin Dosage
Wellbutrin often starts at a lower dose, and then after a set period—depending on the dosage and the condition it is prescribed to treat—it is increased to the maintenance dose. If your symptoms do not improve after weeks of use, there may be another dosage increase.
When your dosage is increased, you may experience some of the common side effects of bupropion, such as dizziness, nausea, constipation, abdominal pain, difficulty sleeping, weight gain, dry mouth, or agitation.
No matter what, it is important to follow your doctor’s instructions and never exceed the maximum recommended dose so as to avoid overdose, which can have symptoms that include hallucinations, seizures, changes in mood or behavior, and fainting. Overdose may cause death. If you take more bupropion than prescribed, contact your healthcare provider immediately.
Monitoring and Long-Term Use
How long Wellbutrin is taken depends on the condition for which it is prescribed. For example, with major depressive disorder, Wellbutrin is typically a long-term treatment, while those who take Wellbutrin for SAD may only take it during the winter months when it is needed to boost their mental health.
No matter what Wellbutrin is prescribed for, it is always important to monitor your symptoms. Let your doctor know if your symptoms have or have not improved and if there are any adverse reactions. This information can help your healthcare provider monitor the effects of Wellbutrin to ensure that you are seeing benefits from it.
If you do not see an improvement, even after weeks of taking Wellbutrin, discuss this with your healthcare provider. They may decide to adjust your dose or try an alternative form of treatment. It is not recommended to stop taking bupropion without first discussing it with your doctor.
Furthermore, if you miss a dose of Wellbutrin, skip the missed dose and take the next dose at the next regularly scheduled time.
Summing Up
Wellbutrin comes in three forms, each with its own indications. Dosage and dosing frequency vary based on the conditions treated, individual response, medical history, and other factors, so it’s essential to follow the personalized instructions established by your medical provider.
During the initial appointment and follow-ups, it is important that you discuss the detailed schedule and potential side effects to watch for. To see the benefit from Wellbutrin, it is important to monitor your symptoms and side effects and discuss both with a healthcare provider so that they can make adjustments to your medication management plan as needed. Book your appointment today to receive a personalized plan for depression treatment and get all your questions about Wellbutrin answered.
