Side Effects of Buproprion (Wellbutrin)
Bupropion, available under the brands Wellbutrin, Zyban, Aplenzin, and Contrave is an antidepressant and is part of the drug class nicotine dependence medications. Wellbutrin is used to treat depression, mental and mood disorders, and smoking cessation. It is also used in combination with naltrexone (available as Contrave) as a weight loss medication.
Serious Side Effects
Wellbutrin has been shown to cause seizures in 1 in 1,000 people. The FDA advises the chances of having seizures is more likely if you regularly consume a lot of alcohol, are diabetic and use insulin or tablets for treatment, have been taking sedatives or if you are going to stop them while on Wellbutrin treatment, and have had a serious head inury or head trauma history. There is also an increased risk of seizures if you take:
- Other depression and mentall illness medications
- Theophylline for asthma or lung disease
- Tramadol (a strong painkiller)
- Medicines against malaria (i.e., mefloquine or chloroquine)
- Stimulants or other medicines to control your weight or appetite
- Steroids (by mouth or injection)
- Antibiotics called quinolones
- Anti-histamines that can cause sleepiness
There may be a higher chance of other side effects in the elderly aged over 65 or in the presence of kidney or liver problems.
Other factors which might increase the risks of drug reactions is the simultaneous consumption of other medicines for: depression (such as amitriptyline, fluoxetine, paroxetine, dosulepin, desipramine or imipramine), mental illness (such as clozapine, risperidone, thioridazine or olanzapine), Parkinson’s disease (levodopa, amantadine or orphenadrine) or medicines that affect your body’s ability to breakdown bupropion (carbamazepine, phenytoin, valproate), cancer treatment medications, such as cyclophosphamide or ifosfamide, medicines used to prevent stroke (i.e., ticlopidine or clopidogrel), beta blockers (such as metoprolol),irregular heart rhythm (propafenone or flecainide), and stopping smoking (nicotine patches).
Patients, especially those younger than 25, who take antidepressants for any condition may experience new or worsening depression, other mental and mood symptoms, or suicidal thoughts or attempts. Therefore, it is very important to discuss with the doctor about the risks and benefits of antidepressant medication, even if treatment is not for a mental/mood condition.
Common Side Effects
Common side effects that may happen in 1 out of 10 patients are: fever, dizziness, itching, sweating and skin rash (sometimes due to an allergic reaction), shakiness, tremor, weakness, tiredness, chest pain, anxious or agitated feelings, stomach pain or other constipation, changes in the taste of food, loss of appetite (anorexia), increase in blood pressure sometimes severe, flushing, ringing in the ears, visual disturbances.
Other common side effects which may affect less than 1 out of 10 people include difficulty in sleeping, headache, dry mouth, feeling sick, and vomiting.
Rare side effects which can affect up to 1 out of a 100 patients include feeling depressed, feeling confused, difficulty concentrating, raised heart rate, and weight loss (Buproprion label as listed by the FDA).
Allergy Reactions to Bupropion
Wellbutrin should not be taken in the presence of known allergy or allergies to it, any other ingredients in Wellbutrin tablet, and consumption of other medicines which contain bupropion.
The Wellbutrin label as published by the FDA includes the following allergic reactions to bupropion:
- Red skin or rash (like nettle rash)
- Itchy lumps (hives) on the skin, some are severe enough to require hospitalization
- Unusual wheezing or difficulty in breathing
- Swollen eyelids, lips or tongue
- Muscle or joint pains
- Collapse or blackouts
FDA Warnings for Wellbutrin
The FDA recommeds to inform your healthcare provider if you have had diagnosis of epilepsy or history of seizures, diagnosis or history of eating disorder, diagnosis of brain tumor. In addition, tell your healthcare provider if you are a heavy alcohol drinker and has just stopped or is about to stop, you have severe liver problems, recently stopped taking sedatives, or to be stopped while taking bupropion, and consumed other medicines for depression called monoamine oxidase inhibitors (MAOIs) in the last fourteen days.
About Pharmacogenetic Testing
Wellbutrin becomes the active metabolite 4-hydroxybupropion in the polymorphism CYP286. Studies have found that bupropion is not catalyzed well with the genetic variant CYP3A4, suggesting that those with this variant are do not metabolize well or are poor metabolizers for Wellbutrin. In addition, Wellbutrin inhibits the breaking down of several CYP2D6 substrates and is unlikely to metabolize CYP2B6, CYP3A4, or CYP2E1.
Most patients do not experience the side effects of Wellbutrin, but others may suffer from mutliple harmful side effects. The reason behind this may be due to different genetic variants of patients.
Know Your Genetic Risk with the Rxight® Genetic Test
Rxight®, developed by MD Labs, is a comprehensive pharmacogenetic test, which sequences 18 genes for 60 alleles. This establishes how well you are likely to respond to over 200 clinically relevant prescription and over-the-counter (OTC) medications.
The Rxight® test is a cheek swab done by a participating pharmacist. The results from this simple test will provide your pharmacist genetic information to design a safe and effective treatment plan.
Contributors to this Article:
Michael Sapko, MD, PhD; and Deborah Kallick, PhD, Medicinal Chemistry
Read more about Rxight® Drug Sensitivity Testing