Bupropion, most often referred to by the brand name Wellbutrin, is an antidepressant. In this article, we are going to cover when does Wellbutrin start working as well as some important information about this medication. 

Wellbutrin is primarily used for treating depression, including major depressive disorder and seasonal affective disorder. Another form of bupropion is sold under the brand name Zyban, which is used to support smoking cessation. It is also used to help treat nerve pain. It is sometimes prescribed off-label, or in ways that haven’t been approved by the Food and Drug Administration (FDA), to treat anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), and social anxiety disorder. 

Wellbutrin isn’t approved for treating anxiety, and the research on its effectiveness for treating anxiety disorders isn’t conclusive. Some patients with both depression and anxiety have seen improvements, but some have experienced an increase in anxiety while on Wellbutrin. 

Wellbutrin is the only medication in its category of norepinephrine-dopamine reuptake inhibitors (NDRIs). It works differently from medications like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), since those affect the neurotransmitters serotonin and norepinephrine. Wellbutrin is thought to work primarily by increasing the neurotransmitters norepinephrine and dopamine. 

How Long Does Wellbutrin Take to Start Working?

Wellbutrin works gradually, not instantly. It’s important to remember that early changes don’t always equal the full benefits one can potentially expect. The beginning stage of treatment is an important step to longer-term progress. 

Antidepressants take time to work because they need to build up in the body and have time to work in all the various ways that they impact the brain and body. People may or may not notice any noticeable changes at first, but some do experience small shifts and improvements.

Week-by-Week Breakdown

Wellbutrin's onset of action varies from person to person. However, there is a timeline of when bupropion typically starts working. 

• Week 1–2: During this period, there may be some early physical or energy changes. This can include improved appetite, better sleep quality, and increased energy. 
• Week 3–4: Some people start to experience mood and motivation shifts during this time, but not all. 
• Week 6–8: Full therapeutic effects typically go into effect, with improvements in mood and an increased interest in activities, sometimes taking up to two-three months. 

Factors That Affect How Quickly Wellbutrin Works

Dosage and Formulation

Wellbutrin comes as an immediate-release, sustained-release (SR), or extended-release (XR) tablet that is taken orally. Certain conditions are treated with different forms of the medication; for example, the extended-release (XR) option is used to treat seasonal affective disorder and major depressive disorder, and the immediate and sustained-release options are used to treat major depressive disorder. 

Professional guidance from your prescriber is essential for adjustments, and many people need to gradually increase the dose to reach full benefits. 

Individual Differences

Medications work differently for different people due to how they metabolize medications, as well as the severity of symptoms they are experiencing. People with more severe forms of depression may require higher doses of medications. People who have co-occurring conditions should consult with their prescriber to see if there is a medication that can help with more than one condition. 

Wellbutrin isn’t for everyone, and shouldn’t be taken by people with a history of eating disorders, seizure disorder, people who are in the process of discontinuing addictive substances, or who are taking certain other medications.

Consistency and Lifestyle Factors

Consistency is key for effectiveness of any treatment, including utilizing bupropion for the treatment of a mental health condition. It is vital to take medication as prescribed, not miss doses, and to follow your prescribers' recommendations. Ensure you discuss with your prescriber what to do if you accidentally miss a dose, as different types of Wellbutrin require different responses. 

Additionally, good self-care is foundational to making progress. Prioritize sleep, good nutrition, movement, leisure activities, and spending time with your social support system. Avoid using alcohol, as it is known to increase the severity of common side effects, and can also increase one’s risk of seizures and thoughts of suicide. 

Side Effects During the Adjustment Period

Common Wellbutrin side effects can include nausea, dizziness, fast heartbeat,  difficulty sleeping, dry mouth, sore throat, weight loss, headaches, and constipation. These typically improve in one to two weeks after starting the medication.

In rare cases, people can experience shakiness and tremors, stomach and muscle pains, anxiety, thought disturbances, agitation, increased urination, and angle closure glaucoma (symptoms of this may include eye swelling, pain, redness in or around the eye, and changes in vision).

If side effects persist for more than two weeks or if they worsen, contact your prescriber as soon as possible. 

Wellbutrin has been known to increase the risk of thoughts of suicide in children, adolescents, and young adults, and if someone younger than 24 is taking this medication, they should be monitored closely for signs of suicide risk.

If you or someone you know is experiencing thoughts of suicide, please call or text the Suicide and Crisis Hotline at 988.

Bupropion, unlike many other antidepressants, isn’t known for causing sexual side effects, and for some people it may even increase libido. 

Depending on someone’s medical history, some people can be at a higher risk of seizure or adverse cardiovascular events, so be sure to discuss all current and past medical conditions with your prescriber, including a history of substance use concerns.

Something important to note is that about half of the people who take antidepressants experience emotional blunting, or the inability to feel emotions like happiness, sadness, anger, and more. This was found to frequently be more of a symptom of the depression itself, rather than a side effect of the medication. 

Although side effects are very common and emotional blunting is normal for patients with depression, ensure you communicate them to your prescriber if you experience these.

What to Do If Wellbutrin Doesn’t Seem to Be Working

If more than two to three months have passed and you are not seeing any improvements, consult with your prescriber about your options. They may recommend changing the dose of your Wellbutrin, or another medication may be a better fit for you. 

Avoid abruptly stopping antidepressant medications. Stopping antidepressant medications like Wellbutrin can cause discontinuation syndrome, which can include symptoms such as nausea, anxiety, trouble sleeping, flu-like symptoms, restlessness,  and sensory disturbances (such as being shocked or tingling sensations). Symptoms may be severe if the medication is suddenly discontinued without tapering off. Symptoms of discontinuation syndrome stop on their own without medical intervention, and while they are unpleasant they aren’t harmful.

When to Seek Immediate Medical Advice

If your mood or anxiety worsens or if you experience severe side effects, get in touch with your prescriber as soon as possible. If you experience thoughts of suicide, seek immediate support by calling the National Crisis Hotline at 988 or going to your nearest emergency room. 

Takeaway 

Wellbutrin is an effective treatment for depression and many other mental health conditions. Recovery from mental health concerns is possible. Medication, along with other forms of support such as therapy and peer support, can make a positive impact. Accurate diagnosis by a licensed healthcare clinician matters for effective treatment and management of these conditions. 

If you or your loved one is looking for mental healthcare or crisis support and prevention, reach out to us at Willow Health today. We offer same-day or next-day appointments with both a psychotherapist and a psychiatric medication clinician, who can assess your needs and identify a plan for individualized care. 

Sources

Food and Drug Administration. Wellbutrin (bupropion hydrochloride) tablets. 

DailyMed - WELLBUTRIN XL- bupropion hydrochloride tablet, extended release 

Bupropion for Smoking Cessation in Patients Hospitalized With Acute Myocardial Infarction: A Randomized, Placebo-Controlled Trial - ScienceDirect 

Emotional blunting with antidepressant treatments: A survey among depressed patients - ScienceDirect 

Pharmacotherapy for Neuropathic Pain: A Review | Pain and Therapy | Springer Nature Link 

Bupropion and Anxiety: A Brief Review - PubMed 

Bupropion (Wellbutrin) | NAMI 

Increased libido as a buproion-SR side effect: Clinical description of a case | European Psychiatry