Bupropion SR (sustained-release) is a prescription antidepressant medication belonging to the class of norepinephrine-dopamine reuptake inhibitors (NDRIs). It is specifically formulated to provide a controlled, steady release of the active ingredient, bupropion hydrochloride, over an extended period. This mechanism supports stable plasma concentrations, which may help reduce the frequency of dosing and improve treatment adherence. Clinically, it is indicated for the treatment of major depressive disorder (MDD) and may also be used as part of a smoking cessation treatment plan. Unlike many SSRIs, bupropion SR is not associated with sexual side effects, making it a favorable option for certain patient populations.

Features

• Sustained-release formulation for consistent 12-hour drug delivery
• Active ingredient: bupropion hydrochloride
• Available in 100 mg, 150 mg, and 200 mg tablet strengths
• White to off-white, round, film-coated tablets
• Requires prescription; not available over-the-counter
• Manufactured under strict pharmaceutical quality standards

Benefits

• Helps alleviate symptoms of depression such as low mood, loss of interest, and fatigue
• Does not commonly cause weight gain or sexual dysfunction, unlike many other antidepressants
• May support smoking cessation efforts when used as part of a comprehensive plan
• Sustained-release design may improve compliance with fewer daily doses
• May provide an alternative for patients who do not respond to SSRIs or SNRIs
• Can contribute to improved overall daily functioning and quality of life

Common use

Bupropion SR is primarily prescribed for the management of major depressive disorder (MDD) in adults. Its unique mechanism of action—inhibiting the reuptake of dopamine and norepinephrine—distinguishes it from many first-line antidepressants, which typically target serotonin. This makes it particularly useful for patients who have experienced inadequate response or intolerable side effects with selective serotonin reuptake inhibitors (SSRIs). Additionally, it is FDA-approved as an aid to smoking cessation, often under the brand name Zyban®, where it helps reduce nicotine cravings and withdrawal symptoms. Off-label uses may include attention-deficit/hyperactivity disorder (ADHD) and seasonal affective disorder (SAD), though these should only be pursued under strict medical supervision.

Dosage and direction

The recommended starting dose for Bupropion SR in the treatment of depression is 150 mg once daily, preferably administered in the morning. Depending on clinical response and tolerability, the dose may be increased to 150 mg twice daily, with at least 8 hours between doses, after several days. The maximum recommended dose is 400 mg per day, given as 200 mg twice daily. For smoking cessation, dosing typically begins with 150 mg once daily for the first 3 days, increasing to 150 mg twice daily thereafter. Tablets should be swallowed whole and not crushed, chewed, or divided, as this can alter the release profile and increase the risk of adverse effects, including seizure. Dosage adjustments are necessary in patients with hepatic or renal impairment.

Precautions

Patients should be monitored for worsening depression, suicidality, or unusual changes in behavior, especially at the beginning of treatment or during dosage adjustments. Bupropion SR may lower the seizure threshold; caution is advised in patients with a history of seizure disorder, head trauma, or other predisposing factors. It should be used cautiously in individuals with hepatic or renal impairment, and dosage adjustment may be required. Alcohol consumption should be minimized or avoided, as it may increase the risk of seizures and other adverse effects. Abrupt discontinuation should be avoided; tapering is recommended under medical supervision to prevent withdrawal symptoms. Use in elderly patients may require careful dose selection due to greater frequency of decreased hepatic, renal, or cardiac function.

Contraindications

Bupropion SR is contraindicated in patients with a known hypersensitivity to bupropion or any component of the formulation. It must not be used in individuals with a current or prior diagnosis of bulimia or anorexia nervosa due to an increased risk of seizures. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated; at least 14 days should elapse between discontinuation of an MAOI and initiation of bupropion SR. It is also contraindicated in patients undergoing abrupt discontinuation of alcohol or sedatives, including benzodiazepines. Use is prohibited in patients with a history of seizure disorder or those taking other medications that lower the seizure threshold.

Possible side effects

Common side effects may include dry mouth, nausea, headache, insomnia, dizziness, and sweating. Less frequently, patients may experience tremors, agitation, anxiety, tinnitus, or skin rash. Serious side effects, though rare, can include seizures, hypertension, hallucinations, severe allergic reactions, and angle-closure glaucoma. Any signs of hypersensitivity (e.g., rash, hives, swelling) should prompt immediate medical attention. Changes in mood or behavior, including suicidal thoughts, should be reported to a healthcare provider without delay. Most side effects are dose-dependent and may diminish over time; however, persistent or severe symptoms warrant clinical evaluation.

Drug interaction

Bupropion SR is a substrate of CYP2B6 and may interact with inhibitors or inducers of this enzyme. Concomitant use with MAOIs is contraindicated due to the risk of hypertensive crisis. It may interact with drugs that lower the seizure threshold, such as antipsychotics, antidepressants, tramadol, or systemic corticosteroids. Caution is advised with drugs metabolized by CYP2D6 (e.g., certain beta-blockers, antidepressants, antipsychotics), as bupropion may inhibit their metabolism and increase their plasma levels. Use with nicotine patches may increase the risk of hypertension. Always inform your healthcare provider of all prescription, over-the-counter, and herbal products you are taking.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one, as this increases the risk of adverse effects, including seizure. Setting a daily reminder or using a pill organizer may help improve adherence. If multiple doses are missed, consult a healthcare provider before resuming therapy to assess whether dose adjustment is needed.

Overdose

Overdose of bupropion SR may lead to severe symptoms, including seizures, hallucinations, tachycardia, hypotension or hypertension, and loss of consciousness. Fatal outcomes have been reported, particularly with large ingestions. In case of suspected overdose, seek emergency medical attention immediately. Treatment is supportive and may include airway management, ECG monitoring, and administration of benzodiazepines for seizure control. Activated charcoal may be considered if ingestion was recent, but whole bowel irrigation is not typically recommended due to the sustained-release formulation.

Storage

Store at room temperature, between 20°C to 25°C (68°F to 77°F), in a tightly closed container. Protect from light, moisture, and excessive heat. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Dispose of unused medication properly through a drug take-back program or according to FDA guidelines; do not flush down the toilet or pour into a drain unless instructed to do so.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here. Individual responses to medication may vary.

Reviews

Clinical studies and patient reports generally indicate that bupropion SR is well-tolerated and effective for many individuals with major depressive disorder. Patients often appreciate the lack of weight gain and sexual side effects compared to other antidepressants. Some note improved energy and focus. However, experiences vary; side effects such as insomnia or anxiety may occur. Always discuss your personal experience and any concerns with your prescribing healthcare provider.