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ArchiveĀ 1

Wellbutrin and psychic energy? Help me understand..

Sustained and Extended Release

What's the difference between sustained release and extended release? --Galaxiaad 20:00, 24 August 2005 (UTC)

Nil. JFWĀ |Ā T@lk 21:22, 24 August 2005 (UTC)
False. SR is sustained release, usually taken twice daily. XL -- extended release -- is a reformulation designed for once-daily dosing.
Not Quite. while SR is sustained release is designed to be taken twice daily

it is also claimed to be safer (lower peak concentration in blood/lower risk of seizure) (reasoning used by glaxo smith kline to justify aditional patents and to doctors prescribing extended release instead of generics to patients) it is preferable to spread out the doses further instead of 150mg twice daily 100mg three times daily

this strategy can reduce the risk of seizures due to the large peak concentration in blood after taking (studys have shown that risk of seizure is directly correlated to peak concentration in blood)

and while xl is designed for once daily dosing these significant peaks still exist it would be preferable to spread out the doses instead of 300mg once daily 150mg twice daily

Psychic energy

This sentance is a little suspect; "psychic energy"?:

Because patients with suicidal thoughts suffering from depression may experience a serious increase of psychic energy before remission of depression is encountered, these patients are at high risk of attempting suicide. If one decides to treat these patients with Bupropion, sedative drugs (benzodiazepines or Chlorprothixene) should be given additionally until remission of depressive disorder occurs.

24.31.191.41

I'll have a look. JFWĀ |Ā T@lk 19:38, 6 November 2005 (UTC)

It means you get the energy to get things done, yet your thinking still has not changed, so you are having negative thoughts and can act upon them. Unlike when you have negative thoughts and are depressed and do nothing at all because you have no energy for anything.

Wellbutrin + Pot

I've been on Wellbutrin XL 300mg for severe depression for over a year now. It seems to have an altering effect on what happens after I smoke pot. It enhances the euphoric feeling (described best as "floating") but occasionally gives me a rush of several mixed feelings all at once (happiness, saddness, agitation, the desire for tranquility, and fear [rarely]). My high also seems to be drawn out longer than smoking when I wasn't on Wellbutrin.

I've also had moments where I would be looking at something (such as a trail in a forest I was walking in) and it would trigger whole dreams to be replayed crystal-clear in my mind. The "something" also had a significant role in the dream, which is why I think it triggered these relapses. The dreams weren't even from recent times, either. All of the dreams I've had relapses of were from my childhood (like second grade) that had long since been forgotten. I usually feel overjoyed after remembering this or that dream.

I remember one time I even had auditory hallucinations right after smoking of a cat meowing and a dog barking from far away in my right ear and indoor laughter in my left ear, which lasted for about 10 minutes. It was strange because I was out at a park and nobody else was in the park aside from the two friends I had been walking with.

The only bad experience I've had has only occured a few times. It's a barrage of ideas, memories, and feelings all at once for about an hour or two. This is basically like an overload of my mind, and the only way I've delt with it is just to ride it through until my high is over.

A few people I know who have/had also been on Wellbutrin seem to describe the same types of things, but everything is subjective and varies a little from person to person.

The resulting psychological effect of mixing Wellbutrin with pot is now referred to by myself and my friends as "Wellbutripping." We hope this will catch on sooner or laterĀ :)

I didn't know where I could enter all of this on the article since it's subjective. Just thought I'd add my two cents to the discussion.

Kokekane9 19:17, 11 January 2006 (UTC)

Interesting experience. Perhaps submit to erowid.orgĀ ? --Pfh 01:59, 21 January 2006 (UTC)
Hookah smoking is much more pleasurable I've found since I've been on this.J. M. 21:04, 5 April 2006 (UTC)

How is the pot smoking affecting your depression? Does it make you more or less depressed?

I find it has a negative affect if the meds are actually working and making you feel better. I love smoking but when I can think clearly by myself (well with the meds) I feel like supressing that feeling makes me really anxious and aggrivated.

--> Um, I don't know if you should smoke pot while taking this drug. I mean who knows what can happen when they interact. Wellbutrin is a very powerful drug and so is THC and its family metabolites. Also, no one has done any studies on THC-budeprion interaction.

Snorting Bupropion Good/Bad

I DID A LOT OF RESEARCH ABOUT BUPROPION. I FOUND IT TO BE A PSYCHOSTIMULANT. I HAVE ALWAYS BEEN LAZY UNMOTAVATED. THE FIRST BOTTLE I SUCKED THE COVERING OFF IT. I THEN CRUSHED IT UP AND SNORTED LIKE COKE I GOT A RUSH AND I WAS UP AND MOVING. BUT THE PROBLEM WAS INSTED OF TAKING 2 A DAY I WOULD SNORT 5 OR 6 A DAY OF THE 150MG. AT WHICH POINT I RAN OUT 3 WEEKS BEFORE MY REFILL.

THIS TIME I AM GOING TO TRY AND TAKE IT AS PERSCRIBED. I AM TRYING TO GET THAT FAST HIGH INSTED OF TAKING IT AS TOLD AND FEELING GOOD ALL THE TIME. PLUS MY NOSE WILL STOP HURTING.

PLEASE GIVE ME FEED BACK ON THIS!!!!!!!!
I HONESTLY THINK CANIBAS(WEED)IS THE BEST THING FOR ALOT OF MY PROBLEMS AND MANY OTHERS.
-- Master Chriztopher 09:21, 18 May 2006 (UTC)

Uhh... well, it is generally best to take medicines in the manner intended by your doctor. Snorting pills is generally of more recreational value than it is of any real medical value. As to the medicinal value of cannabis, I would direct you to that article and it's sub-articles (particularly the Medical cannabis article). Cheers AP
It's a great idea to snort bupropion if you want to have seizures. --Anon. 129.215.16.12 20:12, 20 June 2006 (UTC)
There are better things to snort.
That said, insufflation of prescribed medicines can have its (non-recreational) uses as well, e.g. to achieve a local effect from an otherwise systemic medicine. I wouldn't suggest experimenting with it, though, and your doctor will positively kill you if you ask him/her.Ā ;) ā€”Preceding unsigned comment added by Zuiram (talk ā€¢ contribs) 02:23, 27 October 2006 (UTC)

Risks in tobacco withdrawal

When commenting on the references, please keep commentary to the actual findings reported in the references. In the study on sudden death and bupropion: The conclusion of the general practice case series study states: ā€œbupropion is probably associated with a small increase in seizure rate, which is similar to that seen with most other antidepressants when used to treat depression, but there is no evidence to suggest that the drug is associated with an increased risk of sudden death, and our findings suggest that a hesitancy to use the drug on these grounds is unfounded.ā€ It does not comment on risk of suicide - with a series of 9329 patients it would be notable if any had taken their own life whether using the drug at the time or not. ie The study was not designed to determine risk of suicide - so it cannot say there was an increased risk of suicide (just as it cannot say there was no increase ). Nogwa 13:37, 20 August 2006 (UTC)

Bupropion and insomnia

Has anyone any idea, whether this substance is being used for insomnia treatment? May-be in cases of depression-induced insomnia?Constanz - Talk 17:15, 18 September 2006 (UTC)

The use of stimulant medications in the treatment of insomnia is not exactly routine. Benzos, barbiturates, antihistamines and neuroleptics are the most common, depending on what else you have going on in your head, how long you've had insomnia, and how long the treatment is expected to last.
There are a substantial number of anecdotal reports of stimulants aiding sleep, though, and some doctors prescribe it.
Personally, when I was being treated with tranylcypromine and dexedrine (treatment refractory depression), I would usually take the last dose an hour or two before bed-time if I needed to sleep well. Dexedrine helps me fall asleep, and I wake up well-rested. YMMV.
When asking questions like these, it'd be great if people would include the reason why they are asking, as most people asking these questions are asking the wrong question. Not saying you are, but it'd be a great help in providing the right answer. Do you want to add something about it to the article, are you or someone you know suffering from insomnia, etc?
Zuiram 02:32, 27 October 2006 (UTC)

This pages looks too POV

I know it is the typical thing that people say when they first read an article that they dont like, but I have just viewed a BBC Horizon documentary "we love cigarettes" where they comment that trials of this drug have shown that it can increase the success in quitting smoking from 5% to 55%. It also seems that more thorough tests have shown that it is not so overwhelming but significant enough to gain FDA approval as a medicin to quit smoking.

Taking into account the horrendous statistics around smoking and its health risk, i.e. today 90.000 children tried their first cigarette, 50% of smokers will die as a result of the habit, or smokers die 10years younger. It does seem to me that far more information should be included.

As it stands, and at first glance, it seems to cast a highly negative view, as if it was another "bad" drug: Chronic hepatotoxicity in animals, Contraindications, Side effects, Abuse liability, Additional warnings,increase the incidence of suicidal thoughts, Potential indications of bipolar and schizoaffective disorder, Alleged Risks with certain treatments...

I do not question the encyclopedic value of all this information, but I think that ultimately we are about giving VALUABLE Information and this drug could help thousands of millions of people quit smoking and we should contribute by providing all the possible information to how it works and its success, in addition to discussing its side effects.

If I was the director of a Tobacco company I would be very pleased with the way the article is currently written. Im sure we can do better. 88.15.59.243 17:11, 21 October 2006 (UTC)

If you want to quit smoking, and can't do it on your own, ask your doctor for help. If you don't trust your doctor, you sure shouldn't trust any of the psychopharmacology articles on Wikipedia.
There are a zillion drugs that have some effect or other that is useful in conjunction with smoking cessation, notably MAOIs, stimulants, cholinergics and so forth.
Selecting the right one, working out supportive measures, planning the timetable for quitting, screening for possible interactions and adverse reactions, etc. is a lot more work than the average reader can reasonably cope with.
Bupropion is a great help for some people, both as an antidepressant, and as a smoking cessation aid. But WP is not, and with its current editorbase, cannot be, a guide to selecting drugs.
If you want to help people quit smoking (or, in my case, using snus), you'll want to make a cessation article, and link to it from pages such as nicotine and smoking. This page does a fair job of summarizing some important reference material, and to add anything substantial about its use for a particular purpose would mean a lot of text and tons of sources.
Zuiram 02:41, 27 October 2006 (UTC)

References

Seriously. For example, where does it say that Bupropion has been shown to increase suicidal tendencies of kids? I'm looking for information on this and haven't found anything yet. It's my perception (MAY BE WRONG!) that the warning that gets dumped onto Wellbutrin about suicides is just coming from SSRI's being implicated (even though they are very different drugs). On the other hand, a friend started taking the drug and is having more suicidal visions than before. Anyway, I'm on a tangent. PLEASE GIVE REFERENCES PEOPLE! 129.215.16.12 20:15, 20 June 2006 (UTC)

Much of this seems to be taken verbatim from the instructions included with the drug which includes a special insert for using Bupropion with children and teenagers. There are numerous warnings in there about increased suicidal thoughts. Anyway, shouldn't the source of the entire article be cited?
The actual wardning states that nine antidepressants were studied, and describes them as SSRIs and others.4.234.120.220 02:30, 9 August 2006 (UTC)
Khan et al found no statistically significant difference between SSRIs, active control, placebo or other antidepressants (including buproprion) in terms of suicide attempts or suicidal ideation in their metastudy. Sample population slightly over 48.000 subjects.
Typically, the sources that cite an increase in suicidal ideation, suicidal behaviour and suicide attempts, cite a moderate increase (say 4% vs 2% for placebo) in suicidal ideation. For buproprion, there was a <1% incidence of treatment-emergent suicidal ideation in the profile I read.
HTH. Zuiram 02:07, 27 October 2006 (UTC)

Methylphenidate Hydrochloride and wellbutrin srĀ ?????? high usage

judging by the other entries, this site is not used as a tool to assist foreign police forces, is this the case, I do not live in a Western nation. will information raised here be treated confidentially.

No, information here will not be treated confidentially by any stretch of the imagination.
Zuiram 02:24, 27 October 2006 (UTC)

Suicidal Thoughts

The following under Side Effects is uncited:

Suicidal thoughts and attempts have been reported in children and adolescents.[citation needed] Reports of increasing suicidal thoughts have occurred.[citation needed]

It should probably removed unless there is some research to back it up. Suicidal thoughts are a symptom of the disease it treats, thus it would have to be heavily documented to make it a legitamite side effect of the drug.--Twintone 16:37, 30 October 2006 (UTC)

Suicidal ideation and attempted suicides have a greater incidence with drugs than with placebo for the initial phase of psychopharmacological treatment, at least with SSRIs and SNRIs (the ones that have been studied for this effect).
Based on this, a blanket warning has been issued by the FDA and other countries' counterparts, and this article is merely repeating that. This has been widely publicized, and there is no need to cite it. I'm not sure there is any need to keep it in there either, though.
The net suicidality during such treatment is generally low anyway, with one study citing 2% for placebo and 4% for the SSRI being tested. Significant? Yes. Alarming? Hardly.
Yes, suicidal ideation and behaviour is often a response to the disease, but these drugs sometimes bring it to the surface in people that have previously been perceived as not having such thoughts. The potential reasons for this are many, and the industry is generally content to leave it at providing the actual numbers. One fairly benign interpretation would be that twice as many people actually tell their doctors how they really feel once the treatment starts "opening them up", whereas one fairly malign interpretation would be that the drugs cause twice as many people to feel like killing themselves. Until we have some more solid data to base a conclusion on, these two interpretations, and the ones in between, are simply speculation, and we're stuck reporting the effect-statistics rather than anything about the cause.
Some have even implicated antidepressants in recent high school shootings and people going "postal", etc. Personally, I think they're just searching for someone to blame to make themselves feel better and to soothe the cognitive dissonance of "it won't happen to me" meets "it just happened", though I would venture that 5HT is perhaps not the best receptor to be messing with, especially since the effects are mediated further downstream by all accounts (D2-upregulation and Ī²-downregulation, mostly).
You could make a case that getting your hopes up, then having them torn down further, is a significant cause of these problems. Many describe being met by doctors that appear to not care about you, who calmly put you through the motions of their rx-list in a seemingly endless procession of switch-increase-increase-switch. That was my experience, and it almost cost one or more lives. Still, an anecdote does not demonstrate universal causality.
If you want to clear the text up, just replace it with something to the effect of the usual "The FDA has issued a warning that..." statement used in antidepressant PI sheets. Zuiram 20:18, 30 October 2006 (UTC)
I added a citation for the first statement from a NIH page. It is not original research, but it is a least a reliable source indicating the issue does exist in children. I also removed the second statement as it is totally unclear. Does it refer to adults? If it refers to children how is it different then the first statement? Master shepherd 20:06, 12 December 2006 (UTC)

The Pill?

Anyone know if Wellbutrin interacts with The Pill In All Her Forms? (BCP)

No.

My experiences with the drug and some questions

Im currently taking Wellbutrin XL 150mg and have been doing so for about 3 months. Im also taking Lexapro as well and have been on that for about 4 years. I was wondering what the interactions between these two drugs might be? I had each one prescribed by a different doctor because I moved off to college last year.

I was wondering where I could find out about the interactions of the two drugs. I was taking Lexapro for Depression and Anxiety and Wellbutrin seems to cause Anixiety(based on info from this article) so Im not sure its it being used as it should.

Ok, now for my side effects:

I can vouch for the insomnia. I am up all night every night. Even when I am dead tired. Of course I do have Afternoon classes and wake up at 11am, but Im often up from 2pm til 7am on a regular basis. My sleeping schedule has become very sporatic. Like today, for example, I was up last night from 9pm until 3pm. Then I slept until 1am. And now I am up and it is 3am EST right now. The sweating definitely happens as well. I occasionally(maybe 3-4 times a week) wake up in the middle of the night with sweats. And after I wake up my hands become covered with perspiration to the point that it can (and will) actually drip from my hands. I also have a tendency to feel dizzy and have fainting spells (possibly as a result of Lexapro; its page is not very informative) and I dont know if this is increased by this combination of drugs or not.

I occasionally take Excedrin or Advil for headaches and for the last ten days Ive been taking Sudafed and Amoxiclav for a Sinus/Ear infection. There have been no other drugs used by myself since starting Wellbutrin XL.

Yes, but I was wondering where I might find information about these two drugs and their relations because I have failed to find it through google and am once again coming to Wikipedia for rescuing.

Thanks,

Lamentingvampire09 08:18, 4 November 2006 (UTC)


Lamentingvampire, mail me, and I'll try to give you a good answer. Wikipedia is not the appropriate place for this discussion, as it is an encyclopedia, not a forum or community in that sense. Zuiram 23:41, 4 November 2006 (UTC)

Bupropion vs. modafinil

Does anyone know whether the chemical structures of buproprion and modafinil have any similarities that would suggest similar behavioral/psychoactive effects? We are trying to determine if modafinil effects dopamine and/or norepinephrine systems in a manner similar to drugs like bupropion. Tribeguy13 16:35, 9 November 2005 (UTC)

Who is "we"? What is the hypothesis? JFWĀ |Ā T@lk 17:30, 9 November 2005 (UTC)
Buproprion is not really closely related to modafinil, and the behavioural and psychoactive effects are different. Modafinil affects DA and NE with a much higher Ki, and also affects histamine, oxytocin and others. Trying to determine the effects of a drug by examining its chemical structure is futile, unless you have a very good understanding of the structure of the receptor. AFAIK, none of the receptors have had their structure fully analyzed yet.
There is no need to attempt to determine the effects of modafinil on DA and NE, as it has been fairly well studied already. Have a look at the Ki-database for the constants of inhibition, and look up some of the studies for the receptor subtype specific information if that is relevant.
Zuiram 02:17, 27 October 2006 (UTC)

Side Effects

It might be better if the side effects are listed in an order of prevalence. I know that dry mouth and insomnia are two of the more common side effects, but they're listed first and last in the list.

Are the dangers Zyban/Tobacco Withdrawl only or anti-depressant usage also?
What "dangers" are you referring to? The side-effect profile should be comparable, but both smoking and depression are associated with higher morbidity and mortality than zyban/bupropion is. Zuiram 09:00, 14 November 2006 (UTC)

This site lists common and uncommon side effects: http://www.something-fishy.org/doctors/medications.php#wellbutrin --Lewie 06:54, 30 June 2006 (UTC)

Sorry but that source is worthless for this article, as it does not list the relative incidence of these side effects. A better alternative would be:
[1]
I'll put that on my todo-list. Zuiram 09:00, 14 November 2006 (UTC)

My experience with Welbutrin.

I just wanted to chime in, that while I was taking this evil (imho) drug for depression (under the care of a doctor), I experienced extremely psychotic dreams, to the point of shooting, without emotion, 2 of my closest friends in said dreams.

I may also mention, that a friend of mine, taking the same drug at the same time, with the intention of quitting smoking (under a different doctor's care also) did litterally attempt to strangle his wife (fully conscious event).

And then, I ran out of money, 2 months into using this drug, and the co-pay didn't pan out. I was unable to obtain a refill, and thus forced to stop "cold-turkey". The effect of this, for me personally, was EXTREME depression, with suicidal thoughts. To sum up my feelings, it felt like every atom of the universe harbored a strong hatred of me, and wished me to become non-existant. Perhaps this sudden removal is what triggers the suicidal tendencies of other patients, especially in the case of juveniles who fake taking the drug as a rebellious action against authority (I know I did the same with the Obatan Forte (now banned, alike adverse side effects) that was being foisted on me as a child for hyperactivity, some 25-30 years ago). Then again there may be other reasons.

I just hope anyone who is considering using Welbutrin/Bupropion reads this, and considers their lot first, and may ask their doctor for an alternative. And to those of you who are facing sudden withdrawl, or are now worried about withdrawl... well, the vile effects are extreme for the first day, and are gone in three days (at least for me they were). Just hold on, it's not going to be fun, and cling to your logic.

Zaphod http://zaphodb.dyndns.org ā€”The preceding unsigned comment was added by 69.145.40.116 (talk ā€¢ contribs) 12:28, 3 December 2006 (UTC).

Quite honestly, what you've said here sounds no more than trying to scare people into not taking Wellbutrin without realising obvious things like: Not all drugs are for all people. I believe that my HMO generally puts people on Prozac as the first try for anti-depressants if there's no reason not to. Prozac did not work for me, but I'm never going to tell anyone that they shouldn't take it because they "will" have trouble with the side effects I had trouble with (no sex drive, insomnia/horrible sleeping patterns). However, I then learned that my family has a good history with Wellbutrin, although my father had experienced an unacceptable level of feeling cotton-headed and thus no longer takes it, while my grandmother continues to take 300mg daily. I switched to Wellbutrin as soon as I possibly could and I've enjoyed some of the more positive side effects (quitting smoking was damn easy and sexual activity is far more entertaining), as well as working very well for its prescribed usage.
The suicidal tendencies in the younger set who are prescribed any anti-depressant, not just Wellbutrin, is generally attributed to the fact that the drug "fixes" them enough that they have energy to be active again, but that their way of thinking has not yet changed, thus they now have the energy to carry out suicidal plans.
Also, again you have spoken without researching: Quitting any anti-depressant cold-turkey is going to screw you over. Anti-depressants affect your brain's chemistry, which is why patients are started at low dosages and moved up to a full dosage and then the same is done in reverse when getting off of the drug. I can entirely relate that Wellbutrin withdrawal isn't fun (I've forgotten to take all of my doses or take it at all) and I'm hoping my refill arrives soon, before I run out, and that I can step back up to my normal dosage.
Taking any drug without being fully aware of the side effects is stupid and no doctor should prescribe any drug without fully discussing the side effects with the patient, including what to do if some of the drug's nastier side effects are encountered.
128.153.197.122 03:42, 13 December 2006 (UTC)
Forgive me for being devil's advocate, but why are people posting experiences? Isn't wikipedia not experience based?--69.251.145.233 00:23, 2 January 2007 (UTC)
The above comment was made by me, i forgot to login.--Neur0tikX .talk 00:24, 2 January 2007 (UTC)

Dosage?

I'm curious where the information on the dosage forms came from, because the Wellbutrin I was prescribed does not fall into any of what is mentioned (my prescription is Wellbutrin SR, 100mg, manufactured by Watson, imprint code WPI-858). Any reference/citation anywhere for that? 128.153.197.122 04:09, 13 December 2006 (UTC)

Budeprion SR Merge

I have marked that the page Budeprion SR should be merged here and a redirect set. Master shepherd 17:36, 25 December 2006 (UTC)

Bupropion and MDMA

I tried an average dose of what I knew to be pure MDMA. All my friends "Rolled" But I did not. I take 300mg of Welbutrin XL daily. PErhaps they bind to the same receptor sites. ā€”The preceding unsigned comment was added by 72.94.6.82 (talk) 06:04, 20 December 2006 (UTC).

Most likely, no. It's unlikely as Wellbutrin focuses more on the catecholamine reuptake, not serotonin. Although, if you happen to take antipsychotics such as seroquel or rohypnol it's likely that they interfered with your 'roll', so to speak. Of course, the culprit could be something completely nonpharmaceutical, MDMA interacts with the brain in a very specific way, hence, a roll can be offset by a number of things, as well as a trip. The antipsychotics also interfere with most 'trips', I believe some antipsychotics/neuroleptics are even given to persons who experience a bad trip as they interfere with the many receptors that LSD decides to erratically act on.--Neur0tikX .talk 00:29, 2 January 2007 (UTC)

Eating Disorders?

My doctors have been talking about putting me on Wellbutrin to treat my anxiety and depression. I'm reluctant to try ANOTHER medication, but hopeful at the same time because it's a completely different class of drug than they've ever tried with me before.

I'm just confused about one thing: this page says that common side effects include anorexia and bulemia. Yet I've spoken with about 5 or 6 people who have been prescribed Wellbutrin and all but one of them told me they gained weight on it. The two different doctors I've been conferring with also warned me that if I started taking it, I might experience weight gain. Only one woman I spoke with about it told me that she not only stopped smoking, she stopped eating as well. She said, "It made everything taste bad. I felt like I could taste all the chemicals and preservatives in everything, even water. I just couldn't eat and I really didn't want to smoke."

Regardless of the fact that I refuse to take anything that will make me fat (not to mention that I LOVE smoking my Newports), I'm wondering why there hasn't been anything in this discussion about this particular issue. Is that because it's not a common issue, or is it just like all the other side effects: it varies greatly from person to person? Any additional information on this subject would be greatly appreciated, as I'm supposed to start taking this stuff tomorrow morning. Thanks!

Kryssi Bee 22:56, 21 February 2007 (UTC)

Hello. Anorexia nervosa and bulimia are contraindications, meaning that bupropion shouldn't be prescribed to someone who has one of those disorders (because, as it says in the article, the patient may have a lower seizure threshold, and bupropion already carries a risk of seizures). Anorexia is also listed as a side effect, but in this case "anorexia" refers to the symptom anorexia, simply meaning decreased appetite (see anorexia (symptom)).
As bupropion is a stimulant, I don't think it makes sense for it to cause weight gain or increased appetite, rather the opposite. In the prescribing information for Wellbutrin [2], it says that on 300 mg/day Wellbutrin SR, 3% of patients in the clinical trial gained more than 5 lbs. and 14% lost more than 5 lbs. I would presume that the reason people might associate weight gain with Wellbutrin is because the tricyclics and to some extent the SSRIs (i.e. almost all antidepressants) do have weight gain as a side effect (as well as weight loss... depends on the person). But I can't see how a stimulant would cause weight gain. People's weight changes regardless of what they're taking, and everything is required to be recorded in a clinical trial. That doesn't mean it's related to the medication (indeed, the percent who gained weight on Wellbutrin is not significantly different from that on placebo). So I don't think it should be added to the article.
As for smoking, like it says in the article bupropion is also used to help people quit smoking. I've never heard anyone talk about this as a negative thing though.Ā ;)
For the article, maybe we need to clarify what "contraindications" means? --Galaxiaad 03:39, 22 February 2007 (UTC)

Supposed Banning

http://www.antidepressantsfacts.com/Bupropion-not-prescribed-in-France.htm Sentence I'm removing: Wellbutrin is also banned or restricted from use in several countries. This is the only reference I have found to Wellbutrin/Zyban being banned.. anywhere. And that's not a ban. That's France recommending it not be prescribed as an anti-smoking agent. Not only is a reference needed to make that claim, but the only hint of a reference seems to suggest otherwise. A great many sites -claim- that it is banned, but no reputable sources do, nor can I find a list of countries to suggest such. Until I see something legal and/or legitimate, I am removing this sentence. AltonBrownFTW 04:35, 10 March 2007 (UTC)

SR Bupropion and Seizures

I would argue for the removal of the part of the sentence stating that extended release formulations of bupropion were "intended to reduce the incidence of seizures".

Galaxiaad says that "it doesn't really make sense without saying the SR and XL formulations were intended to reduce incidence of seizures". I disagree for the following reasons.

The usual intent behind development of extended release formulation of drugs is to make life easier for patients, so that they have to take their medication once or twice a day instead of three times a day. This also helps to increase compliance.

The other reason for development of new formulations is so-called "brand life-time management". New formulations are intended to extend the exclusivity period for the drug on the market. They are often claimed to be better than the regular formulation, that is better than generic versions of the same drug. After the main drug patent expired, the patent for the new formulation would still be valid for several years.

This strategy worked beautifully for bupropion. The impression was created that Wellbutrin SR is not only more convenient, but also safer than the generic bupropion. As a result Wellbutrin SR was prescribed preferentially despite its much higher cost. However, the superior safety of Wellbutrin SR and XL in respect to seizures is nothing but drug representative spin. In their publications reputable Glaxo researchers are careful to state that decrease of the seizures incidence for extended release wellbutrin has never been proven clinically. ("Both the prolongation of Tmax and the decrease in the number of peak plasma levels may result in better tolerability, although this has not been formally evaluated." see Prim Care Companion J Clin Psychiatry 2005;7:106ā€“113). I contend that this better tolerability will never be proven and it is impossible to prove, taking into consideration the pharmacokinetics of Wellbutrin SR and XL (see below).

It is generally accepted that peak concentration of the drug in the blood (Cmax) is responsible for the concentration-dependent side effects (as seizures in the case of bupropion). However, the Cmax of Wellbutrin XL (300 mg once a day) is only 3% lower than Cmax of immediate release formulation (100 mg, 3 times a day) and the difference is statistically insignificant (Prim Care Companion J Clin Psychiatry 2004;6:159ā€“166). Glaxo released these numbers only recently, but of course they had known about them all along. And now you know too... Paul gene 00:12, 15 March 2007 (UTC)

Sorry, I misread the bit about immediate-release Wellbutrin. I didn't realize it was put back on the market. That's why I said it only makes sense if the sustained-release formulations were created to replace the IR with less risk of seizure. I was mistaken, though, so it's fine if you remove that bit.
However, I still have a couple questions. Did Glaxo actually claim that SR/XL were safer in their marketing, or just give a vague impression like it sounds like you're saying? If they did actually make that claim, and it's apparently not true, that may be worth saying in the article (especially the peak concentration thing; obviously "never been proven clinically" doesn't make it false).
And I don't know much about pharmacokinetics, but isn't it weird that there would be that little a difference in the peak concentration? (I mean, I guess 3 times a day would keep it pretty steady, but still...) I'm just curious. --Galaxiaad 00:41, 15 March 2007 (UTC)

Of course, Glaxo was careful to never claim outright that SR is safer only, that it "may be safer". Vague impression was sufficient in this case. It is usual tactics in pharmaceuticals sales, so it really does not deserve any mention in the article. Paul gene 09:55, 15 March 2007 (UTC)

Alcohol interactions

I recently started taking bupropion (Wellbutrin XL in fact) and one of the major items listed about it in the documentation I was given by my pharmacist was to avoid the use of alcohol. There is little about this in the article here however and alcohol isn't even listed in the "Contraindications" section. Perhaps it should be? -- UniqueCrash5 17:04, 5 April 2007 (UTC)

Alcohol increases seizure risk, as I recall. --69.124.56.44 18:59, 6 May 2007 (UTC)

Does it help against ADHD?

In Germany Amphetamines are forbitten, so would Wellbutrin be a possible medication against ADHD? --134.155.99.42 12:40, 9 May 2007 (UTC)

Do we need to have two 3-d pictures?

IMHO one of them should be removed, I do not care which.Paul gene 22:12, 9 May 2007 (UTC)

Well, the article is quite long, and images help break up the text a bit. If you feel one is redundant to the other I'd suggest keeping the space-filling model in the Drugbox and removing the second one. FvasconcellosĀ (tĀ·c) 03:59, 10 May 2007 (UTC)

--121.210.90.95 10:40, 20 June 2007 (UTC)

bupropion and sex dysfunction.

I'm thinking of trying it for sex dysfunction that I get from from my anti-psychotics. Has anyone else had it work as an augmentation to their other drugs and treat the sex dysfunction from the other drugs at the same time. I couldn't find any other studies that supported these claims, but I'm going to try it based on this. Especially if it makes me give up smoking, gives me energy, and makes me happy all from one pill. Sounds like a bit of a wonder drug. But as I said I"m mainly after it for the female sex dysfunction thing. It's not papproved for any of these uses in my country, not even an nati-depressent but I'll pay I suppose...

Also there was something about it treating schizo-affective dissorder - isn't that really similar to schizophrenia, does anyone know what it's effects are on schizophrenia aside from being recommended for their chronic smoking habits? I'd like to see more info on this and more back up for the sex dysfunction claims - I can't find one other site that supports this claim or says it's any better than the placebo - however I'll let the whole world know witha loud sexy scream if it works on me as I've been tolerating this problem from my anti-psy's for a long time.

--121.210.90.95 10:41, 20 June 2007 (UTC)

What do you mean you want to see more? Is 13 references to peer reviewed medical journals not enough? As the article says, there are positive and negative studies, all of them are small, so there is a degree of uncertainty even about the SSRI-bupropion augmentation. There have been no studies with bupropion for sexual dysfunction caused by antipsychotics. Paul gene 01:30, 9 July 2007 (UTC)

uhuh Paul yeah no worries, I did an independant search in google and didn't find much that's all I mean. Perhaps they are indeed in your references anyway trial and error see my next post.

I've recently been perscriped this drug (300 mg) for social anxiety disorder. For years prior I took Effexor, and it worked well, but I all but completely lost my sex drive. This drug has no ill-side effects for sex dysfunction that I can see. It works almost as well as the previous drug did with no negative sexual side effects. Good luck. Striker64 14:08, 3 July 2007 (UTC)

bupropion and sex dysfunction #2

Well I got hold of some bupropion. And almost immediately it does indeed seem to be curing my sex dysfunction which is caused by the haloperidol I'm taking. For the first time in almost four years I am having physical sexual sensations again. It also gives me a little lift in spirits and wakefulness I think which is also good for cancelling out side effects from haloperidol. I've got my fingers crossed I can remain on it and it can pose the long term solution as I have a necessity to take the haloperidol really. Other anti psychotics are just as bad or worse than haloparediol in terms of side effects and out of all of them it's most suited, but the sex dysfunction was the bain of my existence. Currently thinking bupropion is the next best thing since sliced bread and will update this in a few weeks to say whether it seems to be still having the positive effects and that it hasn't posed heart problems skin rashes or any other side effects that prevent me being able to have it. It's $75.00 per month but I'm worth it! I mean it's a shame to have to take psychiatric drugs at all but as far as they go I am pretty tolerant of bupropion so far. Sex functioning is just a little pleasure even alone in private, which you don't want to give up when you're already having a hard time with health issues, and to me may well mean the difference between seeking out a bf in life or being almost completely socially isolated and lonely. I had really serious impotence and it's like having a whole other dimension of experience back again. I don't mean to sound like an advert but more women and possibly men with sex dysfunction need to try this drug to test if it can help them too. This drug has been around the whole time I've had this problem and I wish I'd known about it before. As it was I found the answer on here and had to suggest to my sex physician to prescribe it to me. In a few weeks once I can base it upon a fair trial I'm going to tell her the good news and perhaps she can help more people with it too. As I may be the first person whose tried it for this purpose in Australia I think. Thumbs up so far so good. Looking forward to more good news about this drug hopefully. Thank you for the info wikipedia. Still wanting more info on it's effects on schizophrenia, as I noticed it is being researched for schizo affective disorder which is pretty similar isn't it to schizophrenia, it'd be great if it even became the one drug I needed to take for all my problems as it's just more pleasant than the anti-psy's. Purrin --121.210.91.91 01:32, 12 July 2007 (UTC)


Request

It would be great if someone with access to the full text of PMIDĀ 2500425 and PMIDĀ 6406457 could have a read. The first, particularly, appears to be a landmark article regarding the incidence of seizures with bupropion treatment and how it relates to dosage, and both could be used to cite the History section. FvasconcellosĀ (tĀ·c) 15:58, 18 August 2007 (UTC)

J Clin Psych has online archives only beginning from 1996, so someone has to physically go to the library. The review (see seizure part) and prescribing information give a good enough impression of the seizure liability of bupropion. You can refer to the prescribing information.Paul gene 18:31, 18 August 2007 (UTC)

OK, thanks. FvasconcellosĀ (tĀ·c) 00:33, 19 August 2007 (UTC)

Why just these brand names?

The intro of this article says: "marketed as Wellbutrin, Zyban, Voxra, Budeprion, Prexaton or Aplenzin;" Why is there no mention of "Elontril" considering that there is a big market in Germany, whereas "Voxra" (Finland and Sweden) is included here? ā€” Preceding unsigned comment added by 84.58.239.29 (talk) 11:47, 16 September 2012 (UTC)

Make the lead part shorter

The unnecessary inclusion of dosage, adverse effects and availability information overloads the lead part. It also repeats the corresponding parts of the article. I suggest removing the following from the lead:

"In the United Kingdom and Australia, it is only licenced to assist in its cessation of smoking function. The regular dose for treatment and maintenance therapy in clinical depression is 300 mg daily, though doses of up to 450 mg daily may be prescribed by a physician. 150 mg is the daily dose used in the treatment of nicotine dependence.

Common adverse effects include dry mouth, nausea, insomnia, tremor, excessive sweating and tinnitus. Rarer but more serious is the potential for seizures as bupropion lowers seizure threshold and thus caution is advised in situations where they are more likely to occur. Bupropion is not considered dependence-forming, nor is there evidence of increased suicidal behaviour occurring with its use."Paul gene 18:35, 18 August 2007 (UTC)

Paul - the reason I put it in is that the lead is supposed to summarise the salient points of the article - i.e. you could have a quick squiz at the lead and see all you needed to know of high importance at a glance. Most articles at FAC have this approach and I fear that if shortened again there will be a cry for a longer one. I've not been on this article long but it is a tricky one to fingure what should go where in placesĀ :) cheers, CasliberĀ (talkĀ Ā· contribs) 22:27, 18 August 2007 (UTC)

OK. I'll try to shorten it based on WP:Lead guidelines "The lead should be capable of standing alone as a concise overview of the article, establishing context, summarizing the most important points, explaining why the subject is interesting or notable, and briefly describing its notable controversies, if there are any. The emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources. The lead should not "tease" the reader by hinting at but not explaining important facts that will appear later in the article. It should contain up to four paragraphs, should be carefully sourced as appropriate, and should be written in a clear, accessible style so as to invite a reading of the full article."Paul gene 12:13, 19 August 2007 (UTC)

I don't have strong opinions on it either way really so we'll see how it flies..cheers, CasliberĀ (talkĀ Ā· contribs) 13:07, 19 August 2007 (UTC)

Indications for Australia

I suggest removing the Australia part from the following sentence in the History: "In the United Kingdom, bupropion was approved as a smoking cessation aid in 2000, but has not been approved for the treatment of depression;[7] a similar situation exists in Australia." Until somebody finds the reference.Paul gene 18:37, 18 August 2007 (UTC)

I am sorry I didn't get the ref right off but it was late and I was tired. Also I am busy off-keyboard for alot of today. I left it there as there needs to be some global summary of how it is used elsewhere - thus mention of use of other countries will need to be reffed and included prior to FAC being successful - otherwise the article is USA-centric. I'll put a fact tag on it until thencheers, CasliberĀ (talkĀ Ā· contribs) 22:30, 18 August 2007 (UTC)

Comprehensiveness

In order to be fully comprehensive a number of things need to go in:

  • Australia & Europe - licencing indications included and reffed.
  • Mention of concern about associated psychosis and evidence addressing same.

(Others...?)cheers, CasliberĀ (talkĀ Ā· contribs) 22:42, 18 August 2007 (UTC)

I've added a brief reference to its introduction in Australia for smoking cessation, and rephrased the sentence slightly. Not sure if more should be added or not.
I also added information on the associated psychoses to the 'side effects' section. That pretty much came straight from the manufacturer's information. Dr. Cash 23:41, 18 August 2007 (UTC)
Great -I'll hunt around later in some other stuff I have but gotta run now..cheers, CasliberĀ (talkĀ Ā· contribs) 23:53, 18 August 2007 (UTC)
Is this any help? FvasconcellosĀ (tĀ·c) 01:06, 19 August 2007 (UTC)
Sorted! OK well done everybody...would be great if we could get some stuff on licencing in some European countries (sorry to be a pain..). I think we've got the content right, now the prose....cheers, CasliberĀ (talkĀ Ā· contribs) 07:52, 19 August 2007 (UTC)

WP:MEDMOS

I've boldly shifted the sections around for better compliance with WP:MEDMOS. As a guideline, MEDMOS is not set in stone, but I do think the article flows better now. If anyone wishes to revert and discuss, please do! FvasconcellosĀ (tĀ·c) 01:06, 19 August 2007 (UTC)

I moved the 'abuse liability' section down to the bottom, as I feel that there are other sections, like 'mechanism of action' and 'pharmacokinetics', are more important. I also moved the 'overdose' information out of its own section and back into the 'dosage and forms' section, as it really falls under that section. There's no reason for it to be separate. Plus, having several sections in between 'dosage' and 'overdose' really doesn't make sense at all. Yes, I am aware that there is an 'overdose' section in the medical MOS, but I feel that that is an error; (a) there's no section there called 'dosage' or 'dose', just overdose; (b) I think that the order of the sections that they are suggesting for drug articles could be improved. I'll look at this more later, but I would suggest revising the manual of style, at a minimum, to change 'overdose' to 'dose' or 'dosage'. Dr. Cash 07:25, 19 August 2007 (UTC)
Agree with both above. cheers, CasliberĀ (talkĀ Ā· contribs) 07:49, 19 August 2007 (UTC)
Well, there has been some discussion re. not allowing dosage information to be included at all, as it is easily subject to uninformed good-faith edits; MEDMOS currently discourages adding such information altogether. I agree that may be excessive, but this should probably be taken up at the guideline Talk page. FvasconcellosĀ (tĀ·c) 13:34, 19 August 2007 (UTC)

Trade names

Would anyone object to the "Trade names" section being renamed "Availability" so we can expand a bit with licensing/history information from other countries? FvasconcellosĀ (tĀ·c) 13:49, 19 August 2007 (UTC)

Hmm, on having second thoughts of the dosage/overdose issue which I reverted, I started thinking about the dose issue per WP:MEDMOS. One of the possibilities I thought of myself was renaming the section to something like 'availability' (merging 'dosage and forms' and 'trade names'), so as to primarily cover the different forms and brands covered and such. Then, the 'overdose' information could be moved into its own section. Dr. Cash 19:53, 19 August 2007 (UTC)
I've just moved this content, merged with 'trade names', and re-created the 'overdose' section. Still uncertain specifically where to put 'overdose' -- for now, I put it after 'adverse effects', but I'm open to suggestions here. Dr. Cash 20:08, 19 August 2007 (UTC)
Looks good. I'll move some of the "History" content into "Availability" and see if I can get some more international information. FvasconcellosĀ (tĀ·c) 20:09, 19 August 2007 (UTC)

It might also be useful to include some info on relative pricing of the two labels the generic is sold under, generic for Wellbutrin and generic for Zyban. I have found the pricing to vary 2.5:1 with the Zyban generic being the cheaper. I think this is a significant aspect of this drug. It seems like "Availability" would be the right section to include this in. ā€”Preceding unsigned comment added by Gnuarm (talk ā€¢ contribs) 18:37, 28 December 2009 (UTC)

I've removed the following two links from the external links section of the article:

They're largely redundant, and talk more about quitting smoking than bupropion itself. Plus, it really borders on linkspam. This article is about the drug bupropion, which does have one effect of lowering the urge to smoke, but it's still not about 'quitting smoking', so these links are irrelevant. Dr. Cash 16:48, 21 August 2007 (UTC)

Agreed. FvasconcellosĀ (tĀ·c) 16:52, 21 August 2007 (UTC)

Disagree!! although they need not be added back in, bupropion in the U.S. was marketed as Zyban, specifically for the purpose of quitting smoking, the only non-nicotene medication approved by the FDA for this purpose. This was a matter a some confusion for consumers, because GlaxosmithWel. marketed Wellbutrin and Zyban seperately as two brand names for same medication: bupropion for two different purposes, Wellbutrin (in higher dose pills) for depression and Zyban (lower dose pills) for quitting smoking . The main complaint I have is that apparently "Dr.Cash" threw the accusation of "almost linkspam" before researching it! Bupropion sold as Zyban has been out since the '90s at least. Hopefully better links to Bupropion as Zyban will be found, but please don't arbitrarily remove links without actually READING the entire articles!!! Cuvtixo (talk) 01:04, 22 December 2007 (UTC)

I'm sorry, but I have seen these specific two links (saw them back in August as well) and I really don't think they are helpful; that is, I don't think they add anything to the article. Besides, they provide links to objectionable commercial websites (online pharmacies). FvasconcellosĀ (tĀ·c) 01:15, 22 December 2007 (UTC)

A few questions - hope someone can light some insight

The following is an archived discussion of a featured article nomination. Please do not modify it. Subsequent comments should be made on the article's talk page or in Wikipedia talk:Featured article candidates. No further edits should be made to this page.

The article was promoted 21:28, 30 August 2007.

Bupropion

I think this is what you would call a "Featured Article Status", I am thus nominating it, so that it becomes official. Anyways research wise I like this chemical a lot, so if it is not at "FA level" yet, I will improve it based on the comments received I have done like just 4 edits after the FA review started. I am sorry. --Savedthat 03:17, 14 August 2007 (UTC)

I have seen those rules you mentioned, but I cannot connect the dots, what exactly is this article not following? I have decided to go straight to FA candidate because it has a more stringent review system. Thus, I can start doing additional research immediately on this substance if it does not meet criteria.--Savedthat 04:23, 14 August 2007 (UTC)
The article is head and shoulders above most pharm articles, but ... Bolding is used where it shouldn't be, the lead could be expanded to a compelling, stand-alone summary of the entire article, there is incorrect use of hyphens where endashes are needed, all numbers and units of measurement need non-breaking hardspaces, there's a citation in a section heading, you should explain your use of trade names (see the footnote at Tourette syndrome), and section headings don't conform with WP:MEDMOS. Each citation that is not to a journal-published source should be scrutinized to see if it can be replaced with refereed sources. External links can probably be pruned per WP:EL, WP:RS, WP:NOT; is there anything there that can't be found in the DMOZ link or in the article and its sources? If so, the article may not be comprehensive. FvasconcellosĀ (talkĀ Ā· contribs) is familiar with pharm articles and FAC; he might be willing to help out. (Speaking of comprehensive, I don't find the words tic or Tourette syndrome in the article.) SandyGeorgia (Talk) 04:18, 14 August 2007 (UTC)
I've been looking for a sample article to guide you, but I'm afraid you're blazing new territory. Antioxidant is the most recent FA, but it's not a class pharmaceutical, so isn't really comparable. Neither is caffeine. Paracetamol is a very old FA, probably doesn't meet current standards, and needs review. So, there isn't really a pharm FA to compare to, but TimVickersĀ (talkĀ Ā· contribs) could help you prepare for WP:GAC. SandyGeorgia (Talk) 04:29, 14 August 2007 (UTC)

Oppose. Poorly written and MOS breaches.

  • MOS breachsā€”hyphens/dashes; why are simple years linked? Read MOS on linking.
  • compared with for contrasts.
  • "have confirmed efficacy of bupropion"ā€”"the" is missing

And tons more. Tony 10:14, 14 August 2007 (UTC)

Anyway, here we go:
  • The "History" section is excellent, way above average for pharm articles. It is asking for references, though; they shouldn't be too hard to find.
  • The article is quite heavy on stats; this is not a bad thing, but more prose would make it more readable. There are a lot of parenthetical statements throughout. It would be nice to rewrite some of these; get crazy with em dashes.
  • "Pharmacokinetics" is quite technical. I've no problem with it but it is probably above the lay reader. It also took me a couple of seconds to get acquainted with the metabolites table; its syntax could perhaps be improved to make it... prettier?Ā :)
  • "Availability in the UK" should be expanded to "Availability" with country-specific subsections as needed; I hate to toot my own horn, but Orlistat does a good job of this. The list of trade names could go in as a subsection of "Availability" as well; making it two- or three-column, if possible, would help readability.
  • "only if you are able to get a letter from a smoking cessation clinic to your GP"... Second-person writing is a no-no.
  • IMHO there's nothing in "Additional information" which couldn't be rearranged within the rest of the article. "Overdosage" doesn't fit in with "Availability"; it could be a stand-alone section or go with Adverse effects.
There's more to come, but I'm off to lunch nowĀ :) Will see what else I can do later. Best, FvasconcellosĀ (tĀ·c) 15:35, 14 August 2007 (UTC)

Comments:

  • The smoking cessation paragraph under indications should be improved using the later cited cochrane review on antidepressants for smoking cessation.
  • Should a study showing equal effectiveness as placebo be included in the article?
  • The number of prescriptions in one specific year in one specific country does not belong to the lead section I think.
  • History: withdrawal from market, was this in the U.S. only or worldwide?
  • The suicide risk section should start with objective information about the suicide risk, not with "the FDA requires...".

--WS 18:34, 14 August 2007 (UTC)

Comments - go for it - this one is doable. Main thing is that WP is an encyclopedia not a pharmaceutical info pamphlet- so the prose should be richer. I am happy to help with copyediting. Only thing of substance I can't see so far is that it has a reputation for benig psychotogenic (at least in Australia) so evidnce refuting or supporting that would be importand.cheers, CasliberĀ (talkĀ Ā· contribs) 04:55, 16 August 2007 (UTC)

Comments Overall, I think this is one of the best drug articles I've seen on Wikipedia yet! I think it covers the topic quite well, is well-referenced, and interesting to read. I've made a couple of minor changes to the article. A couple of things still remain. Here's my detailed comments:

I am reviewing this version of the article.
The lead is a bit short. It should be a concise summary of the article. As a summary, it should ideally not contain any references (inline citations would be placed on the material later in the article that is being cited). WP:LEAD can help in this regard.
I like the indications section, as it is written out in reasonably good prose and not just a list, like a lot of other drug articles. This provides an excellent example for others to follow.
The metabolism image in the pharmacokinetics section seems a bit odd, with the drug on the right and the metabolites pointing back to the left. I would think that it should be the other way around. Also, the quality of some of the lines in the sketch seems a bit choppy. What chemical software was used to create it?
The pharmacokinetics section seems a bit crowded with the image and the table right next to each other. Perhaps the table could be moved to the bottom of the section, after all the text?
References are only indicated for one of the three bullet points under 'dosage'. With specific dosage information provided, a reference should be there.
While the colorful table in the 'availability in the UK' section looks nice and all; (a) it is unreferenced and (b) I am uncertain exactly what it is contributing to the article? It seems to go a bit beyond the purpose of an encyclopedia to provide a listing and descriptions of each of the different pills of the drug; you can look up ā€” perhaps a far more accurate version ā€” on the manufacturer's official website. Plus, is the table specific to the UK? Where's the US version? I would recommend removing this section, and possibily moving the text at the beginning to another section of the article, and finding a reference for it.
"Recently, addition of bupropion to a mood-stabilizer in patients with bipolar depressions was shown to have the same effectiveness as placebo." -- This statement should probably be integrated with a different section. It seems out of place in its own brief subsection under 'additional information'. Once it's removed, I'd recommend renaming the main section to 'trade names' and removing the identically-named subsection.

Dr. Cash 06:07, 16 August 2007 (UTC)

[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], & [34], thank you Derek.cashman; and here [35] & [36], thank you Outriggr --Savedthat 05:10, 17 August 2007 (UTC)

  • "The lead... should ideally not contain any references" ā€” Dr. Cash (Derek Cashman)
With respect, I don't think that this is correct. Look at Wikipedia:Lead section#Citations in the lead section. This indicates that references in this section are less important (because appropriate references should be present later in the article); "there is not, however, a citation exception specific to leads". Axl 20:34, 17 August 2007 (UTC)
The lead must conform to verifiability and other policies. In particular, material likely to be challenged and quotations should be cited in the lead. --Savedthat 21:19, 17 August 2007 (UTC)
Thanks for correcting me on that. I often think of the lead section in wikipedia as similar to a scientific abstract, which should not contain references. Wiki does take a stand similar to this, but does not explicitly prohibit references in the lead. Dr. Cash 00:01, 18 August 2007 (UTC)
  • Savedthat, thank you for noting my contribution above. However, copyediting is not "done"ā€”the article needs quite a bit of work in this area, and I've done maybe half of it so far. I am willing to continue if there are others also engaged in improving this to FA status. ā€“OutriggrĀ Ā§ 07:27, 18 August 2007 (UTC)
FYI, I've finished my contribution to the copyediting of this article... there is always room for improvement, but I feel it's in much better shape than it was, with the efforts of a number of us. ā€“OutriggrĀ Ā§ 08:53, 19 August 2007 (UTC)
  • Round 2 of copy editing has been done here [47], [48], & [49] thank you Outriggr; and here [50], [51],

[52], [53], [54], [55], [56], [57], [58], [59], [60], [61], [62], & [63], thank you Derek.cashman; and here [64], [65], [66], [67], [68], [69], [70], [71], & [72], thank you Fvasconcellos; and here [73], [74], & [75], thank you Casliber --Savedthat 11:50, 18 August 2007 (UTC)

  • Note on Comprehensiveness - before this can pass, some work needs to be done on comprehensiveness. Rather than clog the page here I am leaving items on the talk page - they are a deal-breaker for me anyway so m vote is currently Oppose for the record but we are really nearly there (nice rhyme ain't it?) and I am close to supporting. The end is in sight.cheers, CasliberĀ (talkĀ Ā· contribs) 23:03, 18 August 2007 (UTC)
  • I'm close to Supporting. The article has improved a lot, particularly with regard to referencing and thanks to copy editing efforts. There are still a few minor (dashes and WP:MOSNUM) and not so minor (a few under-referenced paragraphs) obstacles, but I think this is a strong candidate. FvasconcellosĀ (tĀ·c) 01:14, 19 August 2007 (UTC)
  • Support. The article has come a long way, and, as Casliber says below, I think we're "over the line". Any remaining concerns of mine are minor, and don't stand in the way of an FA pass. FvasconcellosĀ (tĀ·c) 03:22, 22 August 2007 (UTC)
  • Weak Support: the content is impressive, but there seems to be something missing. Perhaps it is the structure of the content. I'm not greatly troubled by the quality of the prose as others are; it's really a matter of susbtance for me. Maybe it's the nature of the subject matter but the content doesn't seem to interlink between sections 100%. But all said I'm still voting support because it's very comprehensive and well-researched. Manderiko 08:38, 19 August 2007 (UTC)
  • Support - I think we're over the line; in terms of sources I think the best has been done from what reliable sources are available and the prose has much improved. cheers, CasliberĀ (talkĀ Ā· contribs) 04:58, 20 August 2007 (UTC)
  • Support - I really like the direction this article has gone over the past couple of days, it has improved a lot. While I may not be as reliable on the copyediting and manual of style perspective as far as FA status goes (I'll defer to other reviewers there), from a scientific standpoint, I think the article is very complete, well referenced, and well written. Dr. Cash 07:11, 20 August 2007 (UTC)


  • Comments regarding Neutral Point of View:


If it is nicotinic antagonist it will make people smoke more to get the same effect. I read some journal article that states when Bupropion is taken in higher doses it makes people smoke more.

Actually, it is postulated that nicotinic antagonists, such as mecamylamine (and to a lesser extent bupropion), reduce the urge to smoke by preventing nicotine from doing its thing. I can't find any such article; do you mean this small study, which used acute, therapeutic doses? FvasconcellosĀ (tĀ·c) 01:58, 23 August 2007 (UTC)
Yes thats the study I was referring to...It makes no sense: increasing the dose of Bupropion has an opposite effect in regards with smoking cessation? --1ws1 02:03, 23 August 2007 (UTC)
Fvasconcellos pretty much has it right. To be specific, bupropion is a competitive antagonist of the [acetylcholinergic] nicotinic receptor. What this means is that it binds at the same active site as nicotine and prevents nicotine from interacting there. So in other words, smoking cigarettes or obtaining nicotine in other ways prevents it from having any effect at its normal site, so it effectively neutralizes it. Dr. Cash 05:49, 23 August 2007 (UTC)
Bupropion is a non-competitive antagonist of nicotinic receptors. See the article. Still prevents nicotine from acting, though.Paul gene 03:48, 25 August 2007 (UTC)


  • "Bupropion improved ratings of "energy", which had decreased under the influence of the SSRI; also noted were improvements of mood and motivation" & "Bupropion is more effective than SSRIs at improving symptoms of hypersomnia and fatigue in depressed patients."

I have the opposite reaction when I take Bupropion. I sleep for hours straight. Aren't there any studies that say Bupropion makes people drowsy?

Agitation is far more common than drowsiness with bupropion. In clinical studies, there was no difference in the incidence of drowsiness between bupropion and placebo. FvasconcellosĀ (tĀ·c) 01:58, 23 August 2007 (UTC)
Bupropion shouldn't cause drowsiness in patients; it's properties as a dopamine reuptake inhibitor should give it an effect similar to other stimulating drugs, such as cocaine, methamphetamine, ritalin, etc. If bupropion is making you "sleep for hours straight" and makes you drowsy, I would think that you might be experiencing an interaction with another drug, or bupropion may just not work with you (drugs do have different effects on different people -- see pharmacogenomics). Anyway, it almost sounds more like you're seeking medical advice than responding to the article, so if you're still having drowsiness issues, I would suggest that you consult your physician. Dr. Cash 06:03, 23 August 2007 (UTC)


If increasing the levels of dopamine & serotonin in the brain via Bupropion & Citalopram (Celexa) can cure depression, reducing the levels of dopamine & serotonin via Zyprexa can cure bipolar depression?

It's not that simple, particularly regarding the word "cure"Ā :) Long story short, olanzapine is prescribed to treat the manic part of bipolar disorder, usually in conjunction with an antidepressant. FvasconcellosĀ (tĀ·c) 01:58, 23 August 2007 (UTC)
If they take anti-depressants along with anti-psychotics the levels of the dopamine & serotonin will remain the same as before as the medicines are now contradicting themselves! --1ws1 10:08, 24 August 2007 (UTC)


  • Bupropion being a dopamine reuptake inhibitor increases the level of dopamine in the brain right? So are there studies for Bupropion to treat Parkinson's disease which is caused by low levels of dopamine?
A single 1984 study found bupropion to be mildly effective in Parkinson's, though side effects limited its utility. I don't have access to the full text, so I don't know whether or not it's even worth a mention. (Good study design, relevance etc.) FvasconcellosĀ (tĀ·c) 02:02, 23 August 2007 (UTC)
Very poor study, claims to be double-blind but no protocol is described. Very poorly written, almost incomprehensible. I relegated it to a footnote in the article.Paul gene 04:34, 25 August 2007 (UTC)


  • Studies on the drug Modafinil (Alertec) have shown it to inhibit the reuptake of dopamine and, more potently, norepinephrine. While the co-administration of a dopamine antagonist is known to decrease the stimulant effect of amphetamine, it does not negate the wakefulness-promoting actions of modafinil.

What was my question again....I forgot... I probably have ADHD....lol--1ws1 01:08, 23 August 2007 (UTC)

I'm not sure this is relevant to the bupropion article, but I believe antipsychotics like Zyprexa are prescribed to treat the manic part of bipolar disorder. A lot of bipolar patients also take an antidepressant.
A friend of mine also reported sedation with bupropion. Can't find anything about it, but I'm not very good at searching for journal articles. --Galaxiaad 01:45, 23 August 2007 (UTC)
There are bound to be idiosyncratic reactions to any drug. I know of a person who gets very irritable and anxious from benzodiazepines.Paul gene 03:48, 25 August 2007 (UTC)



  • Oppose, not there yet, not comprehensive, not necessarily neutral, although it can certainly make it with a bit more attention. Wikipedia has to take care not to be an advertisement for smoking cessation or for GlaxoSmithKline. It doesn't appear that PMIDĀ 17685748 has been factored into the article at all. Causality and comorbidy of smoking with psychiatric disorders have to be sorted out relative to claims that the medication aids in smoking cessation. Whether the bupropion is actually treating underlying psychiatric disorders (ADHD, dpression) that lead to increased smoking, and reduces smoking indirectly via treating other underlying disorders, has not been addressed here. There are also case reports of tic exacerbation in patients on bupropion, which has not been mentioned. We shouldn't downplay side effects of medications or overplay their efficacy. Better attention to wikilinking or definitions is also needed; example onlyā€”it appears that Wiki has no article defining "placebo-controlled", so things like that need to be defined for laypersons who may not understand the significance (alternately, an article on placebo-controlled studies needs to be created). Please run through again and make sure all technical terms, not familiar to a layperson, are linked or defined. SandyGeorgia (Talk) 12:45, 24 August 2007 (UTC)
    • Wow, that's a very recent study. Regarding "Whether the bupropion is actually treating underlying psychiatric disorders...", we need to be very careful not to wander into OR territory, but I don't have to tell you thatĀ :) Is PMIDĀ 8428875 a good enough analysis of tic exacerbation? It's a case series and quite dated, but seems appropriate. Perhaps someone more adept at analysing the literature (hint, hint) could help outĀ :) FvasconcellosĀ (tĀ·c) 13:04, 24 August 2007 (UTC)
The article is not an advertisement for bupropion for smoking cessation. Equal efficacy of nicotine patch is pointed out. The fact that the new medication varenicline is more effective is also noted in the article. Paul gene 04:34, 25 August 2007 (UTC)
The article is not an advertisement for GSK. Personally, I hold a very dim view of GSK, but it has nothing to do with the fascinating pharmacology of bupropion. Please give examples to correct.
PMIDĀ 17685748 is included now.Paul gene 04:34, 25 August 2007 (UTC)
Bupropion is specific for smoking cessation and does not simply treat a possible underlying depression. Results of trials of other antidepressants such as SSRIs (four trials of fluoxetine, one of sertraline and one of paroxetine), venlafaxine and moclobemide for smoking cessation were all negative. See the Cochrane Database review reference in the article.Paul gene 04:34, 25 August 2007 (UTC)
Tics have been reported only in children treated with bupropion for ADHD. Bupropion should not be used in children according to the recent FDA guidelines. And I do not believe anybody uses it in the USA. So the issue of tics is moot.Paul gene 04:34, 25 August 2007 (UTC)
I've struck my Oppose since both of the items I was concerned about have been added, but the commentary above is surprising. Perhaps I'm misunderstanding since the way you interspersed your comments is confusing, but are you really saying that 1) bupropion isn't used in the US, 2) bupropion isn't used off-label in children, and 3) tic exacerbations are moot in a med used often to treat ADHD, considering the high comorbidity between ADHD and tics? <scratching my head ... as long as the article is accurate ... but these certainly are not moot points. Wiki pharm articles have to be comprehensive, and that means common off-label uses have to be considered.> SandyGeorgia (Talk) 23:00, 26 August 2007 (UTC)
O-ops, stupid mistake. Let me re-write incorporating the answer to your objections. Tics have been reported only in children treated with bupropion for ADHD, not in adults. Bupropion should not be used in children. Since 2004, it is not simply an off-label use, it is the use of the drug in a population where it is contraindicated. While it is possible that a very small number of psychiatrists would still use bupropion in children with depression as a drug of the last resort, it is inconceivable and highly improbable that anyone would use it for ADHD in children, since bupropionā€™s efficacy in children with ADHD has not been demonstrated. (In the largest double-blind study conducted bupropion was not better than placebo, for the review see PMIDĀ 9554326). Thus, bupropion for ADHD in children is in no way a common off-label use, and it is not necessary to include the tics issue in the article. By the way, do you think I should add to the article that bupropion is not efficacious for ADHD in children?Paul gene 01:28, 27 August 2007 (UTC)
I linked the article to placebo and blind clinical studies. The two latter articles contain explanations sufficient for understanding the concept of double-blind placebo study.Paul gene 04:34, 25 August 2007 (UTC)


      • Recent, but a well-established phenomenon (something I happen to know because of the issue of self-medication with nicotine in Tourette syndrome); there probably is data to sort that out without getting into OR. If someone does the research and tells me there's no data, I'll strike, but there has been a lot of work on this concept with TS, so I strongly suspect there should be something. If the drug is actually treating underlying depression or attention deficit, it may not actually be acting as an effective smoking cessation medā€”did the studies showing that it helps with smoking cessation control for comorbid psychiatric disorders? Someone has to dig up the research, or convince me there is none; if they haven't controlled for other disorders, that needs to be sorted out somehow, if there's any literature. Similar on exacerbation of tics; people with TS won't touch the stuff because it has that rap. Is the exacerbation actually due to the natural waxing and waning of tics, and do controlled studies show bupropion increases tics no more than placebo (as in the case of stimulants as discussed at Treatment of Tourette syndrome? I really don't know; I don't follow bupropion studies as closely as I follow the stimulants, because people with TS avoid the stuff. ) SandyGeorgia (Talk) 13:48, 24 August 2007 (UTC)
        • Ps, on the hint hint, I would if I knew where to find these answers or if I had free full access to journal articlesā€”I don'tā€”and I'm up to my eyeballs trying to salvage Asperger syndrome at FAR right now. At least I can point others in the direction to look. SandyGeorgia (Talk) 13:50, 24 August 2007 (UTC)
          • I thought of another idea that might help you track this down: are there trials of smoking cessation comparing bupropion to methylphenidate or other stimulants, or SSRIs? If the bupropion is actually working to control smoking because it's addressing self-medication of underlying psychiatric disorders via nicotine, we'd expect to find success in other medications that treat those conditions and comparisons between the types of medications. I just want us to take care in presenting it as a smoking cessation med without a full investigation of other studies; if it's actually working by treating self-medication of underlying conditions like depression or attention deficit, Prozac or Ritalin is probably cheaper, and we shouldn't become an "advert" for Wellbutrin. SandyGeorgia (Talk) 14:32, 24 August 2007 (UTC)
Bupropion is specific for smoking cessation and does not simply treat a possible underlying depression. Results of trials of other antidepressants such as SSRIs (four trials of fluoxetine, one of sertraline and one of paroxetine), venlafaxine and moclobemide for smoking cessation were all negative. See the Cochrane Database review reference in the article.Paul gene 04:34, 25 August 2007 (UTC)
While I haven't been able to find evidence in the literature that suggests that the smoking cessation mechanism works by treating self-medication of underlying conditions like ADHD or depression, this paper (PMIDĀ 12044800), published in 2002, does challenge the earlier research that bupropion is a nicotinic antagonist. The findings indicate that bupropion exhibits a similar overall feeling as nicotine, but works by a different mechanism of action that doesn't involve inhibition of the nicotinic acetylcholine receptor. Dr. Cash 02:54, 25 August 2007 (UTC)

The link does not work, please provide a formal citation or PMID Thank youPaul gene 04:34, 25 August 2007 (UTC). OK. This paper does not present a problem. That study was done on rats. As pointed out in the article, "As bupropion is rapidly converted in the body into several metabolites with differing activity, its action cannot be understood without reference to its metabolism." And "There are significant interspecies differences in the metabolism of bupropion, with guinea pigs' metabolism of the drug being closest to that of humans.[74] Particular caution is needed when extrapolating the results of experiments on rats to humans since hydroxybupropion, the main metabolite of bupropion in humans, is absent in rats.[75]" In mice bupropion does antagonize the behavioral action of nicotine (ref [2] in the article). Later, the authors of the paper you quote (PMIDĀ 12044800), found that some metabolites of bupropion antagonize nicotine's action in rats acting through nicotinic receptors, and some partially substitute for it, probably acting through the NE and SER uptake inhibition (see ref 81). Also look at the receptor inhibition data in the Table 1. The bottom line is, if you see a study of bupropion in rats, disregard it - the researchers did not do their homework.Paul gene 12:32, 25 August 2007 (UTC)

Two issues are troubling me. There is a very high rate of comorbid tics in ADHD (and vica-versa as well), so the issue of tic exacerbation when bupropion is used to treat ADHD needs to be addressed. I don't have the full-text of the Spencer study Fvasconcellos mentioned; I've only seen reference to it in other journal reviews. And, the statement in PMIDĀ 17685748 that stimulant use affected smoking but bupropion didn't raises the question of what's being treated. If there's no data, there's no data, but I wanted to make sure someone looked into this (and can the new study be incorporated?). Will someone pls ping me when these are resolved so I can strike?? Thanks, SandyGeorgia (Talk) 03:01, 25 August 2007 (UTC)
PMIDĀ 17685748 is included now. Drop a note on my user page if you need more detailsPaul gene 04:41, 25 August 2007 (UTC)
  • According to my experience, while taking Celexa a SSRI medication was more useful in smoking cessation. (While not taking Wellbutrin) Seriously, have the scientist done studies on this subject? --1ws1 17:53, 24 August 2007 (UTC)
Yes they did. Bupropion is specific for smoking cessation and does not simply treat a possible underlying depression. Results of trials of other antidepressants such as SSRIs (four trials of fluoxetine, one of sertraline and one of paroxetine), venlafaxine and moclobemide for smoking cessation were all negative. See the Cochrane Database review reference in the article.Paul gene 04:41, 25 August 2007 (UTC)
  • Also regarding "If bupropion is making you "sleep for hours straight" and makes you drowsy, I would think that you might be experiencing an interaction with another drug, or bupropion may just not work with you (drugs do have different effects on different people -- see pharmacogenomics). Anyway, it almost sounds more like you're seeking medical advice than responding to the article, so if you're still having drowsiness issues, I would suggest that you consult your physician." Perhaps, Fvasconcellos can provide the relevant studies which show that "In clinical studies, there was no difference in the incidence of drowsiness between bupropion and placebo.", please? --1ws1 18:00, 24 August 2007 (UTC)
  • One more request to Fvasconcellos, can you provide that study you were talking about regarding Wellbutrin & Parkinson's disease, please? --1ws1 18:03, 24 August 2007 (UTC)
There's a couple of studies regarding bupropion and Parkinson's Disease, most of which are exploring its use to treat depression related to PD, not actual PD itself. This study however, found that it was mildly efficacious in treating PD, due to its dopaminergic agonist (actually, dopamine reuptake inhibitor) properties, but there were significant side effects in treating PD with bupropion. Here is a listing of other scientific publications relating to bupropion and PD, most of which are studies on treating depression related to PD instead of the PD itself. Dr. Cash 18:58, 24 August 2007 (UTC)
Thanks, Derek. Regarding drowsiness, the prescribing information summarizes this in the Adverse effects section. It's linked to from the article, or you can just go here. Again, this issue is best discussed with your physician. FvasconcellosĀ (tĀ·c) 19:16, 24 August 2007 (UTC)


  • Good job Derek in adding the PD section. Fvasconcellos from your link it says that Somnolence was reported in 2% people taking 300mg/day, 3% taking 400mg/day & placebo 2%. So what can be inferred from that? --1ws1 02:00, 25 August 2007 (UTC)
Nothing. The difference is by chance.Paul gene 12:32, 25 August 2007 (UTC)
Yep, that's basically it. FvasconcellosĀ (tĀ·c) 14:29, 25 August 2007 (UTC)


  • Also are there any scientific studies done to explain Why Increasing the dose of Bupropion Has an Opposite Effect in regards with smoking cessation? --1ws1 02:02, 25 August 2007 (UTC)
I've been looking for this at google scholar and pubmed. So far, I haven't found any scientific evidence that supports this assertion. Dr. Cash 02:55, 25 August 2007 (UTC)
  • Support - Am I allowed to delete comments made before 20th August because all issues have been addressed right? Looking forward to seeing this article on the main page, so more scientific studies are done on solving treatment resistant depression. I have tried all the anti-depressants prescribed by my psychiatrist, nothing worked, 6 months per anti-depressant. My only alternative choice is Electric Shock Therapy, which I am scared of. I had rather suicide than let them put electricity in my bran. Do scientists read Wikipedia? --9urges 15:51, 27 August 2007 (UTC)
The above discussion is preserved as an archive. Please do not modify it. Subsequent comments should be made on the article's talk page or in Wikipedia talk:Featured article candidates. No further edits should be made to this page.

Removing the Overdose section

I am removing the overdose section. I have two reasons for that.

1.It is lifted almost verbatim from the prescribing info against the WP guidelines . 2.The detailed directions on how to treat the overdose are against the WP guidelines. They are also useless, since the first thing anyone would do in such a situation is to call the emergency.Paul gene 02:01, 23 August 2007 (UTC)

Sorry Paul, but I don't think these are directions; I would expect information in a drug article as to the existence or not of an antidote, necessary measures, whether dialysis is of value etc. I can't see how they could be construed as medical advice; "Leave the OG kit in the garage, dearā€”better call the paramedics"? :D I also happen to think information on the rarity of death as a result of overdose is an interesting factoid, but that's my take. I won't argue on the prescribing information bit; you have a point, although I'm not clear on the copyright status of PIs. FvasconcellosĀ (tĀ·c) 02:12, 23 August 2007 (UTC)
I completely agree with Fvasconcellos. --WS 17:43, 23 August 2007 (UTC)
I agree with Fvasconcellos & Wouterstomp. There are no problems with the section, and it has been re-added to the article. Dr. Cash 18:12, 23 August 2007 (UTC)


The matter is not the copyright. Wikipedia:Manual of Style (medicine-related articles) specifically discourages cloning of RxList: "Try to avoid cloning drug formularies such as the BNF and online resources like RxList and Drugs.com."


Please compare the following.

RxList bupropion article: "Overdoses of up to 30 g or more of bupropion have been reported. Seizure was reported in approximately one third of all cases." Overdose section: "GlaxoSmithKline has reported that overdoses of 30 g or more of bupropion resulted in seizure in about one-third of cases."

RxList: Other serious reactions reported with overdoses of bupropion alone included hallucinations, loss of consciousness, sinus tachycardia, and ECG changes such as conduction disturbances or arrhythmias. Overdose section: Hallucinations, loss of consciousness, sinus tachycardia, and ECG changes such as conduction disturbance or arrhythmia were also reported as consequences of overdose.

RxList: Fever, muscle rigidity, rhabdomyolysis, hypotension, stupor, coma, and respiratory failure have been reported mainly when bupropion was part of multiple drug overdoses. Overdose section: Multi-drug overdoses that included bupropion resulted in fever, rhabdomyolysis, stupor, hypotension, coma, muscle rigidity, and respiratory failure.

RxList: No specific antidotes for bupropion are known. Overdose section: There is no specific antidote for bupropion

What is it if not cloning?Paul gene 02:22, 24 August 2007 (UTC)


Is the following a medical advice? "treatment is supportive, and focuses on maintaining airway patency and controlling seizures (usually with intravenous benzodiazepines). The manufacturer recommends gastric decontamination through use of activated charcoal and gastric lavage soon after ingestion, and electroencephalographic monitoring for 48 hours subsequently"

It is not directly applicable to the current situation but here is how Wikipedia:Reference desk/guidelines/Medical advice defines medical advice: A treatment is any type or form of medication (Conventional or Alternative) intended to alleviate the presented symptoms or cure the disease as diagnosed. For example, Y says "try chocolate cake; it works like magic with Alzheimer's".

So the Overdose section says: "Try benzodiazepines, activated charcoal and gastric lavage; it works like magic with bupropion overdosage"Paul gene 02:36, 24 August 2007 (UTC)

Erm, no. We are noting standard procedure and backing it up with a reliable reference. If we mention, say, in the myocardial infarction article:
ā€Aspirin should be given at the first signs of a heart attack.ā€,
that is inappropriate, prescriptive, and medical advice. If we say, however:
ā€Aspirin has an antiplatelet effect which inhibits formation of further blood clots that clog arteries. According to the American College of Cardiology and the American Heart Association, 911 dispatchers may advise people suffering heart attack symptoms to take 160ā€“325Ā mg of aspirin, preferably a nonā€“enteric-coated formulation and as long as they are not allergic to it, while they await the arrival of EMS.[76]ā€
thatā€™s not medical advice. We are reporting the generally accepted recommendation of a relevant ā€œauthorityā€, and supporting it with a reference. Thatā€™s encyclopedic. FvasconcellosĀ (tĀ·c) 11:47, 24 August 2007 (UTC)

Wickipedia Manual of Style discourages vague statements: "Vague: The wallaby is small. Precise: The average male wallaby is 1.6 metres (63 in) from head to tail."

The last sentence in the Overdose section is an excellent example of a vague statement: "Bupropion overdose rarely results in death, although cases have been reported, typically associated with massive overdosage." It contains zero information since it is applicable to most of the drugs. For example: "Zoloft overdose rarely results in death, although cases have been reported, typically associated with massive overdosage. Benzodiazepine overdose rarely results in death, although cases have been reported, typically associated with massive overdosage. Sodium chloride overdose rarely results in death, although cases have been reported, typically associated with massive overdosage."

The overdose section as it is has no place in the article. I rest my case.Paul gene 02:53, 24 August 2007 (UTC)

I can certainly live with that; I would, however, like this article to be as comprehensive as possible. What do you think could be done to improve this section? FvasconcellosĀ (tĀ·c) 11:47, 24 August 2007 (UTC)
It needs to stay and if anything needs to be expanded relying less on the manufacturerā€™s information and more on the medical literature. As it stands now it looks 2/3 of people taking 30 g or more of bupropion will be fine when in overdose this drug is quite toxic. Bupropion has been known to cause seizures in high therapeutic doses and in acute overdoses. For example a 16 year old ingested 1.5 g and developed seizures and cardiotoxicity.[77] There are retrospective case series with good information on dose effect relationships[78][79] which could be used in the article. Additionally nobody uses gastric lavage anymore especially in someone about to have a seizure. - Mr Bungle | talk 23:36, 24 August 2007 (UTC)
In my opinion, it is a sore of plagiarism on the body of the article. There would not be much left if I remove the plagiarism. In my opinion this section is unimportant (proportional to its low probability and benign prognosis), and the overdose could be covered by a couple of lines in the adverse effects section. If you feel that the section needs to be rewritten and expanded please do so; I would gladly go along with you. However, the current situation with keeping it as is in the article aspiring to be featured is intolerable.Paul gene 02:06, 27 August 2007 (UTC)

Remove tics in children with ADHD add not efficacious for children with ADHD

I suggest removing the paragraph about bupropion possibly causing the tics in children with ADHD and Tourette's and adding the ref that bupropion is not efficacious for ADHD. The paragraph in question contains information which pertains to the cases which are very unlikely to happen for the following reasons:

Tics have been reported only in children treated with bupropion for ADHD, not in adults. Bupropion should not be used in children. Since 2004, it is not simply an off-label use, it is the use of the drug in a population where it is contraindicated. While it is possible that a very small number of psychiatrists would still use bupropion in children with depression as a drug of the last resort, it is inconceivable and highly improbable that anyone would use it for ADHD in children, since bupropionā€™s efficacy in children with ADHD has not been demonstrated. (In the largest double-blind study conducted bupropion was not better than placebo, for the review see PMIDĀ 9554326). Thus, bupropion for ADHD in children is in no way a common off-label use, and the issue of tics in children is moot, and just takes room and distracts the reader.Paul gene 01:50, 27 August 2007 (UTC)

The cited article (2007, not the 1993 case series) claims that bupropion is a third-line agent in the treatment of ADHD, and (perhaps in Europe) should not be ruled out as therapy for ADHD in children when other approaches have failed. Maybe outside the U.S. this is indeed simply off-label use? Should it be included in some other article? FvasconcellosĀ (tĀ·c) 02:05, 27 August 2007 (UTC)
Do you mean - Poncin Y, Sukhodolsky DG, McGuire J, Scahill L (2007). "Drug and non-drug treatments of children with ADHD and tic disorders"? No, those guys are Americans; did not you notice that, at least judging by the slow approvals of bupropion, Europeans are much more skeptical about it. The fact that bupropion makes teenagers with ADHD to take on smoking makes its use in them even more inconceivable. Can you imagine a child psychiatrist, who knows all of the above, in his right mind prescribing something clearly contraindicated for a disorder that is not critical for the health and wellbeing? Think lost malpractice lawsuit if the patient starts smoking. My guess would be that the authors used some older pre-2004 review or guidelines. Are you sure that the paper said third-line treatment for ADHD in children? Because in adults with ADHD bupropion is legit. Unfortunately, I have access to that journal with the 12-month delay. Do you care to drop an extended citation on my user page? When you ask, Should it be included in some other article? - do you mean the paragraph about bupropion possibly causing the tics in children with ADHD and Tourette's? Maybe to Tourette's... But will moving it make it more relevant? It will still be informational junk.Paul gene 02:44, 27 August 2007 (UTC)
FVasconcellos gave me the quote from the above reference: "In the absence of placebo-controlled data to confirm the attribution of tics to bupropion exposure, the use of bupropion with appropriate monitoring in children with ADHD and tics deserves consideration if other approaches have not been successful." So it looks like I was wrong - psychiatrists are willing to consider bupropion as the drug of last resort for the ADHD in children.Paul gene 00:33, 30 August 2007 (UTC)

Wellbutrin XL is available in the US as a generic formulation

Wellbutrin XL is available in the US as a generic formulation, for example, as Buproprion XL. See any pharmacy store, or drugstore.com onlinePaul gene 00:43, 30 August 2007 (UTC)

Nice catch. FvasconcellosĀ (tĀ·c) 00:44, 30 August 2007 (UTC)

Metabolites image errors

In Image:Metabolites of bupropion.png in the Pharmacokinetics section, the first two compounds (identified as stereoisomers of hydroxybupropion) look wrong. Each has two absolute-configuration labels, but the structures each only have one apparent stereocenter. The "H" wedge/dot substituent is one of two of two "H" on that carbon, so that carbon isn't stereogenic. Should those be methyl groups instead? While that diagram is being fixed, the pedant in me notes that the "R" and "S" stereo-labels should be italicized, and the fourth compound (erythro) needs an optical-rotation designation. DMacks 05:20, 17 September 2007 (UTC)

Ouch! Dangers of copyediting... Thanks for noticing. I fixed it. In the literature I have, there is no optical rotation sign for the R,S-hydrobupropion. Perhaps, you, being a chemist, could check it in SciFinder? Paul gene 10:57, 17 September 2007 (UTC)
I looked further, and while some optical-rotation values are available, I'm not sure it's useful info given that the starting material is racemic. All four stereoisomers of hydrobupropion are known to be formed ("Evidence that the acute behavioral and electrophysiological effects of bupropion (Welbutrin) are mediated by a noradrenergic mechanism". Neuropsychopharmacology. 11: 133ā€“141. 1994. {{cite journal}}: Unknown parameter |authors= ignored (help) which cites "Enantioselective Effects of Hydroxy Metabolites of Bupropion on Behavior and on Function of Monoamine Transporters and Nicotinic Receptors". Mol Pharmacol. 66: 675ā€“682. 2004. {{cite journal}}: Unknown parameter |authors= ignored (help)) DMacks 18:15, 17 September 2007 (UTC) (got the "which one cited which one" backwards -- DMacks)
I have those. One of them says that 1R,2R and 1R,2S hydrobupropions form predominantly, that is why they are drawn. Although the starting material (bupropion) IS racemic, the reductases may be stereoselective. Indeed, this is one of the explanations for the predominance of these two enantiomers. Another evidence in favor of stereoselectivity of reductases is that one of the enantiomers of bupropion is consumed faster in vivo. That creates some kind of dynamic equilibrium between bupropion enantiomers since they slowly interconvert in vivo. Paul gene 10:57, 18 September 2007 (UTC)
Yeah, makes sense. I'm having a heck of a time finding rotation data (no SciFinder or Beilstein Crossfire here, and not a full complement of specialty biochem journals:( From abstracts, maybe in:
Oh well, anyone really needing these values would need to pull the primary sources anyway. DMacks 02:20, 21 September 2007 (UTC)

Request

"In contrast to many psychiatric drugs, bupropion does not cause weight gain or sexual dysfunction." Sloppy and wrong. "Psychiatric drugs"? What this person means is "mood stabilizers and anti-depressants." Second, "does not cause"? Ridiculous and wrong. Wellbutrin is not COMMONLY ASSOCIATED with weight gain, and is not COMMONLY ASSOCIATED with certain types of sexual dysfunction, i.e. decreased libido, impotence, anhedonia. If the difference between "commonly associated" and "does not cause" is unclear to you, you shouldn't be editing an article that involves summarization of data from clinical trials. 02:19, 5 November 2007 128.84.159.160 (Talk) (27,326 bytes)

It can definitely cause weight gain. I have experience in the mental health field... ā€”Ā Preceding unsigned comment added by Oddtruth (talk ā€¢ contribs) 21:32, 30 October 2014 (UTC)

Sloppy and wrong. The newer questions should be placed at the bottom of the page, so I had to move this question from the top. 128.84.159.160 should have read the template header to this page, which says [[Wikipedia:Signatures|Please sign and date your posts by typing four tildes and Put new text under old text. It also would not hurt to Be polite.
Now to the questions.
  • "Psychiatric drugs"? What this person means is "mood stabilizers and anti-depressants." No, what I mean is "many psychiatric drugs" that is many antidepressants, mood stabilizers and anti-seizure medications as well as most of antipsychotics, anxiolytics and hypnotics. And of course the psychostimulants are excluded.
  • Second, what should be used in this case NOT COMMONLY ASSOCIATED or DOES NOT CAUSE? The difference is quite clear but, since bupropion is actually used to counteract weight gain and sexual dysfunction, one can quite safely reject such causality. Paul gene 12:27, 5 November 2007 (UTC)

Mainpage article

Why doesn't the article summary on the main page make any reference to the trade name Wellbutrin? People would be much more likely to read the article if it was clear that bupropion was the chemical name of Wellbutrin. Fuzzform (talk) 01:02, 21 December 2007 (UTC)

The problem with such a suggestion is that it appears the name Wellbutrin is not universal with different names such as Zyban being used by GSK in different countries. Furthermore it appears that bupropion has been out long enough that patent protection is no longer available and there are therefore numerous generics. Also, unlike say for example prozac where the drug became so popular that it is generally recognised under its tradename and not that of any of its generics it's not clear this is the case for bupropion. We will at the very least have to give the names "Wellbutrin, Zyban, Buproprion and Buproban" as in the article but even that may not be enough IMHO. Nil Einne (talk) 04:39, 21 December 2007 (UTC)
I asked on the Wikipedia:Main Page/Errors to put the two most widely known (Wellbutrin, Zyban) tradenames back into the summary. Please support me. Paul gene (talk) 11:17, 21 December 2007 (UTC)

nsri and ssri addiction

A heading should be added to the main page with regard to what is refered to as "discontinuation symptoms" which is a phrase used by the unscrupulous prescribers to avoid the implication of the addictive potential of these drugs. These drugs are highly addictive with sever withdrawal symptoms and the general public is not aware this until they choose to discontinue the drug. ā€”Preceding unsigned comment added by 97.88.205.124 (talk) 17:57, 21 December 2007 (UTC)


No they are not addictive at all let alone highly addictive. You are the kind of person who's ignorance makes wikipedia only good as a jumping off point on a subject but overall a terrible source of actual information if you want it to be correct. ā€” Preceding unsigned comment added by 68.36.10.247 (talk) 01:01, 10 September 2014 (UTC)
  • "addictive" and "addiction" are technical terms that have specific meaning. Anti-deppressants do not meet the conditions for the classic model of addiction. Due weight needs to be paid to the important tpoic of "discontinuation effects" - many people suffer them and are very vocal about the effect, but how many people don't suffer (or only suffer a bit) from discontinuation effects? Dan Beale-Cocks 20:26, 21 December 2007 (UTC)
  • Agreed! Further, bupropion isn't even an SSRI or SNRI, it has no impact on serotonin at all. It's a DNRI. There have been neither clinical nor widespread anecdotal claims made about bupropion discontinuation. Grouping it with the Effexor's and Paxil's of the world is just plain wrong! ā€”Preceding unsigned comment added by 24.252.247.93 (talk) 19:02, 15 February 2008 (UTC)
  • About bupropion not being a serotonergic agent.. That's what I though, until I ran into this: "Modification of norepinephrine and serotonin, but not dopamine, neuron firing by sustained bupropion treatment." Dong, Blier. 2001 Phychopharm. (Berlin) 155(1): 52-7:

(from article text Discussion section): "sustained administration of bupropion, via osmotic minipumps implanted SC, produced an attenuation of the mean spontaneous firing rate of NE neurons that was dose-dependent. At the highest regimen, that of 5-HT neurons was 100% higher than in controls and, unexpectedly, bupropion did not alter the firing rate of DA neurons."

This being said, bupropion's effects on 5-HT are indirect through up-regulation of NE (I think). Moreover, "horrible withdrawal symptoms" probably vary quite a bit from patient to patient. I have been stable on bupropion and low-dose lorazepam for years without any tolerance or withdrawal symptoms (except for ONE time with the lorazepam). Very recently, I switched to oxytocin therapy, and almost completely stopped the bupropion therapy (I take about 37-75 mg IR form every two weeks as needed), and reduced the lorazepam usage from 3 mg/d to 1-2. Oxytocin is a natural neurohormone, and so it's action may be closer to correcting whatever "chemical imbalance" is at the *root* of depression, and I think don't think "addiction to bupropion" and "addiction to oxytocin" can quite be compared (how exactly do you define "addiction" to a chemical your body makes naturally? Especially one such as OT, whose level is not dynamic based on activity and social situation?) The fact that my usage of bupropion basically stopped entirely, with NO taper (perceived) "need" period whatsoever seems to work against the "horrible withdrawal symptoms" - at least as a blanket statement to be applied to everyone. People (especially doctors) need to remember that we don't know how these chemicals *really* work - we know what their primary effects on neurons are, but we have little if any understanding of the secondary, tertiary, or later effects, and to my knowledge have no real idea why depression develops in the first place, and why the brain maintains it. One size does NOT fit all with many many drugs, and neuro-active certainly are in that category. ā€”Preceding unsigned comment added by 216.9.143.129 (talk) 19:58, 21 June 2008 (UTC)

Pill Coating in Adverse Effects section

At the end of the first paragraph of Adverse Effects it currently reads "The development of mild to moderate skin rashes is associated with sensitivity to dye components within the pill coating. This can often be alleviated simply by prescribing a differently colored pill.[52]". The current (August 2007) version of the Prescribing Information document that the #52 reference points to does not mention this coating alternative. Can anyone provide another reference supporting this statement? Thank you. 2old (talk) 23:03, 9 January 2008 (UTC)

smoking cessation

I just have a little question, if bupropion is used as a smoking cessation aid because it produces the same effects or provides the same feeling as nicotine, stimulates the same receptors - gives the same hit - would that not make it highly addictive? I'm looking at my options for quitting smoking and have found the article and the discussion group very helpful. ~ 20th February 2008 ā€”Preceding unsigned comment added by 146.171.254.66 (talk) 22:16, 19 February 2008 (UTC)

Read the article: bupropion is less addictive than caffeine and shown the same efficacy as nicotine patch and lower efficacy than varenicline. Paul Gene (talk) 11:35, 20 February 2008 (UTC)

The pill does help. The challenge is breaking habits, such as smoking while driving, after meals, on the phone, etc... You don't get addicted to it like nicotine, but when you're on it you just stop thinking about nicotine. ā€”Preceding unsigned comment added by 24.150.147.192 (talk) 05:39, 12 April 2009 (UTC)

So Called "Nicotine Replacement Therapy" is anything but. WhyQuit.com points out serious flaws in studies claiming the NRT can 2x chances of quiting vs, cessation alone, and cite studies suggesting cessation is most effective way to quit. The main article stated that Buproprion was similar in effectiveness to helping people quit 'like NRT.' I deleted the comparison to NRT b/c no source was cited studying the relative effectiveness of both approaches, AND i've presented countervailing evidence to the effectiveness of NRT (see WhyQuit.com). And through some personal experience every NRT i've tried (gum, patch) simply drags out withdrawal and creates a prolonged period of anxiety. Making successful completion rather difficult. With cessation alone, most symptoms of anxiety and cravings peak after only 3-5 days. (see WhyQuit.com) NRT therapies run for months. ā€”Preceding unsigned comment added by 69.122.77.243 (talk) 23:40, 11 September 2010 (UTC)

Sexual functioning in men

Re the claim that "Bupropion does not affect any measures of sexual functioning in healthy men":

"In the men, significant improvements over baseline (p < .01) were observed with both doses in overall sexual satisfaction, ability to achieve an erection, and delay in reaching orgasm/ejaculation; significant improvements relative to placebo (p < .05) were observed in overall sexual satisfaction on both doses, ability to achieve erection on 150 mg/day, and delay in orgasm/ejaculation on 150 mg/day. Seventy percent of subjects reported improvement in libido, arousal, or orgasmic function during bupropion administration"

Source: Effect of bupropion-SR on orgasmic dysfunction in nondepressed subjects: a pilot study. Modell JG, May RS, Katholi CR. Department of Psychiatry, University of Alabama at Birmingham, USA. jgmodell@uab.edu http://www.ncbi.nlm.nih.gov/pubmed/10929571

If you believe the Salon.com account at http://archive.salon.com/sex/feature/2000/09/26/wellbutrin/print.html there is an interesting story behind the lack of publicity concerning the sexual side effects of Bupropion.

66.217.83.176 (talk) 04:04, 15 September 2008 (UTC)

The example you have given pertains to "men with orgasmic dysfunction" not healthy men. The statement in the articleĀ :"Bupropion does not affect any measures of sexual functioning in healthy men" Paul Gene (talk) 01:30, 17 September 2008 (UTC)
Every other part of the section talks about sexual dysfunction, and suddenly, right after a passage about sexual dysfunction in women, a statement out of the blue about healthy men is tacked on, giving the distinct impression that it is to be contrasted with the previous material about women. That's misleading, even if factually true. 66.217.82.160 (talk) 17:20, 1 October 2008 (UTC)

Nightmares

I went on Zyban last year to stop smoking. Before I went on it people had told me I might get nightmares (including my doctor). I shrugged it off and did not think anything of it. When I went on the drug I did experience some pretty messed up dreams. After talking to others who have taken the drug, it seems that everyone on it experiences crazy nightmares. This aspect should be included in the side-effects section. ā€”Preceding unsigned comment added by 24.150.147.192 (talk) 05:46, 12 April 2009 (UTC)

I have used every available quit smoking aid on the market. I acieved ultimate success with Zyban. I had regular nightmares with each and every quitting aid, as well as with quitting cold turkey. ā€” Preceding unsigned comment added by 209.77.204.244 (talk) 23:33, 2 September 2011 (UTC)

TNF-alpha inhibition

The article should not mention bupropion as TNF-alpha inhibitor for the following reasons:

  • Bupropion is not a TNF inhibitor. In order to be classed as a TNF-alpha inhibitor the compound should bind to and inhibit TNF-alpha receptors. Bupropion does not do that according to the provided reference (PMIDĀ 16644475). It decreased TNF synthesis via stimulation of the adrenaline and dopamine pathways.
  • The study findings are not relevant to humans. The provided reference is a study in mice. There have been no studies of TNF-related or anti-inflammatory activity of bupropion in humans. Since metabolism of bupropion in humans and mice is very different, the relevance of these findings is questionable.
  • Not notable. There are more than 2000 scientific papers on bupropion in PubMed. This single unconfirmed animal study is simply not notable enough to be included.

The Sceptical Chymist (talk) 11:31, 10 May 2009 (UTC)

One more example of the problems caused by not following WP:MEDRS. This article has probably 10 times as many sources as it ought to, because it relies on primary reports rather than review papers. Once you start admitting primary sources, it's very difficult to draw a line. Looie496 (talk) 16:04, 10 May 2009 (UTC)
this isn't a case if a single unconfirmed animal study.Did you even do a google search? There are many articles, on TNF and Buproprion. I used this reference, because it was the one used in the article TNF inhibitor. Here are just a few of the others, you can find many more: [80], [81],[82],[83],[84] ... MistyWillowsĀ talk 17:42, 10 May 2009 (UTC)
RE: Looie496. Who cares about WP:MEDRS. The policy WP:NOR overrules WP:MEDRS, which is a mere guideline. The policy WP:NOR allows primary sources for descriptive claims. The Sceptical Chymist (talk) 21:53, 10 May 2009 (UTC)
RE: Misty Willows. I apologize. Bupropion, indeed, have been used in humans with autoinflammatory diseases. Please go ahead and insert your references. However, although bupropion decreases the level of TNF alpha, it is not TNF-alpha inhibitor. And none of the articles you quoted says so. The Sceptical Chymist (talk) 21:53, 10 May 2009 (UTC)
The article TNF inhibitor lists bupropion, and it was added there by a doctor. ... MistyWillowsĀ talk 23:51, 17 May 2009 (UTC)

Hi I'm not up to speed on making changes to these pages, but maybe someone else can. I found another page that should be linked to from this page. It is

http://en.wikipedia.org/wiki/Buproprion

Thanks

Marty ā€”Preceding unsigned comment added by 76.21.91.99 (talk) 03:12, 20 June 2009 (UTC)

checkY Done. FvasconcellosĀ (tĀ·c) 23:34, 26 June 2009 (UTC)

Rating templates?

Okay, this I don't get...Casliber (talk Ā· contribs) 11:22, 26 June 2009 (UTC)

WP:CHEM no longer accept FA-Class as part of their assessment schems, which now appears to be focused on the actual chemistry part of articles (e.g. a drug article may be FA, but if it doesn't go into much detail on chemistry, it will be B- or C-Class, etc.). FvasconcellosĀ (tĀ·c) 23:51, 26 June 2009 (UTC)

Risk of suicide and other adverse affects

I don't have time to update Bupropion#Risk of suicide and/or the Adverse effects section just below this but this came out that looks relevant to the article:

When I checked Varenicline I found someone had already added a note about the FDA requirements and so I massaged that into a version for this article. --Marc Kupper|talk 08:58, 2 July 2009 (UTC)
It is not clear what the practical consequences of the FDA warning in regards to bupropion are. Bupropion and all of its formulations already carry the boxed warning (new FDA preferred term instead of black-box warning) about suicidality.
Interestingly, the number of suicides for the 10 years of marketing of bupropion for smoking cessation equals the number of suicides for one year of varenicline marketing. The comparison of these two medications is biased without mentioning that. Cohrane Review already addressed the question of suicidality with bupropion for smoking cessation; it did not come to any conclusion, and this fact is already mentioned in the article.
Remarkably, nicotine preparations did not raise the risk of suicidality, and in that light they look like the best option. I would wait until the FDA-approved new label for Zyban will be posted on their website before making any major additions to the article. I'll also ask them about their logic for including bupropion into the warnings, if I have a chance. The Sceptical Chymist (talk) 14:36, 3 July 2009 (UTC)

Structural diagram vs. Image

Am I crazy, or is the chlorine atom in the structural diagram in a different position on the phenyl group than it is in the 3-d picture right below it? 67.176.82.104 (talk) 18:51, 30 July 2009 (UTC)

The two diagrams are the same structure, but of different conformations. The ring is a regular hexagon that can rotate as a unit relative to the carbonyl. In both structures, the chlorine is attached ortho ("2 positions away", with one hydrogen position between them) relative to where the carbonyl is attached. DMacks (talk) 20:14, 30 July 2009 (UTC)
The two diagrams represent the same structure, at least as far as the phenyl ring is concerned. The 3-D representation can only show one enantiomer (the one shown is the (S)-enantiomer), whereas the line diagram represents a mixture of the two. DMacks, I know you know better, the chlorine is attached meta to the carbonyl ("2 positions away", with one hydrogen position between them) in both cases! Physchim62 (talk) 20:55, 30 July 2009 (UTC)
Well crap, that's what I get for responding before coffee kicks in. *blush*:( DMacks (talk) 21:06, 30 July 2009 (UTC) A quick check of literature finds that the ortho-chloro isomer is scarily harder to make too. DMacks (talk) 21:14, 30 July 2009 (UTC)
Yeah, the chlorine is still meta relative to the carbonyl. My issue with the new structural diagram is it's colored. Why is that? Seemed like someone had too much time on their hands and edited the previous bupropion structure (which I might add, had the chlorine in the other meta position, consistent with the 3D graphic)from a fine black and white representation to some artsy crap. I personally think it should be reverted back to its prior version so that it's #1 consistent with the 3D graphic (to avoid confusion such as the original poster pointed out) and #2 consistent with all other structural diagrams on pharmaceutical and chemical structures. --Novaprospekt (talk) 21:59, 14 August 2009 (UTC)

No weight gain/sex dysfunction claim

The last sentence of the opening section that says "In contrast to many psychiatric drugs, including nearly all antidepressants, bupropion does not cause weight gain or sexual dysfunction."-- shouldn't this require a source? I take bupropion and it certainly has made me LOSE weight and actually made me enjoy sex more (in great contrast to the SSRI's I used to be on-- yuck) but this seems like a big claim that should have a source to back it up. What do you guys think? --Novaprospekt (talk) 03:58, 7 August 2009 (UTC)

REQUEST for review of Bibliography of inventor of Bupropion

I would like to include an article in Bupropion, that gives the bibliography of Nariman Mehta, the inventor of Bupropion. I made a clumsy effort trying to insert a link to his website earlier. I am now attempting to follow the guidelines that have been presented to me. A corrected article is located at user:beach4444/sandbox or the 

website, [[85]].

Beach4444 (talk) 04:56, 3 September 2009 (UTC) Beach4444 (talk) 14:20, 3 September 2009 (UTC)

OCD

Nothing is said about OCD in this article, but these findings seem to be of importance. 78.48.108.115 (talk) 14:09, 26 October 2009 (UTC)

What is important about it? An open-label trial on 12 patients showed that bupropion is not effective for OCD... Big deal... The Sceptical Chymist (talk) 10:01, 27 October 2009 (UTC)

with those findings, OCD should not be mentioned in the article, in my opinion. pilot studies such as this are developed to see if further research is warranted. as this one shows, it is not. ā€” Preceding unsigned comment added by 159.238.36.19 (talk) 21:54, 18 December 2013 (UTC)

what is right?

(1) It acts as a strong norepinephrine and weak dopamine reuptake inhibitor (2) It is about twice as potent an inhibitor of dopamine reuptake than of norepinephrine reuptake

both can not be true ā€”Preceding unsigned comment added by 78.42.4.217 (talk) 16:07, 10 January 2010 (UTC)

Discontinuation syndrome

The percentages are relatively low for this drug, but it should be touched upon.71.134.42.129 (talk) 18:45, 3 March 2010 (UTC)

Sex

I'm surprised that nobody has yet discovered that Bupropion is indeed a strong aphrodisiac. It certainly was for me. The Salon article from 2000 was written a long time ago, but now that Bupropion has been marketed for smoking cessation under the name Zyban, surely many healthy men without depression or sexual dysfunction have had plenty of experience with it and discovered, as I did, a tremendous boost in libido, as well as increased sensitivity in the genitals and stronger erections. My interest in sex was probably lower than most men's, but on Zyban, I soon started masturbating frequently and without experiencing "refractory" periods after orgasms. My penis actually grew and developed an area of hypersensitivity and turgor on the right side, which caused it to bend towards the left. That area became engorged, red, and sensitive when I got an erection, as if it were inflamed, that is, as if it were affected by inflammation. I noticed that my penis was larger even without an erection. Now that I've been off it for a long time, everything has gone back to the way it was before, except that (1) I'm a decade older and (2) I've lost my libido completely. That brings me to another subject, the terminology of "dysfunction", "anhedonia", "sexual problem", etc. Implied in all these discussions is the notion that people who aren't interested in sex at all have problems, and those who are driven to sexual activity are well. That's absurd. It's those with strong sex drives who have problems, and (at least among unmarried people) those who aren't the least bit interested in sex who have no sex problems. The idea that life is unpleasant without sex is simply baseless, and should be rejected as nonsense. Unfree (talk) 03:09, 5 March 2010 (UTC)

Used to treat anxiety??

In the opening paragraph of this article, it states "Bupropion (Wellbutrin, Zyban), previously known as amfebutamone,[1] is an atypical antidepressant and smoking cessation aid. It is also used to treat anxiety."

I'm pretty sure it is -not- used to treat anxiety, in fact I believe it exacerbates any pre-existing anxiety. Not only do I know this from personal experience taking the drug for 2 years now, but its mechanism of action involving norepinephrine, like other amphetamine-like drugs, can cause increased anxiety and is a hallmark side effect of stimulant medications. Bupropion is used to treat major depressive disorder but I've never seen it advertised to treat anxiety as well. There's no source corroborating this claim either so I think it should be removed unless I am wrong here. In the meantime, I added the fact tag to the initial claim, and when I looked further through the article it seems like somebody else fact-tagged another claim about its supposed usage in treating anxiety. -Novaprospekt (talk) 23:39, 29 May 2010 (UTC)

unfortunately, most psychiatrists have no clue about psychopharmacology, and indeed do prescribe it, usually causing more anxiety problems, which is either ignored by the doctors as "beginning side effects that soon will fade away" or "counter-acting" by increasing the dosage, doing even more harm. --Diogenes2000 (talk) 08:47, 13 August 2013 (UTC)
This may just be an anecdotal thing, but I am currently taking Wellbutrin for my anxiety, and it has helped very much. I have heard from my doctor, along with several pharmacists about its efficacy. Ducksandwich (talk) 20:49, 26 November 2013 (UTC)

Adding Bupropion molecule structure image

I have added Bupropion molecule structure image as I think it clarifies the structure of this chemical element,

but now the page is too heavy..or may be it's OK? (3DRivers (talk) 10:50, 10 June 2010 (UTC))

Half-Life

Seems the half life is listed as three different numbers in three different parts of this article. Creates some confusion... and casts doubt on the validity of this page since they are presented as "facts" in each case - not mentioning that there must be some controversy over the subject... ā€”Preceding unsigned comment added by SundayDrinker (talk ā€¢ contribs) 16:41, 25 November 2010 (UTC)

Bupropion Toxicokinetics

Hi I'm new to all this and am a bit computer illiterate. I saw a case report which has some interesting points about bupropion in over dose:

Clin Toxicol (Phila). 2010 May;48(4):385-7.

Bupropion toxicokinetic: a case report. Donnelly K, Walkowiak HB, Donnelly C, Jenkinson E, Rizkalla J, Langford N.

Abstract CONTEXT: The toxicokinetics of sustained-release bupropion are not well described.

CASE: A 23-year-old Caucasian male took an overdose of 5,700 mg of sustained release bupropion with no co-ingestant. Venous serum samples were assayed for bupropion concentrations over the next 5 days. The peak concentration was 1.114 mg/L. The observed T(max) was found to be 8.25 h, the calculated alpha half-life 10.9 h (+/-SE of 4.47%), and the calculated beta half-life 19.8 h (+/-SE 12.62%). The alpha half-life and T(max) differ significantly from those seen in therapeutic doses.

DISCUSSION: Bezoar formation may underlie these differences. Interventions which reduce the absorption of sustained release bupropion may be effective in overdose.

Interesting that overdose changes the kinetics. Could this go in either the overdose or kinetics section?

http://www.ncbi.nlm.nih.gov/pubmed/20230334

Cheers 194.176.105.41 (talk) 21:10, 14 January 2011 (UTC)Kyrone

Chem infobox references

Dear co-Wikis, The chem infobox is really great and actually has become a tool I use regularly. Thanks a lot for setting it up!

It would be great though if references where supplied alongside the values reported. When the data is inserted it should only cost a couple more seconds, later it's not easy at all... Dont know how that would work technically though as they seem to be a different 'thing' than the rest of the page. I was trying to reach where the protein binding information was stored, but couldnt find it. If a database is used (DrugBank, Chembl orĀ ?) it would be great to have that specified.

Thanks again and hope a nice/practical solution can be found. ./Claus

Posted: 213.243.199.58 (talk) 11:10, 12 July 2011 (UTC)

The hyperlink to the article on the FDA web site that is reference number 160 needs to be corrected. The one on there now doesn't work. The correct link is: http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm153270.htm

The name of the article for reference 160 is: Review of Therapeutic Equivalence Generic Bupropion XL 300 mg and Wellbutrin XL 300 mg

If someone could make that change who is familiar with editing these pages, I'd appreciate it!

Thanks. Srpattee (talk) 03:42, 5 January 2012 (UTC)

Fixed, thanks. Materialscientist (talk) 04:46, 5 January 2012 (UTC)

Bad Interpretation of Study

In the "Mechanism of Action" section, the article states that "Chronic treatment with bupropion led to a decrease in locomotor activity. [135]". However, reference [135] (the abstract of an article) doesn't suggest that chronic bupropion treatment reduces locomotor activity, but rather that chronic treatment increases locomotor activity, albeit to a lesser extent than acute treatment. If one looks at the full text, it becomes even more clear that this is what the authors meant.

While an interesting tidbit, it doesn't actually tell us anything about bupropion's mechanism of action, so I'm thinking that the best course of action would be to just remove the sentence. Nargle25787 (talk) 22:46, 11 May 2012 (UTC)

Go for it. Looie496 (talk) 22:48, 11 May 2012 (UTC)

abuse

I read in this article that Wellbutrin is "non-abusable". This is not true-as a drug counsellor I know firsthand that addicts are able to inject these pills-once dissolved in water-producing feelings reported to be similar to that of cocaine use. Thought I should let you know... ā€” Preceding unsigned comment added by 76.67.120.64 (talk) 16:17, 20 June 2012 (UTC)

As usual, provide reliable sources to back this up and it can be changed. Also being in a position to know first-hand, I have never heard of bupropion being abused (though I have heard a couple horror stories from people who have attempted to abuse it)... Addicts can and do inject a lot of crazy stuff, which I'm sure you know; just because an addict reports getting high off it, does not mean that they actually are... the subjective experience of hardcore polydrug addicts can be a unique thing. 156.98.129.16 (talk) 16:26, 10 July 2012 (UTC)

Budeprion taken off the market

Been seeing articles like this over the past few days. Which section would it be appropriate in?

I would put that in the history section. Be sure to mention that only the Teva 300 mg Budeprion had its approval status changed as of now, and why (the PK data did not match the RL drug closely enough). --Aurochs (Talk | Block) 22:53, 5 October 2012 (UTC)
There are two issues: the FDA approval status and the effectiveness. Many WP:RS say that the FDA has approved generics that aren't as effective. The LAT had a couple of good stories about that issue http://www.latimes.com/health/boostershots/la-heb-generic-antidepressant-equivilency-20121005,0,3111072.story http://articles.latimes.com/print/2008/mar/17/health/he-generic17 If there are respected academic experts and professional organizations that challenge the FDA's determinations, we can't assume the FDA's rulings are correct.
And I think the equivalence issue is important enough that it should go in the introduction. --Nbauman (talk)
First, while I'm sure that a general discussion of the validity of the FDA's BE studies would be appropriate in Food and Drug Administration, it most certainly is not appropriate in Bupropion. In this article, we need only state that the FDA has revoked approval for Teva's 300mg Budeprion tablets.
Second, importance does not have anything to do with whether something belongs in an introduction. Introductions are for general information about the subject of the article. This information is too specific to be in an introduction. --Aurochs (Talk | Block) 15:12, 6 October 2012 (UTC)
Expanding on those thoughts:
As you know, there is already a lengthy discussion of the efficacy of generic bupropion in the article. It's buried in the "Availability and dosage forms" section; I'm working to unbury it now. However, I feel like discussions of the general validity of the FDA's bioequivalence studies and whether or not generics in general are actually equivalent to their brand counterparts would go beyond the scope of this article. Such discussions would certainly be appropriate in Food and Drug Administration, and possibly in bioequivalence.
Regarding the assumption that the FDA's rulings are correct, we don't really have to assume that they're scientifically valid in order to know that they exist and that they have the force of law. We put them in drug articles on Wikipedia because they determine whether or not a drug can be sold in the US, which is certainly significant here. I posit that any serious controversy about or challenge to the FDA's rulings is also significant enough to include in Wikipedia, as long as it's in the right place in the right article.
Regarding the intro text, a sentence or two declaring that there is indeed a controversy surrounding the efficacy and safety of generic bupropion would be fine. I'm just concerned that someone is going to put "In October 2012, the FDA revoked approval for Teva's 300mg Budeprion tablets" in the intro, which is clearly not where that sentence belongs. --Aurochs (Talk | Block) 16:12, 6 October 2012 (UTC)
Oh boy I could actually sign my posts, I guess.Ā :) I've never edited medical articles (save 1-2 GA noms) so I wanted to come here and suss out the controversy first rather than being bold. I'm ok with adding this to the history section (and not necessarily the lede just yet) if that's what the consensus is. Protonk (talk) 17:12, 6 October 2012 (UTC)
Since the two of you drew my attention to it, I'm already planning on reorganizing that part of the article. If it doesn't belong wherever you put it afterwards I'll just move it somewhere else and there won't be any hard feelings or anything. =) For now the regulatory history section seems like the most logical place to put it, because it is a regulatory action. It might eventually wind up in multiple places, or things might be consolidated in ways I haven't thought of, but I don't think there's anybody who would argue that it doesn't belong in the article at all. --Aurochs (Talk | Block) 17:29, 6 October 2012 (UTC)
I added a few sentences on the matter after the related discussion about the earlier 2007 investigation.PStrait (talk) 23:43, 6 October 2012 (UTC)
I feel like this information should be more prominent, maybe towards the end of the article, rather that (or in addition to) the middle of the History section.http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm322161.htm ā€” Preceding unsigned comment added by 75.177.132.154 (talk) 14:33, 24 October 2012 (UTC)

Problems

This article has a few problems. I see some [citation needed] tags, and an [improper synthesis] tag under "Psychiatric". I find it very strange that this one sentence has ten footnotes, which is certainly eyebrow raising. Some sections are also short and choppy, including Psychiatric, Interactions, while other sections are underdeveloped (Detection in Biological Fluids, Synthesis, Animal research). Ten Pound Hammer ā€¢ (What did I screw up now?) 07:26, 22 May 2013 (UTC)

There also seems to be a fair bit of primary research within the article so yes I to would support it going to FAR. Doc James (talk Ā· contribs Ā· email) (if I write on your page reply on mine) 09:53, 22 May 2013 (UTC)
I just spent a few hours doing quite a massive rewrite -- the article is now half as long and has half as many sources. Most of the primary sources are now gone. I like to work from the bottom up when cleaning an article -- the lead and the top two sections are the only ones I haven't yet addressed. I haven't done anything to check the validity of most of the statements that were already attributed to good secondary sources. I don't have much experience working with drug articles and certainly don't have any expertise regarding this drug (I still can barely pronounce the name), so anybody who sees a need for changes should step in. (Boghog has already reformatted a bunch of refs.) Looie496 (talk) 03:59, 28 May 2013 (UTC)
Followup: I've now rewritten the lead and the first two sections, so the slash-and-burn part of fixing the article is basically completed. There are still a few smaller issues that need addressing, but comments related to what the article needs to survive an FA review would be welcome. Looie496 (talk) 17:13, 28 May 2013 (UTC)

Cooking and shooting Wellbutrin

http://globalnews.ca/news/846576/antidepressant-wellbutrin-becomes-poor-mans-cocaine-on-toronto-streets/ people are risking death or serious disfiguration due to the fillers in this medicine.65.93.33.119 (talk) 19:13, 18 September 2013 (UTC)

Mode of action

"The primary pharmacological action of the drug is as a mild selective dopamine reuptake inhibitor as well as a nicotinic acetylcholine receptor antagonist. "

is being changed to:

" The primary pharmacological action of the drug is as a mild dopamine reuptake inhibitor and also a much weaker norepinephrine reuptake inhibitor as well as a nicotinic acetylcholine receptor antagonist. "

The factual accuracy of this edit is disputed. Please use a source, see WP:MEDRS, thank you. Lesion (talk) 23:03, 7 October 2013 (UTC)

There's more than one way for a drug to influence transporter reuptake activity than to bind directly at the transporter; e.x. drugs can (directly or indirectly) influence transporter-autoreceptors, i.e. bind at the autoreceptor (e.x. dopamine at D2sh) or bind at a receptor site that interacts with the transporter-autoreceptor (ex: amphetamine affecting DAT,NET, and SERT through TAAR1-mediated mechanisms), bind to the transporter directly (ex. bupropion at the norepinephrine transporter in the paper you cited), and competitively inhibit them by serving as an exogenous substrate for the transporter (amphetamine, N-methylphenethylamine, phenethylamine at DAT, NET, SERT, and VMAT2). I won't pretend I understand the more esoteric parts of the neuropharmacology in that respect though. That's why your study doesn't make it solely a DRI, Nikpapag. A clinical example is that amphetamine has negligible binding affinity at the serotonin transporter, but it still has enough of an effect via indirect mechanisms on serotonin reuptake that it can cause serotonin toxidrome just like SSRI's when taken in binge doses. This is how it induces rhabdomyolysis and hyperthermia.Seppi333 (talk) 01:35, 9 October 2013 (UTC)
Edit - I forgot pharmacokinetic considerations. You need to consider the metabolites of a drug, as these may be pharmacologically active and thus contribute to the pharmacological profile of the parent compound. In Bupropion's case, the article mentions that its active metabolites are: R,R-hydroxybupropion, S,S-hydroxybupropion, threo-hydrobupropion and erythro-hydrobupropion. An extreme example of why active metabolites matter is inactive prodrugs; for example, lisdexamfetamine isn't pharmacologically active at all, but its metabolite, dextroamphetamine, obviously is active, and the pharmacodynamics of dextroamphetamine (and its metabolites) are what makes lisdexamfetamine do anything.Seppi333 (talk) 05:15, 9 October 2013 (UTC)
Further edit: A drug's pharmacological profile can also be influenced by alterations in neurotransmitter biosynthesis and the pharmacodynamics of the altered endogenous neurotransmitters may affect transporters as well. Perfect example: Phenethylamine is a ligand for (binds to) TAAR1 just like amphetamine. Amphetamine has been shown to GREATLY increase phenethylamine biosynthesis in primary studies (citation removed - see a revid from user:Seppi333 at the time of this post for the citations). Consequently, the pharmacodynamics of phenethylamine contribute to amphetamine's TAAR1-mediated effects and therefore its pharmacological profile related to DAT, NET, and SERT reuptake inhibition.
I hope you understand why your edit isn't factually accurate in light of all that, Nikpapag. It's worth noting that bupropion is an amphetamine (a keto-amphetamine, or cathinone), so all of the above is quite relevant to bupropion.Seppi333 (talk) 06:05, 9 October 2013 (UTC)

Adverse effects

An IP editor just added alopecia to the list of side effects in this edit [86]

I note that there is a long list of references for the side effects, but ideally this needs to be inline citation. See for example Xerostomia#Signs_and_symptoms, where each item in the list is directly sourced. A bit annoying, but only needs to be done once. Future editors are less likely to add unreferenced content, and unreferenced content that is added is more easily identified. Thank you, Lesion (talk) 10:05, 30 October 2013 (UTC)

That whole long list of side effects was just added recently, and I personally don't think it belongs, at least beyond the common ones. In any case I've removed alopecia pending a source for the information. Looie496 (talk) 14:52, 30 October 2013 (UTC)

Lead

At the moment there is no references to support material in the lead. Fuse809 (talk) 11:22, 9 November 2013 (UTC)

Many articles follow the practice of minimizing references in the lead and placing the necessary references in the body of the article, for the sake of readability. Regarding the changes you made, it is important to realize that this is a very widely read article, with over 1000 page views per day, and surely the great majority of readers are non-scientists who want to get basic information about the properties of the drug that are relevant to somebody who uses it. It's important that at least the lead give them the information they need, in language as non-technical as possible. I feel like at least the main factors that distinguish Bupropion from SSRIs belong in the lead. Looie496 (talk) 15:50, 9 November 2013 (UTC)

Rotating graphic is TERRIBLE web design

This page violates Wikipedia accesibility standards. See: Wikipedia:Manual_of_Style_(accessibility)#Animations.2C_videos_and_audio "To be accessible, an animation (GIF ā€“ Graphics Interchange Format) should either: not exceed a duration of five seconds (which results in making it a purely decorative element),[6] or be equipped with control functions (stop, pause, play).[7]" I find that rotating graphic extremely distracting and I know other users do as well. MadScientistX11 (talk) 19:50, 23 December 2013 (UTC)

This gif is 3 seconds long, so it doesn't need to be equipped with control functions. The policy doesn't address animations being subjectively distracting. You say that it distracts others... Let them come speak for themselves, then. I, for one, see nothing wrong or distracting with this gif. Attaboy (talk) 01:58, 25 December 2013 (UTC)
I don't know what you mean about 3 seconds, it goes on indefinitely on my computer, it doesn't stop animating after 3 seconds or ever as long as I waited. And saying "well I like it anyway" is not a justification for ignoring a standard design policy. When I said "it anoys others" I mean I have talked to other people who find these kinds of animations very unsettling. I shouldn't need to take a poll, the fact that it clearly violates Wiki accesibility guidelines should be enough. MadScientistX11 (talk) 13:54, 25 December 2013 (UTC)
I agree that the animation is distracting and would favor removing it. Looie496 (talk) 16:46, 25 December 2013 (UTC)
Go take a look at the file. The gif is 3 seconds long. It does what all gifts do: repeat itself. There's nothing wrong with this. Attaboy (talk) 14:58, 26 December 2013 (UTC)
It doesn't matter what it says in the file what matters is what the user sees. I just used the timer on my phone and the gif (for THIS article) kept animating for over a minute. (BTW it didn't stop after that, I don't think it ever stops) If you see something different then that is a technical issue although so far you haven't actually said what you see on the screen you only have said what the file says. So look at the article. Does the image stop animating and when? And if not look at that quote I have up above from the Wikipedia accesibility standards and tell me how that behavior doesn't clearly violate the standard. MadScientistX11 (talk) 15:52, 26 December 2013 (UTC)
I see. I don't have the know how to change it the file so it won't repeat. If you can find an alternate image, you can go ahead and change it out. Attaboy (talk) 17:50, 26 December 2013 (UTC)
Unfortunately, I don't have the skills to edit it either. I don't think its that easy to do, I can usually figure these things out most of the time and I tried to deal with this issue for another gif and it seemed like the only way to deal with it was to turn it into a video which I have neither the skill nor interest in doing. I don't know enough about this topic to feel competent making decisions about alternative images, whether to just remove the image, etc. So I'm just whining about the problem but at least the issue is documented. MadScientistX11 (talk) 20:51, 26 December 2013 (UTC)
I appreciate these GIF images as they give a great 3D view of the molecular structure. Disabling animation would make them less demonstrative. However I have to admit that they are a bit distracting and also a bit dizzying. Therefore I suggest to slow them down. By the way: Using Firefox, animations can be either turned completely off or prevented from repeating over and over. Enter about:config in the address bar, hit Enter, search for image.animation_mode and change the preference either to none or once. Hope that helps. Cheers. SelfishSeahorse (talk) 10:59, 27 December 2013 (UTC)
How distracting this is is a matter of opinion and we will never agree. I find it terribly distracting and the rate of movement has nothing to do with it but I appreciate that other people have different opinions. That is why we have standards. The discussion here shouldn't be on how fast the gif is moving or how much value a moving animation has over a non moving one the starting point should be: WHY DOES THIS PAGE VIOLATE WIKIPEDIA ACCESIBILITY STANDARDS? Is there some really pressing reason that we need an animated picture of the molecule? I haven't heard one and IMO without such a justification the only thing we should be talking about is how to change the page so it DOES NOT VIOLATE WIKIPEDIA ACCESIBILITY STANDARDS. MadScientistX11 (talk) 15:20, 27 December 2013 (UTC)
I've created a new version of the file. The animation now stops after one cycle and is half the speed. Hope everyone is lucky now.Ā :) SelfishSeahorse (talk) 21:08, 27 December 2013 (UTC)
Great! thanks. MadScientistX11 (talk) 13:54, 28 December 2013 (UTC)

Wellbutrin

Wellbutrin and psychic energy? Help me understand.. Freudian1 (talk) 19:44, 26 October 2020 (UTC)

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