Bupropion (Wellbutrin) Mnemonic

February 20, 2025

Key Points

Bupropion (Wellbutrin) is an atypical antidepressant primarily used to treat depression and aid in smoking cessation.
Wellbutrin works by inhibiting the reuptake of dopamine and norepinephrine, enhancing the signaling of these neurotransmitters in the brain.
Bupropion is notable for its ability to promote weight loss and its lack of sexual side effects, making it distinct from other antidepressants.
It is contraindicated in patients with eating disorders such as bulimia or anorexia nervosa due to an increased risk of seizures.
Side effects of Bupropion include tachycardia, insomnia, and headaches.
Patients should avoid alcohol and not crush or chew the pills, as both can heighten the risk of seizures.

Mechanism of Action

Bupropion inhibits the reuptake of norepinephrine and dopamine, increasing their levels in the brain to improve mood and reduce cravings.
It does not affect serotonin, making it different from most antidepressants like SSRIs and SNRIs.
Bupropion’s lack of impact on serotonin helps avoid side effects like sexual dysfunction, often seen with other antidepressants.
Its stimulant-like effects can also promote weight loss, though it may cause insomnia or increased heart rate in some patients.

Bupropion is used to treat Major Depressive Disorder (MDD), Persistent Depressive Disorder (PDD), and Seasonal Affective Disorder (SAD).
It also aids in smoking cessation, reducing withdrawal symptoms by mimicking nicotine’s effects on the brain.
Typically prescribed as a 2nd or 3rd line treatment for depression after SSRIs, and can be used as adjunctive therapy.
Classified as an atypical antidepressant, it offers an alternative treatment option, especially for patients who don’t respond well to SSRIs.

Seizures are the primary side effect of bupropion.
- It lowers the seizure threshold, and the risk increases with higher doses.
- Contraindicated in patients with a history of seizure disorders, bulimia, or anorexia nervosa
- Crushing or chewing the pills increases absorption and raises the seizure risk.
- Patients should limit alcohol intake, as it can further lower the seizure threshold.
Does not cause sexual side effects, unlike SSRIs, which often cause sexual dysfunction.
Promotes weight loss, in contrast to SSRIs and mirtazapine, which can cause weight gain.
Side effects like tachycardia, insomnia, and headaches may occur.
Increased risk of suicidal behavior early in treatment, particularly in adolescents and young adults.

Bonus Mnemonic: “BUPROPION”

B - Bulimia and anorexia nervosa contraindicated (due to seizure risk)
U - Under no circumstances should the dose be doubled if missed
P - Pill must be taken at the same time every day
R - Risk of seizures increases with higher doses
O - Overuse of alcohol lowers the seizure threshold further
P - Pills must not be crushed or chewed (raises absorption and risk of seizures)
I - Increased risk of seizures in patients with a history of seizure disorders
O - Out of control seizures are the primary side effect
N - No sexual side effects