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A healthy diet and proper exercise are heralded for their wondrous effects on weight loss. However, there are some people who – no matter how hard they try – can’t shed the extra pounds with the aforementioned methods.

If you are one of these unfortunate few, you need not worry – medications such as Wellbutrin is now being considered a ‘miracle drug’ for weight loss.

What is Wellbutrin?

Wellbutrin, with the generic name bupropion, is an aminoketone medication used to treat major depressive and seasonal affective disorders. In some cases, it has been used to treat anxiety, attention deficit hyperactivity disorder, post-traumatic stress disorder, social phobia, and nerve pain.

Its mechanism of action is widely hazy, although experts contend that it works by affecting the reuptake of the neurotransmitters dopamine and norepinephrine.

Wellbutrin is available in two dosage forms, with the 75 mg tablet colored yellow-gold, and the 100 mg tablet colored red.

The usual recommended initial dose is 200 mg per day, with a dose of 100 mg at two times a day. It can then be increased to as much as 300 mg day at three divided doses of 100 mg tabs, spaced at an interval of at least 6 hours.

A maximum of 450 mg Wellbutrin can be given in a day, which can be taken in four doses of 100 mg tablets. Such can also be taken at 150 mg per dose at three times a day.

The dosage is adjusted to a maximum of 75 mg per day for patients with liver problems. Similar dosage reductions are also recommended for individuals with kidney problems.

Wellbutrin for Weight Loss

How Wellbutrin brings about weight loss remains a puzzle to most experts.

Some believe that since it is chemically same with amphetamines, it brings about the appetite suppression that is associated with the said drugs.

Others, on the other hand, postulate that its role as a norepinephrine and dopamine uptake inhibitor plays a major role in moderating the eating process. Both hormones, after all, have been linked with the intensity of food cravings.

In Depressed Patients

Fact: most antidepressants bring about weight gain.

In fact, a study by Serretti and Mandelli showed that “Psychotropic drugs often induce weight gain, leading to discomfort and discontinuation of treatment and, more importantly, increasing the risk of obesity-related illnesses such as diabetes mellitus, hypertension, and coronary heart disease.”

But with Wellbutrin, the case is the actual opposite. In fact, many studies have proven its effectiveness when it comes to weight loss.

To wit, a 2002 study by Jain et al and described in studies at Thyroid Advisor, has shown that obese patients with depressive symptoms who took Bupropion alongside a 500 kcal/d-deficit diet lost an average of 4.4 kilograms. Not only did the drug improve physical appearance after 6 months of treatment, the accompanying weight loss has also been linked with ‘improved mood’ amongst the study participants.

Bupropion’s effects are not only short-term; they are effective in the long run as well. Proving this was the study by Arteburn et al, which has shown that Bupropion was the sole antidepressant that can lead to long term weight loss. Results showed that those who took Bupropion lost as much as 8.4 pounds in a span of two years.

The limitation to Bupropion’s ability though is that the long-term weight loss is only applicable to nonsmokers. While Wellbutrin is used as an adjunct drug for smoking cessation, disruption of said vice has always been linked with weight gain.

As such, smokers taking Bupropion are expected to exhibit weight gain rather than weight loss. This was explicitly shown in the study as it was noted that smokers who took the drug gained as much as 14.2 pounds.

Due to the promising effects of Bupropion, Arteburn and his colleagues recommend that it be the “first-line drug of choice for all overweight and obese patients unless there are other existing contraindications such as a history of seizure disorder, anorexia nervosa or bulimia, or patients undergoing abrupt discontinuation of ethanol or sedatives including anticonvulsants, barbiturates, or benzodiazepines. All other antidepressant medications should be considered second-line pharmacological treatments for depression among overweight and obese patients.”

In Non-Depressed Patients

Wellbutrin is initially prescribed for overweight or obese depressed patients because of its weight loss capabilities. Outside its primary use, several studies have shown that Wellbutrin is just as effective in non-depressed individuals who wish to lose weight.

A 2001 study by Gadde et al showed that “Bupropion was more effective than placebo in achieving weight loss at 8 weeks in overweight and obese adult women.” Those who completed the program – which included a 1600 kcal/day diet and the use of food diaries – mean weight loss percentage was as much as 6.2% for the Bupropion group compared to 2.9% of the placebo group. In fact, 12 of the 18 participants of the Wellbutrin cluster achieved a whopping 5% weight loss.

Echoing this finding was the study of Anderson et al, where participants were placed in the placebo, Bupropion 300 mg/day, and Bupropion 400 mg/day groups respectively. Those who completed the 24-week therapy – which included exercise, meal replacements, and energy-restricted diets – weight loss was 7.2% and 10.1% for the Bupropion 300 mg and 400 mg groups respectively. Those who finished the 48-week program maintained losses of 7.5% for the Bupropion 300 mg group and 8.6% for the Bupropion 400 mg group.

Similarly, Anderson et al has the same recommendation as that of Arteburn. The authors go on to say that “Because of its effectiveness and safety, bupropion SR warrants consideration as an adjunct to lifestyle changes for enabling obese individuals to lose weight.”

Wellbutrin and Naltrexone for Weight Loss

Because of Wellbutrin’s effects on weight loss, it has been marketed with Naltrexone in obesity treatment. Further studies show that both medications exert short- and long-term weight loss effects, resulting to as much as 5% body weight loss.

While a healthy diet and exercise are instrumental for  weight loss, Tek, in his paper, recognized that sometimes, they are not enough. He goes on to say that “the problem is that very few obese/overweight people can adequately follow these diets and exercise routines, and even fewer people can sustain them over long periods of time.”

As such, he recommends pharmacological support such as that of Wellbutrin and Naltrexone, “since obesity affects not only how one thinks about food and activity, but also the brain physiology that is connected to energy regulation.”

True enough, both medications are successful when it comes to weight loss because they affect brain processes that lead to overeating. As it was mentioned, Bupropion can affect the reuptake of neurotransmitters that lead to intense food cravings. Naltrexone, on the other hand, has the ability to modify a person’s eating behavior by modifying the brain’s reward systems.

The Wellbutrin-Naltrexone pill has recently been approved for use in the United States and Europe. The available sustained release tablet comes at a dose of 90 mg and 8 mg for Bupropion and Naltrexone, respectively. According to medical experts, the recommended maximum dose for weight loss is at 360 mg Bupropion and 32 mg of Naltrexone.

Considerations While Taking Wellbutrin

Although many studies have proven that Wellbutrin leads to weight loss, the study by Anderson et al noted that “Bupropion SR seems to have a weight-neutral effect for most depressed individuals of normal weight.”

With that being said, experts recommend the use of Wellbutrin ONLY for overweight or obese individuals (in conjunction with exercise and a healthy diet of course,) as it will most likely be ineffective in normal-weight individuals who are looking for an instant way to lose further weight.

Should you decide to take Wellbutrin for weight loss, you need to disclose your complete medical history to your doctor – including ailments such as neurologic, cardiac, renal, and liver diseases, as well as glaucoma, diabetes, and other mental illnesses. Do note that Wellbutrin might cause seizures if taken with certain drugs prescribed to cure certain conditions.

Keep yourself safe by following these pointers once you get started with Wellbutrin therapy:

• Swallow your bupropion tablet entirely. Avoid chewing, crushing, or breaking the pill.
• You can take the drug with or without food.
• Store the drug in room temperature; avoid exposing it to light and moisture.
• Side effects of Wellbutrin treatment include dizziness, joint pain, mild anxiety, nausea, constipation, stuffy nose, dry mouth, and sleeping problems.
• Do not take the last dose beyond 5 pm in order to avoid the insomniac effect associated with bupropion.
• Provide a 6-hour interval in between taking dosages as this will help reduce, if not eliminate the possibility of seizures associated with Wellbutrin use.
• Wellbutrin can cause sedation and impaired concentration, as such avoid driving or performing other hazardous tasks after the intake of the drug.
• Discontinue use if you experience signs of Wellbutrin allergy such as difficulty in breathing, hives, and facial swelling.
• Consult with your doctor immediately once you experience the following adverse effects:
  • Seizures
  • Mood or behavioral changes
  • Rapid heartbeat
  • Manic episodes (irritability, talkativeness, heightened energy, racing thoughts, callous behavior, extreme happiness, and difficulty sleeping)
  • Vision problems (blurring, tunnel vision, halos, pain, or inflammation of the area)
• It is important to distinguish signs of bupropion overdose, which include loss of consciousness, slow heartbeat, unusual tiredness, fainting, dizziness, and lightheadedness. Contact your doctor immediately once you experience any of the aforementioned symptoms.
• Women who plan are pregnant or nursing should avoid Wellbutrin as the medication can pass through the baby through breastfeeding.
• Should you need to undergo a drug test, tell the examiner that you are taking bupropion as such can lead to a false-positive result.
• Suicidal thoughts are common in young (adolescent and teen) first-time takers of antidepressants such as bupropion. As such, tell your doctor if you feel anxious, or if you experience panic attacks. Your relative or caregiver should be wary to report any signs of behavioral changes such as irritability, impulsiveness, hostility, aggressiveness, restlessness, hostility or hyperactivity, to name a few.

Here are more pointers (DON’TS) that you need to remember while undergoing Wellbutrin therapy:

• Don’t discontinue your Wellbutrin treatment abruptly as this will lead to uncomfortable withdrawal symptoms.
• Do not take Wellbutrin with Zyban, a drug prescribed to stop smoking.
• Don’t take Wellbutrin if you have an eating disorder or if you suffer from seizure episodes.
• Avoid taking bupropion if you have just stopped taking sedatives, seizure medication, or alcohol.
• If you have taken MAO Inhibitors such as linezolid, phenelzine, isocarboxazid, selegiline, rasagiline, and tranylcypromine within the past 14 days, keep away from Wellbutrin as the marriage of these drugs might cause a hypertensive crisis and untoward side effects.

In a Nutshell…

Wellbutrin is effective for weight loss, as long as two important criteria are met. You have to be a) overweight or obese and b) you must be a non-smoker.

While Wellbutrin use for weight loss is promising, ALL studies show that it is more effective if it is complimented with a healthy diet and exercise. With that being said, you can’t pin all your weight loss hopes on Wellbutrin alone – you need to do your part too. As long as you eat healthy and exercise regularly, bupropion can help out with the rest of your weight woes.

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