March 28, 2023

A quick look at the five most common side effects experienced in the new users of Bupropion also known as Wellbutrin or Zyban and some solutions to them to enable continued use of this wonder drug for depression and smoking cessation.

The doctor is in hi guys thanks for joining back in this is your pal again dr sal and in today’s episode let’s take a look at the medical topic of bupropion so brypopian comes in several different strengths just like most other medicines because one size does not fit all you would not be happy going into a shoe store and just finding it had one size so similar

For medications there’s always a spectrum because there’s always going to be differences in consumer needs so b propane comes as 100 100 milligrams and 150 milligrams so this is bu pro pn um and typically with bupropion it’s called sr which stands for slow release there’s also another variation which also comes in 150 and 300 milligrams which is called

Welbutrin now for the life of me i try to see if there’s any differences between these two oh sorry wellbutrin xl which stands for extra long release and it appears to me that there is no substantial difference the half-lives are the same the side effects are the same so it appears to me to simply be a marketing gimmick they’re basically all the same thing

By different names um the marketing gimmick goes even deeper than that however because you may recognize in that name bupropion this guy here the 150 has also been further marketed as zyban which is used to help in smoking cessation but it is essentially all the same thing so all these artificial divisions are really just marketing divisions all right so

That out of the way let’s look at the most common side effects with the side effects i basically took the studies done on this brand the bupropion sr however when i compared the results it was very similar to the wellbutrin xl except that at the higher ends of the strength obviously if you’re comparing 150s here and 300s this one double as much you’re going

To see that the side effect profile is pretty much the same except that the percentage points increment slightly above what you would expect on the halfling strength and that totally makes common sense so what is it licensed for it’s licensed for treatment of depression but as you just saw here there’s other uses as well for example in smoking and that tells

You right there that there’s probably other indications that they’re just not licensed for because smokers often will take a cigarette to get a pick-me-up which which is basically combating depression but you’ll also find a lot of smokers if they’re under a lot of strength stress and or anxiety or things just not going their way the first thing they’ll do is

Go and look for a cigarette to calm down so i find it also works for anxiety too so it works for mixed mood disorder where there’s combinations of depression and anxiety but the official license is for treating depression and under the zyban flag for treating smoking all the same thing however don’t be fooled by the marketing plan so in terms of side effects

Um the study i was looking at um they had 873 people uh on the actual bupropion versus uh 385 on a placebo so basically taking a sugar pill or some other inert substance so what did we find from that we found that the most common side effect by far in almost one in every three people so 27 and a half percent uh was headache so headache was the main complaint

By far and above any other uh headache consider any other side effect consideration that being said however i have seen that uh starting people on bupropion however very often if the individual will persist with it for a few days the headache will get less and less and then extinguish itself and then for months or years later you’re still getting the benefit

Without the headaches i can only think in the last year of one case uh where it simply was a deal breaker i think they tried it for at least two or three weeks and found that they were getting a chronic daily headache so that unfortunate individual had to stop that but we were ultimately able to find something else that worked just as well but for most people

Uh this can be a deal breaker but very often if this persists a little longer they adapt to it all right the next uh most common side effect in what was it 13 percent of people was uh draymond and i’ve also seen this but typically i’ve never seen it where it was severe enough that i had to discontinue somebody’s uh therapy just on account of the dry moth it’s

Usually more of a minor nuisance and not not really a deal breaker especially if it’s working well for what we started it for which is usually depression or anxiety treatment so the depression or anxiety is usually far away is the the balance of the nuisance of the dremel all right next up in about one in every 10 people so 10 percent complained of nausea that

Nausea tends to be a common threat across all drugs almost any medicine that you take can have a side effect of nausea in some people worse than others generally a simple workaround for the nausea is just to take it at um take it with food take it with meal time uh think of it very simply if you took a garlic clove and just put plots on your mouth and started

Chewing it that’s a pretty intense and especially if you’re a vampire very awful experience however if you take that same clove of garlic and you chop that up into little fine pieces and then put it in toast and then chew on the same thing is far less consequential you hardly even notice it so dilution of the drug by having food inside your stomach to buffer

Its presence makes a lot of sense in reducing nausea all right next up is uh what was that one that was nausea so in about eight percent of people 7.9 complained of insomnia back to this schematic up here generally for depression you’re just taking these drugs once a day usually in the morning the only time that you’re going to take it morning and night

Is when you’re using it as i bend for smoking cessation so from the majority people actually using it for depression or anxiety i typically instruct them don’t take this thing at nighttime because it’s it’s stimulatory so there’s a good chance that it’s going to affect your sleep oh and i completely forgot to mention at the start there the mechanism of action

Of this thing is quite different from most of the other antidepressants so most of the other antidepressants are working on the snr ssris they’re like the dominant food group right now so the ssri stands for serotonin reuptake inhibitor these fellas here this this other category are snris s and r a so the end there is standing for norepinephrine reuptake

Inhibitor so what that’s doing is um when your circuitry releases some norepinephrine instead of pulling it back out of the circuit immediately these reuptake inhibitors force it to linger a little longer increasing the the rate of firing within those circuits that are affected and what that uh translates to is feeling a little more energy and more drive and

Less depression so this tends to be a more stimulatory type antidepressant than the ssris that’s going to be important in a sec when we come back to something else um so that’s the part of the reason for that insomnia side effect the next uh next most common okay we’re doing we’re just doing the five most common this is not an exhaustive list there’s probably

Half of a hundred different side effects i could have listed these are just the ones that were five percent or greater uh the next one is um 9.9 people complained of like stuffy nose rhinitis uh this one is kind of hard for me to assess in my population because where i’m at we’ve got lots of seasonal allergies in the springtime there’s a whole bunch of pollens

And then in the fall we get a bunch of other um things like ragweed and stuff floating around so the baseline population around me including myself tends to have seasonal allergies anyway so it’s kind of hard to distinguish whether somebody’s coming in with a stuffy nose and sneezing because of some dandelions outside or is it really because of the bupropion

And in all across my entire career over the last 15 years i don’t remember ever having to discontinue someone’s bupropion therapy because of rhinitis itself all right so those are the the main five side effects that might be a barrier to you getting the the excellent results you’re looking for from zeiban like i said most of them are pretty straightforward to

Deal with the headache might be the only one that if it won’t uh subside on its own could be a deal breaker and then it’s very simple you just switch out of this class and maybe go back to the accessories now so who who do i typically keep in mind to put on this stuff who’s a good candidate so the the main people that i usually would consider um putting on

Bupropion as first line treatment is people who are not just depressed but lethargically depressed so these are the guys that they can’t get out their own way they can’t get out of bed they’ve got no interest in anything no drive no motivation no ambition they’re just tired and they feel low so those would be guys who i would consider be a good candidate for

Something that’s a little pick-me-upper so these guys who are lethargically depressed so who else so that’d be one so who else do i keep in mind for bupropion well smokers so if somebody comes in and they tell me they’re suffering with low mood and depression and they feel like life’s against them and they tell me that they’re smoking and they would like to

Quit why don’t we just kill two birds with one pill start non-bupropion aka zeiban fix the depression fix his smoking at the same time beautiful easy peasy all right third guy that i would consider this in is uh very often with the ssris a lot of guys in particular complain of a lot of erectile dysfunction or sexual dysfunction in general loss of libido etc

I want to say a lot but proportionately it’s a lot when it’s happening to you put it that way so the bupropion family group tend not to cause any sexual dysfunction so in somebody who uh needs something for depression they start on an ssri and then they notice again these taking the joy out of the life because they’ve got no libido anymore then i’ll probably

Try switching them and try out the buproping problem solve and then a fourth group that i would tend to keep in mind for using bupropion is uh those in which they’re on ssri it’s working pretty decent but they’ve reached it the maximum dose you can take so say they have somebody on paxol they’ve reached up to 40 milligrams i can’t push the dots anymore they’re

Feeling a lot better than when they’re on zero but it’s still not quite there well in case like that then i’ll do a combination so i’ll combine the ssri and then add in a low dose of the sn array magic so that ladies and gentlemen concludes a quick overview of some of the side effects that you might experience when first starting out on bupropion wellbutrin

Zyban by another name and some workarounds over it and who in the population of those depressed branches most would benefit from being on this drug overall i’ve had very good results with it over the years as with many others obviously it’s never one size fits all it’s not going to help everyone so some people need to keep searching it’s just like trying on

Shoes so that’s uh bupropion in a nutshell thanks so much for watching and we’ll talk again soon thanks for watching get notified of new videos subscribe now if you found this video helpful support us by sharing it with all of your friends and throw us a like below you’re a star cheers and cheerio

Transcribed from video
5 Most Common Side Effects on Bupropion Wellbutrin Zyban By DoctorSecrets