If you experience severe or continuous side effects If your depression or disorder is not under control with Wellbutrin. For example, your depression may not be adequately controlled if you have persistent sad, anxious or empty feelings, irritability, loss of interest in pleasurable activities or hobbies, fatigue, difficulty concentrating, sleep disturbances such as insomnia or excessive sleeping, appetite changes, thoughts of suicide, or physical aches and pains. [1] X Trustworthy Source National Institute of Mental Health Informational website from U. S. government focused on the understanding and treatment of mental illness. Go to source It is important to note that Wellbutrin generally takes up to eight weeks to fully work and may require dosage increases. If you have been on Wellbutrin for a while (six to 12 months) and your doctor feels that you are not at risk for (or do not have) chronic or recurrent depression[2] X Research source
Serious side effects include seizures, hallucinations, irregular heartbeat, or allergic reactions. Stop taking Wellbutrin, and call your doctor right away if you experience any serious side effects. Ideas of suicide may present in younger adults and children. Let your doctor know right away if you have thoughts related to suicide.
Abdominal issues such as nausea, vomiting, diarrhea, or cramps Sleep issues such as insomnia or nightmares Balance issues such as dizziness or lightheadedness Sensory or movement issues such as numbness, tingling, tremors, and lack of coordination Feelings of irritability, agitation, or anxiety This constellation of symptoms is sometimes called “discontinuation syndrome”
The usual target dose of Wellbutrin according to the manufacturer is 300 mg per day in the form of 150 mg twice daily (with a maximum dose at 400mg per day as 200 mg twice daily);[4] X Research source however, your specific prescription may vary. Always follow prescribed dosages. The standard reduction schedule for patients at the target dosage of 300 mg daily is to reduce to 200 mg at the first reduction, followed by subtracting 50 mg on subsequent reductions;[5] X Trustworthy Source Harvard Medical School Harvard Medical School’s Educational Site for the Public Go to source however, the amount of time and dosage between reductions will ultimately depend on your first initial reaction to the first reduction, which your doctor will monitor closely to help your determine the best reduction schedule for you. The process can take anywhere from weeks to months depending on the individual patient. [6] X Trustworthy Source Harvard Medical School Harvard Medical School’s Educational Site for the Public Go to source For regular, immediate release tablets your doctor may recommend cutting the tablet to change the dose; however, it is important to note that Wellbutrin is usually prescribed as a longer-acting tablet. With extended or sustained release formulations, you cannot cut the tablets. Tapering these formulations may include having to prescribe lower dose tablets or taking the same dose at longer intervals such as every other day. Keep track of your tapering schedule by writing down the dates and the dosage changes.
Discontinuation symptoms have a quick onset, slowly get better over one to two weeks, and include more physical complaints. In order to differentiate between relapse and discontinuation symptoms, look at when the symptoms start, how long they last, and the type of symptoms. While discontinuation symptoms with bupropion are not common, there is a greater risk of side effects with discontinuing if the patient not starting a new antidepressant with a similar pharmacodynamic profile. Relapse, or the recurrence of your depression, may also occur with discontinuation of your therapy. Keep you doctor informed about how you are feeling and if you have concerns about a relapse. Relapse symptoms gradually develop after two to three weeks and get worse over two to four weeks. Contact your doctor if any symptoms last more than one month. [7] X Trustworthy Source Harvard Medical School Harvard Medical School’s Educational Site for the Public Go to source [8] X Trustworthy Source American Academy of Family Physicians Organization devoted to improving the health of patients, families, and communities Go to source
Selective serotonin reuptake inhibitors (SSRIs), including Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Celexa (citalopram), or Lexapro (escitalopram) Serotonin norepinephrine reuptake inhibitors (SNRIs), such as Effexor (venlafaxine) Tricyclic Antidepressants (TCAs), such as Elavil (amitriptyline) Monoamine oxidase inhibitors (MAOIs) can also be used after waiting at least two weeks after discontinuation of Wellbutrin. [10] X Research source
Omega-3- fatty acids are contained in foods such as kale, spinach, flaxseeds, walnuts, and fatty fish such as salmon. They are also available over the counter, usually as fish oil gelatin capsules. Studies that showed benefit of omega-3 fatty acids in mood disorders included doses between 1 – 9 grams; however, more evidence supports the lower doses in that range. [12] X Research source
Going to bed and getting up the same time each day Avoiding stimulation before sleeping, such as exercise, watching TV, or doing computer work Avoiding alcohol and caffeine before bed Avoiding eating large meals and drinking large amounts of liquid within a few hours of bedtime Sleeping in a cool, dark and quiet room Associating your bed with sleep as opposed to reading or doing other work
Generally, there isn’t a maximum amount of exposure for sunlight. Make sure you do wear sunscreen if you are going to be in the sun longer than 15 minutes. [14] X Research source
Cognitive behavioral therapy’s (CBT) goal is help a person think more positively and influence behavior. It focuses on current problems and solutions to those problems. A therapist helps the person identify unhelpful thinking and change inaccurate beliefs, thus aiding a change in behavior. CBT is particularly effective for depression. Other therapies — such as interpersonal therapy, which focuses on improving communication patterns; family-focused therapy, which helps by resolving family conflicts that may be influencing the patient’s illness; or psychodynamic therapy, which focuses on helping people gain self-awareness — are also available options.
Focus — Focusing on a specific object, image, or breathing can free your mind of worry and stress. Relaxed breathing — Slow, deep, diaphragmatic breathing (breathing that makes your belly rise when you inhale, not your chest) activates your parasympathetic nervous system, which has a calming effect Quiet setting — This is an important aspect to meditation, especially for beginners, so that you have fewer distractions.
