logo created by RKL

Originally marketed by its brand name Wellbutrin, most people receive the far less expensive generic bupropion.  The drug remains one of the most frequently prescribed anti-depressants capitalizing on the widespread perception it causes fewer side effects.  Arguably less weight gain and fatigue occur with bupropion than with other anti-depressants.  Additionally it may alleviate some of the sexual dysfunction associated with members of the SSRI family such as Prozac, Zoloft and Celexa.

While physicians tend to champion one anti-depressant over another, statistics fail to reveal substantial difference between drugs commonly utilized to combat the disorder.  Due to individual sensitivity, some people may respond more favorably to one drug or experience fewer side effects compared to other options.  Interestingly for the majority of people, none of the anti-depressants routinely available appear superior or uniquely successful.  Treatment often requires a combination of several agents and rarely succeeds in completely eliminating symptoms of depression.

Wellbutrin supposedly boosts the amount of norepinepherine and dopamine present at nerve synapses.  Whether this actually represents the mechanism of action of the drug in combating depression continues as a source of debate.

Known for its versatility, some physicians prescribe this drug for conditions well beyond its anti-depressant activities.   Sold as Zyban, this form of bupropion supposedly assists those interested in discontinuing a cigarette habit.  Combined with naltrexone and marketed as Contrave for weight loss, it failed to gain traction.  The company behind the venture filed for protection under the bankruptcy act in March 2018.

Although little evidence exists to support bupropion as therapy for attention deficit hyperactivity disorder or ADHD, some physicians prescribe it for this condition.  Bupropion fails to assist in treating dependence on either cocaine or methamphetamine.  Similarly it lacks merit in low back pain and peripheral neuropathy.

Bupropion may elevate blood pressure, increase the likelihood of seizures and cause manic attacks especially in those with bipolar disorder.  In some individuals it may predispose to psychotic episodes manifest by delusions, hallucinations, paranoia and confusion.  A variety of potentially serious drug interactions exist necessitating caution for those receiving other medications.

As an example of the lunacy in drug pricing, consider a one month supply of the generic burpopion extended release drug carries a cash price at Costco of less than $25.  Contrast this to the trade name preparation, Wellbutrin XL, from Valeant Pharmaceuticals for more than $1500 at CVS.  Interestingly Valeant answers decreasing sales of their medicine by further price gouging.


One Comment

Leave a Reply

Your email address will not be published. Required fields are marked *