Wellbutrin withdrawal. Wellbutrin withdrawal side effects, withdrawal warnings, withdrawal precautions, withdrawal adverse effects, overdose, withdrawal symptoms and Wellbutrin natural alternatives. Before you begin the spiral down with Wellbutrin withdrawal, try giving your body what it really wants.
Wellbutrin Withdrawal Side Effects
This site gives basic information about Wellbutrin and other psychoactive medication.
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Wellbutrin Clinical Trials
Lau AJ, Chang TK.
Drug Metab Dispos. 2009 Jun 1. [Epub ahead of print]
Wellbutrin: 19487249 [Wellbutrin - as supplied by publisher]
Hays JT, Hurt RD, Decker PA, Croghan IT, Offord KP, Patten CA.
Nicotine Tob Res. 2009 May 29. [Epub ahead of print]
Wellbutrin: 19483180 [Wellbutrin - as supplied by publisher]
Dopheide JA, Pliszka SR.
Pharmacotherapy. 2009 Jun;29(6):656-79.
Wellbutrin: 19476419 [Wellbutrin - in process]
Kortmann GL, Dobler CJ, Bizarro L, Bau CH.
Am J Med Genet B Neuropsychiatr Genet. 2009 May 27. [Epub ahead of print]
Wellbutrin: 19475569 [Wellbutrin - as supplied by publisher]
Dervaux A, Laqueille X.
JAMA. 2009 May 27;301(20):2093; author reply 2093. No abstract available.
Wellbutrin: 19470985 [Wellbutrin - indexed for MEDLINE]
Zernig G, Wallner R, Grohs U, Kriechbaum N, Kemmler G, Saria A.
Addiction. 2008 Dec;103(12):2024-31.
Wellbutrin: 19469746 [Wellbutrin - in process]
Maccaroni E, Malpezzi L, Masciocchi N.
J Pharm Biomed Anal. 2009 May 3. [Epub ahead of print]
Wellbutrin: 19464134 [Wellbutrin - as supplied by publisher]
Moss TG, Sacco KA, Allen TM, Weinberger AH, Vessicchio JC, George TP.
Drug Alcohol Depend. 2009 May 15. [Epub ahead of print]
Wellbutrin: 19447570 [Wellbutrin - as supplied by publisher]
Biała G, Kruk M.
Pharmacol Rep. 2009 Mar-Apr;61(2):236-44.
Wellbutrin: 19443934 [Wellbutrin - in process]
Int J Environ Res Public Health. 2009 Jan;6(1):209-24. Epub 2009 Jan 9.
Wellbutrin: 19440278 [Wellbutrin - in process]
Serretti A, Chiesa A.
J Clin Psychopharmacol. 2009 Jun;29(3):259-66.
Wellbutrin: 19440080 [Wellbutrin - in process]
Binfaré RW, Rosa AO, Lobato KR, Santos AR, Rodrigues AL.
Prog Neuropsychopharmacol Biol Psychiatry. 2009 Apr 30;33(3):530-40. Epub 2009 Feb 11.
Wellbutrin: 19439241 [Wellbutrin - in process]
Rubinstein A, García Martí S, Souto A, Ferrante D, Augustovski F.
Cost Eff Resour Alloc. 2009 May 6;7:10.
Wellbutrin: 19419570 [Wellbutrin - in process]
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009.
Yatham LN, Kennedy SH, Schaffer A, Parikh SV, Beaulieu S, O'Donovan C, MacQueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Young AH, Alda M, Milev R, Vieta E, Calabrese JR, Berk M, Ha K, Kapczinski F.
Bipolar Disord. 2009 May;11(3):225-55.
Wellbutrin: 19419382 [Wellbutrin - in process]
Schmauß M, Messer T.
Fortschr Neurol Psychiatr. 2009 May 4. [Epub ahead of print] German.
Wellbutrin: 19415584 [Wellbutrin - as supplied by publisher]
Painter MM, Buerkley MA, Julius ML, Vajda AM, Norris DO, Barber LB, Furlong ET, Schultz MM, Schoenfuss HL.
Environ Toxicol Chem. 2009 Apr 30:1. [Epub ahead of print]
Wellbutrin: 19405782 [Wellbutrin - as supplied by publisher]
Simon JA, Duncan C, Huggins J, Solkowitz S, Carmody TP.
Nicotine Tob Res. 2009 Jun;11(6):663-669. Epub 2009 Apr 24.
Wellbutrin: 19395688 [Wellbutrin - as supplied by publisher]
Stapleton JA, Keaney F, Sutherland G.
Nicotine Tob Res. 2009 Jun;11(6):685-689. Epub 2009 Apr 24.
Wellbutrin: 19395684 [Wellbutrin - as supplied by publisher]
Garrison GD, Dugan SE.
Clin Ther. 2009 Mar;31(3):463-91.
Wellbutrin: 19393839 [Wellbutrin - in process]
Hall SM, Humfleet GL, Muñoz RF, Reus VI, Robbins JA, Prochaska JJ.
Addiction. 2009 Jun;104(6):1043-52. Epub 2009 Apr 9.
Wellbutrin: 19392908 [Wellbutrin - in process]
CNS Drugs. 2009;23(4):309-29. doi: 10.2165/00023210-200923040-00004.
Wellbutrin: 19374460 [Wellbutrin - in process]
Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H, Churchill R, Barbui C.
Cochrane Database Syst Rev. 2009 Apr 15;(2):CD006532. Review.
Wellbutrin: 19370639 [Wellbutrin - in process]
Cipriani A, La Ferla T, Furukawa TA, Signoretti A, Nakagawa A, Churchill R, McGuire H, Barbui C.
Cochrane Database Syst Rev. 2009 Apr 15;(2):CD006117. Review.
Wellbutrin: 19370626 [Wellbutrin - in process]
Plodkowski RA, Nguyen Q, Sundaram U, Nguyen L, Chau DL, St Jeor S.
Expert Opin Pharmacother. 2009 Apr;10(6):1069-81.
Wellbutrin: 19364254 [Wellbutrin - in process]
Henningfield JE, Shiffman S, Ferguson SG, Gritz ER.
Pharmacol Ther. 2009 Jul;123(1):1-16. Epub 2009 Apr 8.
Wellbutrin: 19362108 [Wellbutrin - as supplied by publisher]
Nicholson KL, Balster RL, Golembiowska K, Kowalska M, Tizzano JP, Skolnick P, Basile AS.
J Pharmacol Exp Ther. 2009 Apr 8. [Epub ahead of print]
Wellbutrin: 19357320 [Wellbutrin - as supplied by publisher]
Steinberg MB, Greenhaus S, Schmelzer AC, Bover MT, Foulds J, Hoover DR, Carson JL.
Ann Intern Med. 2009 Apr 7;150(7):447-54.
Wellbutrin: 19349630 [Wellbutrin - indexed for MEDLINE]
Ellerbeck EF, Mahnken JD, Cupertino AP, Cox LS, Greiner KA, Mussulman LM, Nazir N, Shireman TI, Resnicow K, Ahluwalia JS.
Ann Intern Med. 2009 Apr 7;150(7):437-46.
Wellbutrin: 19349629 [Wellbutrin - indexed for MEDLINE]
[No authors listed]
Ann Intern Med. 2009 Apr 7;150(7):I-36. No abstract available.
Wellbutrin: 19349626 [Wellbutrin - indexed for MEDLINE]
Gariti P, Lynch K, Alterman A, Kampman K, Xie H, Varillo K.
J Subst Abuse Treat. 2009 Mar 30. [Epub ahead of print]
Wellbutrin: 19339135 [Wellbutrin - as supplied by publisher]
Arias HR, Gumilar F, Rosenberg A, Targowska-Duda KM, Feuerbach D, Jozwiak K, Moaddel R, Wainer IW, Bouzat C.
Biochemistry. 2009 Apr 10. [Epub ahead of print]
Wellbutrin: 19334677 [Wellbutrin - as supplied by publisher]
Einarson A, Choi J, Einarson TR, Koren G.
Can J Psychiatry. 2009 Apr;54(4):242-6.
Wellbutrin: 19321030 [Wellbutrin - in process]
Jacot Sadowski I, Ruffieux C, Cornuz J.
BMC Fam Pract. 2009 Mar 25;10:22.
Wellbutrin: 19320964 [Wellbutrin - indexed for MEDLINE]
Ghibellini G, Park J, Brittain CF, Iavarone L, Andorn AC, Levy N, Muir KT.
J Clin Pharmacol. 2009 Apr;49(4):489-95. No abstract available.
Wellbutrin: 19318697 [Wellbutrin - in process]
Wilkinson J, Carroll F, Bevins R.
J Psychopharmacol. 2009 Mar 20. [Epub ahead of print]
Wellbutrin: 19304864 [Wellbutrin - as supplied by publisher]
Biala G, Kruk M.
J Pharm Pharmacol. 2009 Apr;61(4):493-502.
Wellbutrin: 19298697 [Wellbutrin - in process]
Fernández de Bobadilla Osorio J, Sánchez-Maestre C, Brosa Riestra M, Arroyo O, Sanz de Burgoa V, Wilson K.
An Med Interna. 2008 Jul;25(7):342-8. Spanish.
Wellbutrin: 19295994 [Wellbutrin - in process]
Carney RM, Freedland KE.
Am J Psychiatry. 2009 Apr;166(4):410-7. Epub 2009 Mar 16. Review.
Wellbutrin: 19289455 [Wellbutrin - indexed for MEDLINE]
Tashkin DP, Murray RP.
Respir Med. 2009 Mar 14. [Epub ahead of print]
Wellbutrin: 19285850 [Wellbutrin - as supplied by publisher]
Aguiar M, Todo-Bom F, Felizardo M, Macedo R, Caeiro F, Sotto-Mayor R, Bugalho de Almeida A.
Rev Port Pneumol. 2009 Mar-Apr;15(2):179-97. English, Portuguese.
Wellbutrin: 19280068 [Wellbutrin - in process]
Clausius N, Born C, Grunze H.
Neuropsychiatr. 2009;23(1):15-25. Review. German.
Wellbutrin: 19272288 [Wellbutrin - indexed for MEDLINE]
Rajkumar R, Pandey DK, Mahesh R, Radha R.
Eur J Pharmacol. 2009 Apr 17;608(1-3):32-41. Epub 2009 Mar 6.
Wellbutrin: 19269287 [Wellbutrin - in process]
Davis MF, Miller HS, Nolan PE Jr.
J Clin Psychiatry. 2009 Feb;70(2):297-8. No abstract available.
Wellbutrin: 19265649 [Wellbutrin - indexed for MEDLINE]
Wang X, Hripcsak G, Markatou M, Friedman C.
J Am Med Inform Assoc. 2009 May-Jun;16(3):328-37. Epub 2009 Mar 4.
Wellbutrin: 19261932 [Wellbutrin - in process]
Bredesen H, Lous J.
Ugeskr Laeger. 2009 Feb 23;171(9):683-8. Danish.
Wellbutrin: 19257992 [Wellbutrin - indexed for MEDLINE]
Quaak M, van Schayck CP, Knaapen AM, van Schooten FJ.
Eur Respir J. 2009 Mar;33(3):468-80.
Wellbutrin: 19251795 [Wellbutrin - in process]
Tidey JW, Rohsenow DJ.
Nicotine Tob Res. 2009 Mar;11(3):308-12. Epub 2009 Feb 26.
Wellbutrin: 19246631 [Wellbutrin - in process]
Ebbert JO, Croghan IT, Sood A, Schroeder DR, Hays JT, Hurt RD.
Nicotine Tob Res. 2009 Mar;11(3):234-9. Epub 2009 Feb 25.
Wellbutrin: 19246427 [Wellbutrin - in process]
Talwar A, Jain M, Arora G.
Medscape J Med. 2008;10(12):291. Epub 2008 Dec 26. No abstract available.
Wellbutrin: 19242597 [Wellbutrin - indexed for MEDLINE]
Gervasoni N, Bryois C, Barbe R, Bertschy G.
Rev Med Suisse. 2009 Jan 14;5(186):138-42. French.
Wellbutrin: 19238934 [Wellbutrin - indexed for MEDLINE]
Verbeeck W, Tuinier S, Bekkering GE.
Adv Ther. 2009 Feb;26(2):170-84. Epub 2009 Feb 23.
Wellbutrin: 19238340 [Wellbutrin - in process]
Cahill K, Stead L, Lancaster T.
Drug Saf. 2009;32(2):119-35. doi: 10.2165/00002018-200932020-00005. Review.
Wellbutrin: 19236119 [Wellbutrin - indexed for MEDLINE]
Riemerth A, Kunze U, Groman E.
Wien Med Wochenschr. 2009;159(1-2):47-52.
Wellbutrin: 19225735 [Wellbutrin - indexed for MEDLINE]
Tschabitscher P, Homaier I, Lichtenschopf A, Groman E.
Wien Med Wochenschr. 2009;159(1-2):17-23. German.
Wellbutrin: 19225731 [Wellbutrin - indexed for MEDLINE]
Abrantes AM, Strong DR, Lloyd-Richardson EE, Niaura R, Kahler CW, Brown RA.
Am J Addict. 2009 Jan-Feb;18(1):100-1. No abstract available.
Wellbutrin: 19219672 [Wellbutrin - indexed for MEDLINE]
Carpenter KM, McDowell D, Brooks DJ, Cheng WY, Levin FR.
Am J Addict. 2009 Jan-Feb;18(1):53-64.
Wellbutrin: 19219666 [Wellbutrin - indexed for MEDLINE]
Efstathiou SP, Skeva II, Dimas C, Panagiotou A, Parisi K, Tzanoumis L, Kafouri A, Bakratsas K, Mountokalakis TD.
Atherosclerosis. 2009 Jan 24. [Epub ahead of print]
Wellbutrin: 19217624 [Wellbutrin - as supplied by publisher]
Harv Mens Health Watch. 2009 Jan;13(6):8. No abstract available.
Wellbutrin: 19216119 [Wellbutrin - indexed for MEDLINE]
Lucero CA, Moss DR, Davies ED, Colborn K, Barnhart WC, Bogen DL.
Breastfeed Med. 2009 Feb 11. [Epub ahead of print]
Wellbutrin: 19210131 [Wellbutrin - as supplied by publisher]
Salize HJ, Merkel S, Reinhard I, Twardella D, Mann K, Brenner H.
Arch Intern Med. 2009 Feb 9;169(3):230-5; discussion 235-6.
Wellbutrin: 19204212 [Wellbutrin - indexed for MEDLINE]
Subst Abus. 2009 Jan-Mar;30(1):81. No abstract available.
Wellbutrin: 19197785 [Wellbutrin - indexed for MEDLINE]
Lee JJ, Erdos J, Wilkosz MF, LaPlante R, Wagoner B.
Ann Pharmacother. 2009 Feb;43(2):370-4. Epub 2009 Feb 3.
Wellbutrin: 19193596 [Wellbutrin - in process]
Dent LA, Harris KJ, Noonan CW.
Ann Pharmacother. 2009 Feb;43(2):194-201. Epub 2009 Feb 3.
Wellbutrin: 19193572 [Wellbutrin - in process]
Bond DJ, Noronha MM, Kauer-Sant'Anna M, Lam RW, Yatham LN.
J Clin Psychiatry. 2008 Oct;69(10):1589-601. Review.
Wellbutrin: 19192442 [Wellbutrin - indexed for MEDLINE]
Florek E, Piekoszewski W.
Przegl Lek. 2008;65(10):700-5. Review. Polish.
Wellbutrin: 19189582 [Wellbutrin - indexed for MEDLINE]
Billert H, Gaca M, Adamski D.
Przegl Lek. 2008;65(10):687-91. Review. Polish.
Wellbutrin: 19189579 [Wellbutrin - indexed for MEDLINE]
Richmond R, Butler T, Wilhelm K, Wodak A, Cunningham M, Anderson I.
Tob Control. 2009 Jun;18(3):176-82. Epub 2009 Feb 2.
Wellbutrin: 19188210 [Wellbutrin - in process]
Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, Tansella M, Barbui C.
Lancet. 2009 Feb 28;373(9665):746-58. Review.
Wellbutrin: 19185342 [Wellbutrin - indexed for MEDLINE]
Fant RV, Buchhalter AR, Buchman AC, Henningfield JE.
Handb Exp Pharmacol. 2009;(192):487-510. Review.
Wellbutrin: 19184660 [Wellbutrin - indexed for MEDLINE]
Ray R, Tyndale RF, Lerman C.
J Neurogenet. 2009 Jan 23:1-10. [Epub ahead of print]
Wellbutrin: 19169923 [Wellbutrin - as supplied by publisher]
Metabolic activation of mifepristone [RU486; 17beta-hydroxy-11beta-(4-dimethylaminophenyl)-17alpha-(1-propynyl)-estra-4,9-dien-3-one] by mammalian cytochromes P450 and the mechanism-based inactivation of human CYP2B6.
Lin HL, Zhang H, Hollenberg PF.
J Pharmacol Exp Ther. 2009 Apr;329(1):26-37. Epub 2009 Jan 23.
Wellbutrin: 19168709 [Wellbutrin - indexed for MEDLINE]
Bauer M, Tharmanathan P, Volz HP, Moeller HJ, Freemantle N.
Eur Arch Psychiatry Clin Neurosci. 2009 Apr;259(3):172-85. Epub 2009 Jan 22.
Wellbutrin: 19165525 [Wellbutrin - in process]
Hewett K, Chrzanowski W, Jokinen R, Felgentreff R, Shrivastava R, Gee M, Wightman D, O'Leary M, Millen L, Leon M, Briggs M, Krishen A, Modell J.
J Psychopharmacol. 2009 Jan 22. [Epub ahead of print]
Wellbutrin: 19164492 [Wellbutrin - as supplied by publisher]
Mil Med. 2008 Oct;173(10):1042-3. Review.
Wellbutrin: 19160627 [Wellbutrin - indexed for MEDLINE]
[No authors listed]
Harv Ment Health Lett. 2008 Dec;25(6):1-3. No abstract available.
Wellbutrin: 19160573 [Wellbutrin - indexed for MEDLINE]
Parsons AC, Shraim M, Inglis J, Aveyard P, Hajek P.
Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006219. Review.
Wellbutrin: 19160269 [Wellbutrin - indexed for MEDLINE]
Hajek P, Stead LF, West R, Jarvis M, Lancaster T.
Cochrane Database Syst Rev. 2009 Jan 21;(1):CD003999. Review.
Wellbutrin: 19160228 [Wellbutrin - indexed for MEDLINE]
McEwen A, West R.
BMC Public Health. 2009 Jan 21;9:28.
Wellbutrin: 19159473 [Wellbutrin - indexed for MEDLINE]
Raw M, Regan S, Rigotti NA, McNeill A.
Addiction. 2009 Feb;104(2):279-87.
Wellbutrin: 19149825 [Wellbutrin - indexed for MEDLINE]
Billups SJ, Delate T, Dugan D.
Pharmacoepidemiol Drug Saf. 2009 Mar;18(3):253-7.
Wellbutrin: 19148878 [Wellbutrin - indexed for MEDLINE]
Domino EF, Tsukada H, Harada N.
Psychopharmacology (Berl). 2009 May;204(1):149-53. Epub 2009 Jan 10.
Wellbutrin: 19137279 [Wellbutrin - in process]
Schnoll RA, Patterson F.
Drug Alcohol Depend. 2009 Jan 7. [Epub ahead of print]
Wellbutrin: 19135319 [Wellbutrin - as supplied by publisher]
MMW Fortschr Med. 2008 Nov 13;150(46):42-3. German. No abstract available.
Wellbutrin: 19133359 [Wellbutrin - indexed for MEDLINE]
JAMA. 2009 Feb 4;301(5):522-31. Epub 2009 Jan 6.
Wellbutrin: 19126801 [Wellbutrin - indexed for MEDLINE]
Carrozzi L, Pistelli F, Viegi G.
Ther Adv Respir Dis. 2008 Oct;2(5):301-17. Review.
Wellbutrin: 19124379 [Wellbutrin - indexed for MEDLINE]
Rovina N, Nikoloutsou I, Dima E, Michailidou M, Roussos C, Gratziou C.
Ther Adv Respir Dis. 2007 Dec;1(2):93-104.
Wellbutrin: 19124351 [Wellbutrin - indexed for MEDLINE]
Park YM, Lee HJ, Kang SG, Choo CS, Cho JH.
Prog Neuropsychopharmacol Biol Psychiatry. 2009 Mar 17;33(2):380-1. Epub 2008 Dec 13. No abstract available.
Wellbutrin: 19121360 [Wellbutrin - indexed for MEDLINE]
Gollust SE, Schroeder SA, Warner KE.
Milbank Q. 2008 Dec;86(4):601-27.
Wellbutrin: 19120982 [Wellbutrin - indexed for MEDLINE]
Richert L, Tuschl G, Abadie C, Blanchard N, Pekthong D, Mantion G, Weber JC, Mueller SO.
Toxicol Appl Pharmacol. 2009 Feb 15;235(1):86-96. Epub 2008 Dec 10.
Wellbutrin: 19118567 [Wellbutrin - indexed for MEDLINE]
Wills BK, Zell-Kanter M, Aks SE.
Am J Ther. 2009 Mar-Apr;16(2):193-6.
Wellbutrin: 19114875 [Wellbutrin - indexed for MEDLINE]
J Child Adolesc Psychopharmacol. 2008 Dec;18(6):565-71. Review.
Wellbutrin: 19108661 [Wellbutrin - indexed for MEDLINE]
Silverstone PH, Williams R, McMahon L, Fleming R, Fogarty S.
Ann Gen Psychiatry. 2008 Dec 23;7:27.
Wellbutrin: 19105845 [Wellbutrin - in process]
Evid Based Nurs. 2009 Jan;12(1):10. No abstract available.
Wellbutrin: 19103828 [Wellbutrin]
Eur J Pharmacol. 2009 Jan 28;603(1-3):1-11. Epub 2008 Dec 16. Review.
Wellbutrin: 19101536 [Wellbutrin - indexed for MEDLINE]
Iñiguez SD, Warren BL, Parise EM, Alcantara LF, Schuh B, Maffeo ML, Manojlovic Z, Bolaños-Guzmán CA.
Neuropsychopharmacology. 2009 May;34(6):1609-24. Epub 2008 Dec 17.
Wellbutrin: 19092782 [Wellbutrin - in process]
Wilkinson JL, Li C, Bevins RA.
Addict Biol. 2009 Apr;14(2):165-73. Epub 2008 Dec 12.
Wellbutrin: 19076926 [Wellbutrin - in process]
Fan L, Wang JC, Jiang F, Tan ZR, Chen Y, Li Q, Zhang W, Wang G, Lei HP, Hu DL, Wang D, Zhou HH.
Eur J Clin Pharmacol. 2009 Apr;65(4):403-9. Epub 2008 Dec 9.
Wellbutrin: 19066872 [Wellbutrin - indexed for MEDLINE]
Vasc Health Risk Manag. 2008;4(4):837-45. Review.
Wellbutrin: 19066000 [Wellbutrin - indexed for MEDLINE]
Cardoso CC, Lobato KR, Binfaré RW, Ferreira PK, Rosa AO, Santos AR, Rodrigues AL.
Prog Neuropsychopharmacol Biol Psychiatry. 2009 Mar 17;33(2):235-42. Epub 2008 Nov 27.
Wellbutrin: 19059299 [Wellbutrin - indexed for MEDLINE]
Nishiya Y, Hagihara K, Ito T, Tajima M, Miura S, Kurihara A, Farid NA, Ikeda T.
Drug Metab Dispos. 2009 Mar;37(3):589-93. Epub 2008 Dec 1.
Wellbutrin: 19047469 [Wellbutrin - in process]
Below is a list of Wellbutrin withdrawal side effects. These Wellbutrin side effects can occur while taking the Wellbutrin before withdrawal or may become apparent once Wellbutrin withdrawal begins. It is imperative you use a Wellbutrin withdrawal plan designed to eliminate or reduce Wellbutrin withdrawal side effects. Once Wellbutrin withdrawal side effects begin, they are more difficult to get rid of.
8. Wellbutrin withdrawal - Bundle Branch Block Right – These are specialized cells in the upper right heart chamber and are the heart’s pacemaker. They send electrical signals to the heart that keeps it beating or contracting regularly. Normally the signal goes to the lower heart chambers at the same time through the bundle of His (hiss) on both the left and right sides of the heart, so the lower chambers contract at the same time. When the bundle is damaged on the right side, the signal does not fire at the same time as the left, which changes the pace of blood flow. This can lead to a person fainting.
Triglycerides are three fatty acids bound together in one molecule stored by the body and available to create high levels of energy when used.
Wellbutrin withdrawal. How to avoid Wellbutrin withdrawal side effects click here
Wellbutrin hydrochloride, an antidepressant of the aminoketone class, is chemically unrelated to tricyclic, tetracyclic, or other known antidepressant agents. Its structure closely resembles that of diethylpropion; it is related to phenylethylamines. It is designated as (±)-1-(3-chlorophenyl)-2-[(1,1-dimethylethyl)amino]-1-propanone hydrochloride. The molecular weight is 276.2. The emperical formula is C13H18CINO*HCl. Wellbutrin powder is white, crystalline, and highly soluble in water. It has a bitter taste and produces the sensation of local anesthesia on the oral mucosa.
Wellbutrin is supplied for oral administration as 75 mg (yellow-gold) and 100 mg (red) film-coated tablets. Each tablet contains the labeled amount of
Wellbutrin hydrochloride and the inactive ingredients: 75 mg tablet - D&C Yellow No. 10 Lake, FD&C Yellow No. 6 Lake, hydroxypropyl cellulose, hydroxypropyl
microcrystalline cellulose, polyethylene glycol, talc, and titanium dioxide; 100 mg tablet - FD&C Red No. 40 Lake, FD&C Yellow No. 6 Lake, hydroxypropyl cellulose, hydroxypropyl methylcellulose, microcrystalline cellulose, polyethylene glycol, talc, and titanium dioxide.
Clinical PharmacologyPharmacodynamics and Pharmacological Actions:
The neurochemical mechanism of the antidepressant effect of Wellbutrin is not known. Wellbutrin does not inhibit monoamine oxidase. Compared to classical tricyclic antidepressants, it is a weak blocker of the neuronal uptake of serotonin and norepinephrine; it also inhibits the neuronal re-uptake of dopamine to some extent.
Wellbutrin produces dose-related CNS stimulant effects in animals, as evidenced by increased locomotor activity, increased rates of responding in various schedule-controlled operant behavior tasks, and, at high doses, induction of mild stereotyped behavior.
Wellbutrin causes convulsions in rodents and dogs at doses approximately tenfold the dose recommended as the human antidepressant dose.
Absorption, Distribution, Pharmacokinetics, Metabolism, and Elimination:
Oral bioavailability and single-dose pharmacokinetics:
The absolute bioavailability of Wellbutrin tablets in humans has not been determined because an intravenous formulation for human use is not available.
However, it appears likely that only a small proportion of any orally administered dose reaches the systemic circulation intact. For example, the absolute bioavailability of Wellbutrin in animals (rats and dogs) ranges from 5% to 20%.
Several of the known metabolites of Wellbutrin are pharmacologically active, but their potency and toxicity relative to Wellbutrin have not been fully characterized. However, because of their longer elimination half-lives, the plasma concentrations of at least two of the known metabolites can be expected, especially in chronic use, to be very much higher than the plasma concentration of Wellbutrin. This is of potential clinical importance because factors or conditions altering metabolic capacity (e.g., liver disease, congestive heart failure, age, concomitant medications, etc.) or elimination may be expected to influence the degree and extend of accumulation of these active metabolites.
Furthermore, Wellbutrin has been shown to induce its own metabolism in three animal species (mice, rats, and dogs) following subchronic administration. If induction also occurs in humans, the relative contribution of Wellbutrin and its metabolites to the clinical effects of Wellbutrin may be changed in chronic use.
Plasma and urinary metabolites so far identified include biotransformation products formed via reduction of the carbonyl group and/or hydroxylation of the tert-butyl group of Wellbutrin. Four basic metabolites have been identified.
They are the erythro- and threo-amino alcohols of Wellbutrin, the erythro-amino diol of Wellbutrin, and a morpholinol, metabolite (formed from hydroxylation of the tert-butyl group of Wellbutrin).
The morpholinol metabolite appears in the systemic circulation almost as rapidly as the parent drug following a single oral dose. Its peak level is three times the peak level of the parent drug; it has a half life on the order of 24 hours; and its AUC 0 to 60 hours is about 15 times that of Wellbutrin.
The threo-amino alcohol metabolite has a plasma concentration time profile similar to that of the morpholinol metabolite. The erythro-amino alcohol and the erythro-amino diol metabolites generally cannot be detected in the systemic circulation following a single oral dose of the parent drug. The morpholinol and the threo-amino alcohol metabolites have been found to be half as potent as Wellbutrin in animal screening tests for antidepressant drugs.
During a chronic dosing study in 14 depressed patients with left ventricular dysfunction, it was found that there was substantial interpatient variability (two- to five-fold) in the trough steady-state concentrations of
The effect of other disease states and altered organ function on the metabolism and/or elimination of
The effect of age on plasma concentrations of Wellbutrin and its metabolites has not been characterized.
In vitro tests show that Wellbutrin is 80% or more bound to human albumin at plasma concentrations up to 800 micromolar (200 mcg/mL).
Indications And Usage Back to top of pageWellbutrin is indicated for the treatment of depression. A physician considering Wellbutrin for the management of a patient's first episodes of depression should be aware that the drug may cause generalized seizures with an approximate incidence of 0.4% (4/1000). This incidence of seizures may exceed that of other marketed antidepressants by as much as fourfold. This relative risk is only an approximate estimate because no direct comparative studies have been conducted.
The efficacy of Wellbutrin has been established in three placebo-controlled trials, including two of approximately 3 weeks duration in depressed inpatients, and one of approximately 6 weeks duration in depressed outpatients. The depressive disorder of the patients studied corresponds most closely to the Major Depression category of the APA Diagnostic and Statistical Manual III.
Major Depression implies a prominent and relatively persistent depressed or dysphoric mood that usually interferes with daily functioning (nearly every day for at least 2 weeks); it should include at least four of the following eight symptoms: change in appetite, change in sleep, psychomotor agitation or retardation, loss of interest in usual activities or decrease in sexual drive, increased fatigability, feelings of guilt or worthlessness, slowed thinking or impaired concentration, and suicidal ideation or attempts.
Effectiveness of Wellbutrin in long-term use, that is, for more than 6 weeks, has not been systematically evaluated in controlled trials. Therefore, the physician who elects to use
Wellbutrin for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient.
Contraindications Back to top of pageWellbutrin is contraindicated in patients with a seizure disorder. Wellbutrin is also contraindicated in patients with a current or prior diagnosis of bulimia or anorexia nervosa because of a higher incidence of seizures noted in such patients treated with Wellbutrin. The concurrent administration of Wellbutrin and a monoamine oxidase (MAO) inhibitor is contraindicated. At least 14 days should elapse between discontinuation of an MAO inhibitor and initiation of treatment with Wellbutrin. Wellbutrin is contraindicated in patients who have shown an allergic response to it.
Warnings Back to top of pageSeizures:
Wellbutrin is associated with seizures in approximately 0.4% (4/1000) of patients treated at doses up to 450 mg/day. This incidence of seizures may exceed that of other marketed antidepressants by as much as fourfold. This relative risk is only an approximate estimate because no direct comparative studies have been conducted. The estimate seizure incidence for Wellbutrin increases almost tenfold between 450 and 600 mg/day, which is twice the usually required daily dose (300 mg) and one and one-third the maximum recommended daily dose (450 mg). Given the wide variability among individuals and their capacity to metabolize and eliminate drugs, this disproportionate increase in seizure incidence with dose incrementation calls for caution in dosing.
During the initial development, 25 among approximately 2400 patients treated with Wellbutrin experienced seizures. At the time of seizure, seven patients were receiving daily doses of 450 mg or below for an incidence of 0.33% (3/1000) within the recommended dose range. Twelve patients experienced seizures at 600 mg per day (2.3% incidence); six additional patients has seizures at daily doses between 600 and 900 mg (2.8% incidence).
A separate, prospective study was conducted to determine the incidence of seizure during an 8-week treatment exposure in approximately 3200 additional patients who received daily doses of up to 450 mg. Patients were permitted to continue treatment beyond 8 weeks if clinically indicated. Eight seizures occurred during the initial 8-week treatment period and five seizures were reported in patients continuing treatment beyond 8 weeks, resulting in a total seizure incidence of 0.4%.
The risk of seizure appears to be strongly associated with dose and the presence of predisposing factors. A significant seizure, CNS tumor, concomitant medications that lower seizure threshold, etc.) was present in approximately one-half of the patients experiencing a seizure. Sudden and large increments in dose may contribute to increased risk. While many seizures occurred early in the course of treatment, some seizures did occur after several weeks at fixed dose.
Recommendations for reducing the risk of seizure:
Potential for Hepatotoxicity:
Precautions Back to top of page
Agitation and Insomnia: A substantial proportion of patients treated with
Wellbutrin experience some degree of increased restlessness, agitation, anxiety, and insomnia, especially shortly after initiation of treatment. In clinical studies, these symptoms were sometimes of sufficient magnitude to require treatment with
sedative/hypnotic drugs. In approximately 2% of patients, symptoms were sufficiently severe to require discontinuation of treatment with
Psychosis, Confusion, and Other Neuropsychiatric Phenomena: Patients treated with Wellbutrin have been reported to show a variety of neuropsychiatric signs and symptoms including delusions, hallucinations, psychotic episodes, confusion, and paranoia. Because of the uncontrolled nature of many studies, it is impossible to provide a precise estimate of the extent of risk imposed by treatment with Wellbutrin. In several cases, neuropsychitric phenomena abated upon dose reduction and/or withdrawal of treatment.
Activation of Psychosis and/or Mania: Antidepressants can precipitate manic episodes in Bipolar Manic Depressive patients during the depressed phase of their illness and may activate latent psychosis in other susceptible patients. Wellbutrin is expected to pose similar risks.
Altered Appetite and Weight: A weight loss of greater than 5 pounds occurred in 28% of patients receiving Wellbutrin. This incidence is approximately double that seen in comparable patients treated with tricyclics or placebo. Furthermore, while 34.5% of patients receiving tricyclic antidepressants gained weight, only 9.4% of patients treated with Wellbutrin did. Consequently, if weight loss is a major presenting sign of a patient's depressive illness, the anorectic and/or weight reducing potential of Wellbutrin should be considered.
Suicide: The possibility of a suicide attempt is inherent in depression and may persist until significant remission occurs. Accordingly, prescriptions for Wellbutrin should be written for the smallest number of tablets consistent with good patient management.
Use in Patients with Systemic Illness:
Because Wellbutrin HCl and its metabolites are almost completely excreted through the kidney and metabolites are likely to undergo conjugation in the liver prior to urinary excretion, treatment of patients with renal or hepatic, impairment should be initiated at reduced dosage as Wellbutrin and its metabolites may accumulate in such patients beyond concentrations expected in patients without renal or hepatic impairment. The patient should be closely monitored for possible toxic effects of elevated blood and tissue levels of drug and metabolites.
Information for Patients:
Patients should be instructed to take Wellbutrin in equally divided doses three or four times a day to minimize the risk of seizure.
Patients should be told that any CNS-active drug like
Wellbutrin may impair their ability to perform tasks requiring judgment or motor and cognitive skills. Consequently, until they are reasonably certain that
Patients should be told that the use and cessation of use of alcohol may alter the seizure threshold, and, therefore, that the consumption of alcohol should be minimized, and, if possible, avoided completely.
Patients should be advised to inform their physician if they are taking or plan to take any prescription or over-the-counter drugs. Concern is warranted because Wellbutrin and other drugs may affect each others metabolism.
Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy.
However, animal data suggest that Wellbutrin may be an inducer of drug metabolizing enzymes. This may be of potential clinical importance because the blood levels of co-administered drugs may be altered.
Alternatively, because Wellbutrin is extensively metabolized, the co-administration of other drugs may affect its clinical activity. In particular, care should be exercised when administering drugs known to affect hepatic drug-metabolizing enzyme systems (e.g., carbamazepine, cimetidine, phenobarbital, phenytoin).
Studies in animals demonstrate that the acute toxicity of buproprion is enhanced by the MAO inhibitor phenelzine (see CONTRAINDICATIONS).
Limited clinical data suggest a higher incidence of adverse experiences in patients receiving concurrent administration of Wellbutrin and L-dopa. Administration of Wellbutrin to patients receiving L-dopa concurrently should be undertaken with caution, using small initial doses and small gradual dose increases.
Concurrent administration of Wellbutrin and agents which lower seizure threshold should be undertaken only with extreme caution (see WARNINGS). Low initial dosing and small gradual dose increases should be employed.
Carcinogenesis, Mutagenesis, Impairment of Fertility:
Wellbutrin produced a borderline positive response (2 to 3 times control mutation rate) in some strains in the Ames bacterial mutagenicity test, and a high oral dose (300, but not 100 or 200 mg/kg) produced a low incidence of chromosomal aberrations in rats. The relevance of these results in estimating the risk of human exposure to therapeutic doses is unknown.
A fertility study was performed in rats; no evidence of impairment of fertility was encountered at oral doses up to 300 mg/kg/day.
Pregnancy: Teratogenic Effects:
Labor and Delivery:
Use in the Elderly: