Disclaimer: This is for the purpose of education only. Don’t try to self supplement or self medicate.
Introduction to Wellbutrin (Bupropion)
The clinical pearls of Wellbutrin are discussed. It’s a very safe medication that treats many things on its own as well as in combination with other medications.
Wellbutrin takes a few weeks to kick in. Remember that with a lot of medications that must get into your brain to work, their effects are usually delayed for a couple weeks, and it’s important you understand why. They’re not just telling your body to do things. They have to actually tell the DNA in your mitochondria or nucleus of your cells to change proteins they are creating. That takes some time. Then, once they’ve started changing the proteins they make, those proteins must go out to talk to other cells, usually in tiny vesicles that the cell secretes called exosomes Those must travel in the intracellular tissue. And sometimes the proteins need to travel in the bloodstream further away. It’s an exciting new area of biological research. But we are understanding more and more about how cells talk to each other every day. Anyway. The Wellbutrin tells your cells to change the types of proteins they are making, and thus other cells that respond to that protein have to change their activity. So, you can imagine it takes more than a couple weeks to really work.
So what does Wellbutrin really help with. One, it makes cigarettes taste bad. Two, it produces weight loss. Three, it increases an interest in having sex (not to be confused with increasing sexual ability which it does not do). Four, it treats depression.
To understand how Wellbutrin treats depression, you have to understand how depression occurs in your body. There are two main types of neurons (brain cells) that produce the depressed state. The motivation neurons and the happiness neurons. If you are motivated and happy, you are not depressed. If you are missing one of those, then you are depressed.
That is, if you are not motivated but are happy, you can be depressed. You see some guys out there shooting hoops and it looks like fun, but you can’t get yourself to go play with them. Sound familiar? Right? Now… If you are motivated and not happy, you can be depressed. In fact, that’s the worst form of depression. That’s the worst form of depression because… Think about it… You are super motivated, and you are super unhappy. So, you might be super motivated enough to go get a gun. So. Yeah. Not good.
And a third possible combination, you are super unhappy and you are super unmotivated. Another really bad form of depression. Will almost always need multiple antidepressants to treat both motivation and happiness.
Wellbutrin really only increases the motivation component of depression significantly. It has a slight increasing effect on the happiness component. So, too much Wellbutrin when used for depression simply increases your motivation too much, without paying attention to your happiness. If you get super motivated as I just stated above and you leave the happiness behind, you could go get a gun. Follow? That’s quite Wellbutrin in a truly depressed patient is often used in combination with another medication which will attend to the happiness component of depression at the same time, so both motivation and happiness are elevated at the same time. That is a safer care plan.
Many psychiatrists unfortunately don’t combine Wellbutrin with another medication. The patient starts out on the Wellbutrin – motivation going ever upwards, happiness not improving at all. They get the bill for the psychiatric care four weeks later, feeling super motivated, but still super unhappy… Bam, it triggers suicidal thoughts. I’m not kidding. This is a well-documented effect. Doctors must treat both motivation and happiness in the depressive patient, often times with two separate drugs, often times one of those drugs is Wellbutrin. And not charge too much. Now, there I’m kidding.
Its side effects stem from getting too much of any one of its effects. For example, if you notice, because it is a bit of an upper, then too much of it could cause jitteriness, and even higher doses could cause seizures. (Conversely, stopping it suddenly could make you feel down or dangerously depressed.) Another toxicity, since it causes an interest in sex, too much of an increased interest in sex can be bad. Your psychiatrist doesn’t want you bopping everyone in town.
And in closing, another very important side effect of Wellbutrin that many a psychiatrist often forget about (I’m not trying to slam you guys), Wellbutrin can, since it’s a bit of an upper, increase anxiety. That’s a very bad side effect. Then you’re showing up at your psychiatrist complaining about anxiety. And the psychiatrist forgets that he’s got you on Wellbutrin. So, he simply slaps you another drug for your anxiety instead of just lowering your Wellbutrin dose. Really common scenario. Watch for that if you’re on it.