Wellbutrin XL (bupropion hydrochloride) and Suicidal Thoughts – Black Box Information

Wellbutrin XL and Zyban contain bupropion. Like many other antidepressants, these medications have “black box” warning regarding the increased risk of suicidal thoughts.

The black box warning on antidepressants is required by FDA to provide important safety information. However, some of these warnings are exaggerated, causing panic and decrease access to mental health care. When it was implemented in 2005, the magnified danger message resulted in a slew of media reports about the link between antidepressants and suicide.

The black box warning on the FDA website states, “Advise patients and caregivers that the patient using bupropion for smoking cessation should stop taking bupropion and contact a healthcare provider immediately if agitation, hostility, depressed mood, or changes in thinking or behavior that are not typical for the patient are observed, or if the patient develops suicidal ideation or suicidal behavior.”

Bupropion hydrochloride is an antidepressant used for smoking cessation (Zyban) and to treat a variety of conditions, including depression and other mental disorders or mood disorders (Wellbutrin XL). Antidepressants can help prevent suicidal thoughts or attempts and provide other benefits. However, a small number of people (especially people under the age of 25) who take antidepressants for any condition may experience new or worsening depression, other mood symptoms, or suicidal thoughts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication, even if treatment is not for a mental or mood condition.

There is no question that antidepressant medications can cause harm if used inappropriately.  What the FDA may not recognize is that a black box warning can stop many adolescents and young adults from seeking care. According to Statnews.com, this has led to a decrease in seeking help for these conditions. Without seeking help, appropriate medication therapy can be provided. Without drug therapy for these individuals, suicide attempts may actually increase.

Antidepressant medications do have a place in modern medicine. These drugs help many people fight depression. Medications like Wellbutrin (bupropion) are effective for many individuals if it is prescribed safely. Patients should get a proper counselling regarding the use of these medications, including risks and benefits. This discussion with your health care provider needs to take place at the time of prescribing.

For further information about antidepressants and black box warnings please consult with your physician or health care provider.  These important conversations should provide a more realistic view of the risks versus the benefits of antidepressant medications.

Tablet, sustained-release (Wellbutrin SR)

• 100mg
• 150mg
• 200mg

Tablet, extended-release (Wellbutrin XL)

• 150mg
• 300mg

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use exactly as directed by your healthcare provider.

You may take bupropion with or without food.

The usual starting dose for adults is 200 mg a day, given in two doses of 100 mg (bupropion SR). After which your doctor may increase your dose which will be given in divided doses; with at least a six-hour interval between doses.

The extended release (Wellbutrin XL) is usually started at 150mg given once a day in the morning within a 24-hour time frame.

Try to take your bupropion (Wellbutrin XL) at the same time each day and avoid it being too close to bedtime.

Do not crush, chew, or break your bupropion tablet. Swallow it whole.

You should not change your dose or stop using bupropion suddenly, without consulting your doctor. Stopping suddenly can cause unpleasant withdrawal symptoms. Ask your doctor how to safely stop using bupropion.

Bupropion can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking bupropion.

If you miss a dose, take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Store at room temperature; away from moisture, heat, and light.

You should not take bupropion if you are allergic to it, or if you have:

• a seizure disorder;
• an eating disorder such as anorexia or bulimia; or
• if you have suddenly stopped using alcohol, seizure medication, or a sedative such as Xanax, Valium, Fiorinal, Klonopin, and others).

Bupropion is not approved for use by anyone younger than 18 years old.

Drinking alcohol and using illegal drugs with bupropion may increase your risk of seizures. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Bupropion can also cause seizures in a regular drinker who suddenly stops drinking at the start of treatment with bupropion.

Bupropion may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Bupropion may cause seizures, especially if you have certain medical conditions or use certain drugs. Tell your doctor about all of your medical conditions and the drugs you use.

To make sure bupropion is safe for you, tell your doctor if you have:

• a history of head injury, seizures, or brain or spinal cord tumor;
• narrow-angle glaucoma;
• been diagnosed with an eating disorder such as anorexia or bulimia;
• heart disease, high blood pressure, history of heart attack;
• diabetes;
• kidney or liver disease (especially cirrhosis);
• bipolar disorder or other mental illness; or
• abruptly stopped drinking or are still drinking alcohol or
• had an allergic reaction to bupropion previously.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Bupropion can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• a seizure (convulsions);
• unusual changes in mood or behavior;
• hallucinations;
• shortness of breath;
• swollen glands;
• increased frequency of urination;
• a manic episode–racing thoughts, increased energy, reckless behavior, feeling extremely happy or irritable, talking more than usual, severe problems with sleep;
• blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• fast heartbeats; or
• severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

• dry mouth, stuffy nose;
• nausea, constipation;
• sleep problems (insomnia);
• feeling anxious;
• dizziness; or
• joint pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Tell your doctor about all your other medicines, especially:

• drugs that reduce the threshold for seizures such as prochlorperazine (Compazine), chlorpromazine (Thorazine), etc.;
• benzodiazepines such as diazepam (Valium), alprazolam (Xanax);
• Carbamazepine (Tegretol)
• Ritonavir (Norvir)
• MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Do not take bupropion to treat more than one condition at a time.

This list is not complete. Many drugs may affect this medication, including prescription and over-the-counter medicines, vitamins, and herbal products.

Seek emergency medical attention

If you have any questions about buying discount Bupropion (Wellbutrin XL) or any other prescription products online, you can contact us.