Bupropion (Wellbutrin XL) tips from pharmacists

• Bupropion is available in different brands and generics, with different formulations (extended-release, immediate-release, and sustained-release). Make sure you are using the correct medication and formulation. Ask your pharmacist if you are unsure which bupropion formulation you are taking. 
• Seizures are one of the most common adverse effects of bupropion. You must stop bupropion immediately and contact your healthcare provider if you have seizures while taking it. 
• Like other antidepressants, bupropion can worsen existing depression, causing suicidal thoughts and ideation, especially during the first few months of treatment. Let your doctor know if you experience any changes in mood and behavior. Seek emergency medical care if you feel suicidal or have an increased urge for self-harm.
• Let your loved ones know when you start taking bupropion so they can watch out for any changes in your mood and behavior, especially if you have a history of depression and are using  bupropion for smoking cessation in combination with nicotine replacement therapy. 
• You should avoid drinking alcohol as much as possible while being on bupropion treatment. A large amount of alcohol or sudden discontinuation of alcohol use can increase your risk of seizures. Alcohol can also enhance the CNS depressant effects and make you dizzier. 
• Even if you take it for seasonal depression, you should not stop taking bupropion suddenly as it can cause unpleasant withdrawal symptoms. Talk to your doctor on how to safely taper off bupropion. 
• You can take bupropion with or without food in the morning to avoid sleeping problems.
• Do not cut, chew, crush or cut the sustained-release or extended-release bupropion formulation.
• For most medications, if you miss a dose, you should skip that dose. If it is close to the time for the next scheduled dose, you should wait until the next scheduled dose to take the medicine. This fact is extremely important with bupropion. You should never take a double dose of bupropion, as too much bupropion can increase your risk of a seizure. For the same reason, you should separate bupropion doses by at least 6 to 8 hours if you take multiple doses of bupropion throughout the day. 
• Bupropion can cause dizziness and affect your coordination and concentration. You should not drive, operate hazardous machinery, or perform activities that require mental alertness. 
• Like other antidepressants, it can take several weeks or months to feel the full antidepressant effects. You may experience more adverse effects than improvement at the beginning of treatment. However, if those side effects or your depression worsen or do not improve, discuss with your doctor to see if you should switch to another medication.