General
Description & Use
Treats depression. Also, aids in quitting smoking. Belongs to
a class of drugs called antidepressants. Bupropion (INN; previously
known as amfebutamone, Wellbutrin, Zyban) is an atypical antidepressant
that acts as a norepinephrine and dopamine reuptake inhibitor,
and nicotinic antagonist. Bupropion belongs to the chemical class
of aminoketones and is similar in structure to the stimulant cathinone,
to the anorectic diethylpropion, and to phenethylamines in general.
Initially researched and marketed as an antidepressant, bupropion
was subsequently found to be effective as a smoking cessation
aid. In 2007 it was the fourth-most prescribed antidepressant
in the United States retail market, with 20.184 million retail
prescriptions. Bupropion lowers seizure threshold and its potential
to cause seizures was widely publicized. However, at the recommended
dose the risk of seizures is comparable to that observed for other
antidepressants. Bupropion is an effective antidepressant on its
own but it is particularly popular as an add-on medication in
the cases of incomplete response to the first-line SSRI antidepressant.
In contrast to many psychiatric drugs, including nearly all antidepressants,
bupropion has a low risk of weight gain or sexual dysfunction.
Quit
Smoking with Zyban
In
1996, the FDA approved a sustained-release formulation of bupropion
called Wellbutrin SR (Zyban), intended to be taken twice a day
(as compared to three times a day for immediate-release Wellbutrin).
In 2003 the FDA approved another sustained-release formulation
called Wellbutrin XL, intended for once-daily dosing. Wellbutrin
SR and XL are available in the United States and Canada in generic
form. In 1997, bupropion was approved by the FDA for use as a
smoking cessation aid under the name Zyban. In 2006, Wellbutrin
XL was similarly approved as a treatment for seasonal affective
disorder. Bupropion reduces the severity of nicotine cravings
and withdrawal symptoms. After a seven-week treatment, 27% of
subjects who received bupropion reported that an urge to smoke
was a problem, versus 56% of those who received placebo. In the
same study, 21% of the bupropion group reported mood swings, versus
32% of the placebo group. The bupropion treatment course lasts
for seven to twelve weeks, with the patient halting the use of
tobacco about ten days into the course. The efficacy of bupropion
is similar to that of nicotine replacement therapy. Bupropion
approximately doubles the chance of quitting smoking successfully
after three months. One year after the treatment, the odds of
sustaining smoking cessation are still 1.5 times higher in the
bupropion group than in the placebo group. The combination of
bupropion and nicotine appears not to further increase the cessation
rate. In a direct comparison, varenicline (Chantix, Champix) showed
superior efficacy: after one year, the rate of continuous abstinence
was 10% for placebo, 15% for bupropion, and 23% for varenicline.
Weight
Loss with Zyban
Bupropion slows the weight gain that often occurs in the first
weeks after quitting smoking (after seven weeks, the placebo group
had an average 2.7 kg increase in weight, versus 1.5 kg for the
bupropion group). With time, however, this effect becomes negligible
(after 26 weeks, both groups recorded an average 4.8 kg weight
gain). A recent meta-analysis of anti-obesity medications pooled
the results of three double-blind, placebo-controlled trials of
bupropion. It confirmed the efficacy of bupropion given at 400
mg per day for treating obesity. Over a period of 6 to 12 months,
weight loss in the bupropion group (4.4 kg) was significantly
greater than in the placebo group (1.7 kg). The same review found
the differences in weight loss between bupropion and other established
weight-loss medications, such as sibutramine, orlistat and diethylpropion,
to be statistically insignificant. Although attention-deficit
hyperactivity disorder (ADHD) is not an approved indication, bupropion
was found to be effective for adult ADHD. There have been many
positive case studies and other uncontrolled clinical studies
of bupropion for ADHD in minors. However, in the largest to date
double-blind study, which was conducted by GlaxoSmithKline, the
results were inconclusive. Aggression and hyperactivity as rated
by the children's teachers were significantly improved in comparison
to placebo; in contrast, parents and clinicians could not distinguish
between the effects of bupropion and placebo.
The
2007 guideline on the ADHD treatment from American Academy of
Child and Adolescent Psychiatry notes that the evidence for bupropion
is "far weaker" than for the FDA-approved treatments. Its effect
may also be "considerably less than of the approved agents...
Thus it may be prudent for the clinician to recommend a trial
of behavior therapy at this point, before moving to these second-line
agents." Similarly, the 2006 guideline from the Texas Department
of State Health Services recommends considering bupropion or a
tricyclic antidepressant as a fourth-line treatment after trying
two different stimulants and atomoxetine (Strattera).
For
your safety the product well sell is the genuine Glaxo medication
and not a low cost copy
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