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  • There appears to be a pattern of symptoms that are inadequately addressed by serotonergic antidepressants – loss of pleasure, loss of interest, fatigue and loss of energy1
  • Evidence suggests that symptoms of decreased positive affect might be mediated by the dysregulation in noradrenergic and dopaminergic neurotransmitters1
Based on references 1, 4-8
2
6
  • Wellbutrin XR is available as both 150 mg tablets and 300 mg tablets
  • Wellbutrin XR is indicated for use in adults over 18 years of age for the treatment of major depressive episodes

3
5
  • Patients with major depression should be treated for a sufficient period of at least 6 months to ensure that they are free from symptoms
  • 300 mg tablet once daily if no improvement is seen after 4 weeks of initial treatment with 150 mg tablet once daily
  • Morning dosing recommended (Insomnia is a very common adverse event which is often transient. Insomnia may be reduced by avoiding dosing at bedtime)
dosage chart
WELLBUTRIN XR is contraindicated in patients:9
  • with hypersensitivity to bupropion or any of the excipients
  • taking any other medicinal product containing bupropion, as the incidence of seizures is dose dependent and to avoid overdosage
  • with a current seizure disorder or any history of seizures
  • with a known central nervous system tumour
  • who, at any time during treatment, are undergoing abrupt withdrawal from alcohol or any medicinal product known to be associated with a risk of seizures on withdrawal (in particular benzodiazepines and benzodiazepine-like agents)
  • with severe hepatic cirrhosis
  • with a current or previous diagnosis of bulimia or anorexia nervosa
Concomitant use of WELLBUTRIN XR and monoamine oxidase inhibitors (MAOIs) is contraindicated. At least 14 days should elapse between discontinuation of irreversible MAOIs and initiation of treatment with WELLBUTRIN XR. For reversible MAOIs, a 24 hour period is sufficient.9
The recommended dose of modified release bupropion tablets should not be exceeded, since bupropion is associated with a dose-related risk of seizure. The overall incidence of seizure with modified release bupropion tablets in clinical trials at doses up to 450 mg/day was approximately 0.1%.9
Very common side effects with Wellbutrin XR use could be insomnia, headache, dry mouth, gastrointestinal disturbance including nausea and vomiting.9

In order to ensure that this product information reflects the most up-to-date clinical and post-marketing surveillance data, please always refer to the latest Summary of Product Characteristics (SPC) which is available from GlaxoSmithKline (Malta)
Ltd (Tel: +356 21238131)

REPORTING ADVERSE EVENTS (AEs):
If you become aware of any AEs, medication errors and/or use during pregnancy in association with GSK products, please report the event promptly to: GSK (Malta) Limited, 1, De la Cruz Avenue, Qormi QRM 2458, Malta
(Tel: +356 21238131)

Alternatively, any suspected AEs and medication errors can also be reported via the national Adverse Drug Reactions (ADRs) reporting system:
Report forms can be downloaded from http://www.medicinesauthority.gov.mt/adrportal and posted to the Malta Medicines Authority, Post-licensing Directorate, 203, Level 3, Rue D’Argens, Gżira GŻR 1368, MALTA, or sent by email to [email protected]

 
Wellbutrin XR should not be used together with other Bupropion containing medicinal products. Wellbutrin XR tablets should be swallowed whole and not crushed or chewed.
 
References
  1. Nutt DJ, Demyttenaere K, Janka Z, Aarre T, Bourin M, Canonico PL, et al. The other face of depression, reduced positive affect: the role of catecholamines in causation and cure. J Psychopharmacol 2007; 21: 461–471.
  2. Fava M, Rush AJ, Thase ME, Clayton A, Stahl SM, Pradko JF, et al. 15 years of clinical experience with bupropion HCl: from bupropion to bupropion SR to bupropion XL. Prim Care Companion J Clin Psychiatry 2005; 7:106–13.
  3. 3. Stahl SM, Pradko JF, Haight BR, Modell JG, Rockett CB, Learned- Coughlin S. A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. Prim Care Companion J Clin Psychiatry 2004; 6: 159–66.
  4. 4. Stahl SM. Essential Psychopharmacology. Second edition ed. New York, NY: Cambridge University Press; 2000.
  1. Foote SL, Aston-Jones GS. Chapter 29. Pharmacology and physiology of central noradrenergic systems. In: Bloom FE, Kupfer DJ, editors. Psychopharmacology: the fourth generation of progress. New York: Raven Press Ltd; 1995. p. 335–45.
  2. Shelton RC, Tomarken AJ. Can recovery from depression be achieved? Psychiatr Serv 2001; 52: 1469–78.
  3. Stahl SM. Deconstructing psychiatric disorders, part 2: An emerging, neurobiologically based therapeutic strategy for the modern psychopharmacologist. J Clin Psychiatry 2003; 64: 1145–6.
  4. Nutt DJ. Relationship of neurotransmitters to the symptoms of major depressive disorder. J Clin Psychiatry 2008; 69 Suppl E1:4–7.
  5. Wellbutrin XR SPC (NOV14).
 
Job No: MLT_GIB/BHC/0001/16
Date of preparation: March 2016
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