Wellbutrin IR

[Mass Effect]

Is there a reason not to prescribe the IR formulation of Wellbutrin? I notice no one does and then I read that it was discontinued, but when I checked with my local CVS, they still have it. Do you guys use it? And if not, aside from the inconvenience of having to take it multiple times a day, is there a reason?

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[MedMan80]

It has a higher seizure risk than SR and XL formulations, also i think the convenience of XL makes the up to 4 times daily dosing inconvenient..

 

[st2205]

I still use it. Hx gastric bypass and also if I’m using it more for its stimulant-like effect. Also if there’s a reason to move away from SR or XL. Also when people have gotten a benefit from the medication but have not tolerated 150 of XL or 100 of SR. Haven’t heard anything about it being discontinued.

 

[NickNaylor]

I never use IR. I use SR quite a bit - or at least did when I was working in our indigent clinic as XL generally wouldn't be covered - and XL more rarely.

 

[whopper]

I usually prescribe the XL version only because once a day dosing is more convenient. I at times do prescribe the IR version only because some patients have no insurance and would rather take that version cause it's cheaper. Another reason is on rare occasions I get a patient who can tolerate IR and not the XL version. When this happens it's likely the excipients in the pill causing the problem and not the medication itself.

 

[tr]

I have used IR bupropion successfully prn to counteract libido impairment from SSRIs. For use as an antidepressant I don't see a reason to subject patients to the rapid swings in energy level and the inconvenience of 3x/day dosing when SR and XL are available.

 

[randomdoc1]

I have used IR bupropion successfully prn to counteract libido impairment from SSRIs. For use as an antidepressant I don't see a reason to subject patients to the rapid swings in energy level and the inconvenience of 3x/day dosing when SR and XL are available.

How have you dosed it for countering sexual SE? Very interesting indeed.

 

[Mass Effect]

I have used IR bupropion successfully prn to counteract libido impairment from SSRIs. For use as an antidepressant I don't see a reason to subject patients to the rapid swings in energy level and the inconvenience of 3x/day dosing when SR and XL are available.

I have very limited experience with IR. I know Wellbutrin in general is stimulating, but are these swings actually noticeable? Is it similar to a stimulant in the IR formulation?

 

[tr]

How have you dosed it for countering sexual SE? Very interesting indeed.

I've used it mostly for libido impairment in women; not sure if it would have any benefit for delayed ejaculation/anorgasmia in men. For most women 75 mg is enough, a few have needed 150.

 

[tr]

I have very limited experience with IR. I know Wellbutrin in general is stimulating, but are these swings actually noticeable? Is it similar to a stimulant in the IR formulation?

Yes energy variability is usually very noticeable, although as always people differ and YMMV. I've had a few patients whose GPs accidentally switched them from XR to SR, which typically resulted in an afternoon crash. IR is very stimulating as per the reports of my patients who take it prn for sexual impairment.

Bupropion is an NDRI, so it is 'stimulant lite' in some sense. I've used it successfully for attention/focus as well (usually SR/XR). I understand the IR formulation also has a street value when crushed and snorted, although I don't know much about its effects on NAcc/reward signaling so not sure if there is addictive potential.

 

[Jules A]

Yes energy variability is usually very noticeable, although as always people differ and YMMV. I've had a few patients whose GPs accidentally switched them from XR to SR, which typically resulted in an afternoon crash. IR is very stimulating as per the reports of my patients who take it prn for sexual impairment.

Bupropion is an NDRI, so it is 'stimulant lite' in some sense. I've used it successfully for attention/focus as well (usually SR/XR). I understand the IR formulation also has a street value when crushed and snorted, although I don't know much about its effects on NAcc/reward signaling so not sure if there is addictive potential.

I have had patients describe feeling it wear off but so far no one complained of a crash. What is your prn recommendation? I've done it as daily dosing but would much prefer prn if applicable when largely used for sexual side effects.