Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regards to prescription medication.
Wellbutrin is one of the most popular medications for depression, taken by millions of patients annually in the U.S. alone. It also has a side effect in some people, and an off-label usage of inducing weight loss, even though it’s not approved by the Food and Drug Administration (FDA) for this purpose.
In this article we’ll review the research behind Wellbutrin to determine whether we believe it’s a safe and effective method for treating depression, as well as discuss some natural alternatives.
What Is Wellbutrin?
Wellbutrin is a brand name drug that has a generic version called bupropion. We will use these two terms interchangeably throughout this article, since much of the medical research is on the generic bupropion. This same chemical compound makes up one of the two active ingredients in Contrave, which we reviewed previously.
Bupropion is the only active ingredient in Wellbutrin. We reviewed the inactive ingredients in Wellbutrin XL and they seem very safe and non-toxic, which is favorable in comparison to Contrave which included artificial food colorants in their inactive ingredients.
Regular Wellbutrin contains not only artificial food dye (Yellow No. 10 Lake, Yellow No. 6 Lake), but also talc which has been associated with increased risk of cancer when ingested based on medical research. The amount in Wellbutrin is likely very small as it’s an inactive ingredient, but we generally recommend consumers avoid potentially harmful filler ingredients when they can. There is no health benefit to talc ingestion.
Does Wellbutrin Work?
Medical research suggests Wellbutrin is effective for depression, as prescription medications have to clear rigorous medical trials to be approved. A medical review from the Therapeutic Advances in Psychopharmacology Journal found that Wellbutrin reduced depression on average in 24 of 27 medical trials evaluated.
In trials where Wellbutrin was compared with placebo, it was superior in 5 of the 6 trials. The researchers also noted that Wellbutrin was found to be similarly effective to other antidepressant medications like sertraline (brand name Zoloft) but not superior.
Another extensive medical review concluded similar: that Wellbutrin in all of its formats (extended release, standard release, twice-daily) was effective for major depressive disorder. The review also noted that Wellbutrin had a lower incidence of common side effects caused by antidepressants such as sexual dysfunction and weight gain.
How Does Wellbutrin Work?
Wellbutrin inhibits reuptake of two neurotransmitters: norepinephrine and dopamine. This means that the drug delays the natural processing of these neurotransmitters by the body, resulting in higher circulating levels in the brain.
Dopamine directly affects mood and motivation, and low levels are thought to be associated with higher risk of depression.
Norepinephrine is necessary for proper sympathetic nervous system function, and similar to dopamine low levels of the neurotransmitter have been associated with increased risk of depression.
By artificially increasing levels of these neurotransmitters in patients with low levels, Wellbutrin can potentially normalize symptoms of depression, which is how the drug is thought to work.
Is Wellbutrin an SSRI?
No, but it has a similar mechanism of action. SSRI stands for selective serotonin reuptake inhibitor, and this class of drugs artificially increases circulating levels of a neurotransmitter called serotonin.
Wellbutrin affects reuptake of norepinephrine and dopamine instead. This makes it a SNDRI (selective norepinephrine dopamine reuptake inhibitor).
Wellbutrin and Weight Loss
Weight loss in patients taking Wellbutrin was noted in some of the early studies, and there have now been further studies specifically on Wellbutrin as a weight loss aid.
One clinical trial in the Obesity Research Journal found that Wellbutrin standard release was significantly more effective than a placebo pill for weight loss. Patients on Wellbutrin lost 4.6% of their baseline weight over 12 weeks, while the placebo group lost an average of 1.8% of their baseline weight.
A more recent review of Wellbutrin for weight loss analyzed several individual trials on the topic, and found that the medication was significantly more effective than placebo. The researchers noted that although Wellbutrin isn’t approved by the FDA for weight loss, “There might be a role for this drug as a second-line consideration for obesity”.
Overall, Wellbutrin does seem to be effective on average for improving weight loss outcomes, likely due to its effect on norepinephrine. That being said, we don’t recommend Wellbutrin for weight loss as we believe the risks are not worth the potential benefits when there are so many proven lifestyle modifications for weight loss.
Wellbutrin Side Effects
Wellbutrin has a relatively significant side effect profile, with research noting that “many side effects occur” in over 10% of patients on the medication. Some of the most common side effects are tachycardia (rapid heart beat), headache, insomnia and constipation.
The same biological mechanism likely causing the increased weight loss (increased norepinephrine) is likely responsible for most of these side effects, as this neurotransmitter is stimulatory to the central nervous system.
This is the double-edged sword of most pharmaceutical treatments in our opinion; a drug may be effective on average but there are often significant side effects to weigh its use against.
Natural Alternatives to Wellbutrin
As stated in the disclaimer section at the top, we don’t recommend that patients discontinue use of Wellbutrin without consulting their doctor. This section provides some information on natural compounds that have been studied to be effective for depression, and may have a safer risk profile than Wellbutrin.
St. John’s Wort
We covered this herb in our Cymbalta reviews article, as it’s one of the most well-studied natural treatments for depression.
St. John’s Wort, when taken in extract format, has been shown in medical research to be as effective as prescription medication for mild-to-moderate depression. It has a much more favorable side effect profile in our opinion, with no major adverse effects reported.
St. John’s Wort used in medical trials is usually an extract standardized to 2-5% hyperforin and 0.3% hypericin. These are the active chemical compounds in the plant.
Omega-3 Fatty Acids
Omega-3 fatty acids, found in high concentrations in fish, have a host of proven health benefits. Preliminary research has found their supplementation to be effective for depression.
One medical study found that omega-3 supplementation at 6.6 grams (g) a day was effective for major depressive disorder, which is impressive given that severe depression can be harder to treat with mild natural treatments. Recall that St. John’s Wort was only proven effective for mild-to-moderate depression.
A more recent medical review of 26 individual studies found that omega-3 supplementation even at as low a dose as 1 g or less daily is effective for depression.