Wellbutrin (active ingredient bupropion) is an incredibly versatile antidepressant that can be used by itself or paired with an SSRI such as Lexapro or Zoloft for treating depression.

It is one of the go-to agents in my clinical practice because it works incredibly well!

However, it must be dosed appropriately to maximize therapeutic benefit and minimize its adverse events, which can be severe if your healthcare provider is not careful.

The signs Wellbutrin is working may include:

• Gradual improvement in mood (won’t start working right away)
• Relief from persistent feelings of sadness, hopelessness, and anxiety
• Increased happiness and interest in activities
• Boost in energy levels and motivation

What Is Wellbutrin (Bupropion)?

Wellbutrin (Bupropion) is an antidepressant medication belonging to a class of drugs called norepinephrine and dopamine reuptake inhibitors (NDRIs).

Bupropion works specifically on norepinephrine and dopamine, two brain chemicals that are important in regulating mood, mental health, and emotions.

Wellbutrin is FDA-approved for treating:

• Adult major depressive disorder
• Seasonal affective disorder
• Smoking cessation (if you want to quit smoking)

Wellbutrin’s non-FDA approved, off-label uses include:

• Anti-depressant-induced sexual dysfunction
• Attention-deficit/hyperactivity disorder (ADHD)
• Bipolar disorder-associated depression
• Obesity

As I mentioned, Wellbutrin’s mechanism of action (how it works on the brain) targets two specific neurotransmitters:

Norepinephrine and Dopamine.

Specifically, the medication blocks these two brain chemicals from being reabsorbed by neurons in the brain.

This action helps restore balance to the brain’s chemical signaling pathways, ultimately improving mood and reducing symptoms of depression.

The video below from a psychiatrist’s YouTube channel describes how Wellbutrin works:

Additionally, I really like how the doctor describes the side effects of Wellbutrin.

Some of these can be serious, as I have seen in my clinical practice several times.

More on this later…

How Does Wellbutrin Make You Feel?

At therapeutic doses, Wellbutrin improves your mood and overall well-being.

However, individual responses may vary, so it’s important to continue taking Wellbutrin as prescribed, even if you don’t immediately feel the effects.

When Wellbutrin starts to work, you may notice a gradual improvement in your mood.

Persistent feelings of sadness, hopelessness, and anxiety may begin to diminish, allowing you to experience increased happiness and interest in activities.

In addition, Wellbutrin may boost your energy levels and motivation, providing you with a sense of renewed vitality.

Better sleep patterns may also be observed, contributing to an overall improvement in your well-being.

While it’s important to be aware of the potential side effects of Wellbutrin, such as headaches, dry mouth, nausea, insomnia, and mild agitation, these side effects tend to improve over time.

It’s also crucial to communicate any side effects you experience with your healthcare provider, as they can help monitor your response to the medication and make any necessary adjustments.

How Long Does Wellbutrin Take to Work?

While it’s not likely to feel the positive effects of the medication on the first day, it’s important to be patient.

It typically takes some time for Wellbutrin to start working, with most individuals experiencing improvements within 2 to 6 weeks.

It can take even longer for some people to start seeing the full therapeutic effects of Wellbutrin.

Again, it is important to be patient and not stop taking the medication unless instructed to do so by your medical professional.

The main reason why Wellbutrin and other antidepressants take a while to work is that they are changing the levels of their target brain chemicals, and the downstream effect of these changes takes time to see the full therapeutic benefits.

Can You Feel Wellbutrin on the First Day?

Feeling the effects of Wellbutrin on the first day is highly unlikely.

As I stated, when you start treatment with Wellbutrin for symptoms of depression, it takes time for the medication to reach therapeutic levels in your body.

Some people claim that they started seeing benefits on the first day of treatment with Wellbutrin, but I attribute this to the placebo effect.

This is when the anticipation of therapeutic benefit from taking Wellbutrin leads the person to feel subjectively better despite the medication not even having had the opportunity to begin its pharmacological effect on the brain.

10 Signs Wellbutrin Is Working

As you continue taking Wellbutrin (Bupropion), certain signs indicate the medication is working effectively.

You may notice an improvement in your mood, with a gradual lifting of feelings of sadness, hopelessness, and anxiety.

Additionally, you may experience an increase in your interest and enjoyment of activities, along with a boost in energy levels and better focus and concentration.

Improved sleep patterns may also be observed as a positive sign of Wellbutrin’s effectiveness.

1. Improvement in your mood

You may notice a gradual lifting of your emotional burden and a greater sense of well-being as Wellbutrin starts to take effect.

Improvement in mood and reduced feelings of depression are some of the signs that bupropion is working.

Again, time to therapeutic effect varies among people.

For some, it can take a week or two to start seeing this uptick in mood.

For others, it may take longer.

If it has been several weeks (as in 8 or more weeks) and you are not seeing any benefits, I recommend calling your prescribing medical professional to discuss options and possible changes to your medication regimen.

2. Your interest and enjoyment increases

Notice an increase in your interest and enjoyment as Wellbutrin (Bupropion) starts to take effect.

As Wellbutrin begins to work, you may experience the following:

• Heightened interest in activities and hobbies
• Increased enjoyment and pleasure from daily experiences
• Renewed motivation and engagement in social interactions

3. Your energy levels increase

With Wellbutrin (Bupropion) starting to take effect, you may begin to experience an increase in your energy levels.

Your fatigue seems to dissipate slowly, and you may experience a “get-up-and-go” type of energy.

You will be motivated to participate in and complete tasks and responsibilities that you found uninteresting before beginning your bupropion therapy.

4. You have better focus and concentration

As bupropion continues to take effect, you may find that your focus and concentration improve.

Here are three signs to look out for:

• Increased ability to stay on task and complete activities without distractions.
• Improved mental clarity and ability to think clearly.
• Enhanced ability to pay attention and retain information.

Just like with the other symptoms, it’s important to note that the positive effects of focus and concentration may take time to manifest fully.

In the first week or two of starting Wellbutrin, you may not experience these improvements immediately.

However, with continued use, these negative effects do improve.

5. Your sleep improves (IF you take it the right way!)

You may experience better sleep when Wellbutrin (Bupropion) works effectively for you.

Sleep disturbances, such as insomnia or restless sleep, are common symptoms of depression.

With the alleviation of depressive symptoms, you may find that you fall asleep more easily, stay asleep throughout the night, and wake up feeling more rested and refreshed.

However, the dose and WHEN you take bupropion matters.

Due to the activating nature of norepinephrine and dopamine, avoid taking Wellbutrin later in the day or before bedtime.

Doing so can actually cause sleep disturbances and insomnia.

There are two formulations of this medication: Wellbutrin XL and Wellbutrin SR.

The XL formulation is dosed once daily, so it is best taken in the morning.

The SR formulation is dosed twice daily.

The second dose of Wellbutrin SR should be taken 8 hours after the morning dose.

I tell my patients to take their second dose around 4 or 5 pm (time it with dinner).

You may need to experiment with the timing or to keep things less complicated, ask your doctor if they can prescribe you the once-daily XL formulation instead.

6. Your appetite improves

Here are three signs that Wellbutrin is positively impacting your appetite:

• Increased hunger: You may start to feel more hungry and have a greater desire to eat.
• Improved food enjoyment: Wellbutrin can enhance your pleasure from eating, making meals more satisfying.
• Stable weight: If you were experiencing weight loss or gain due to depression or other factors, Wellbutrin’s effectiveness may result in weight stabilization.

7. Suicidal thoughts decrease

With Wellbutrin (Bupropion), a decrease in suicidal thoughts can be observed as a positive sign that the medication is working effectively.

It’s important to note that suicidal thoughts may not completely disappear immediately, but a decrease in their frequency and intensity is a promising indication that Wellbutrin is having a positive effect.

A very important note: As with all other antidepressants, Wellbutrin has a Box warning for increased suicidality in children, teenagers, and young adults.

Clinicians think that this is because as Wellbutrin starts working to give people more energy and motivation, certain people with already existing suicidal thoughts may be at risk of carrying through on their plans.

Close monitoring is needed during this brief period of time to ensure your safety or that of your loved ones.

If you’re experiencing a decrease in suicidal thoughts, it’s crucial to continue taking the medication as prescribed and communicate this improvement to your healthcare provider.

They can provide guidance and monitor your progress to ensure that Wellbutrin continues to be effective for you.

8. Your anxiety decreases

Wellbutrin can lead to a reduction in anxiety symptoms.

Here are three signs that Wellbutrin is working:

• Decreased feelings of restlessness and worry
• Relief from racing thoughts and panic attacks
• Improved ability to cope with stress and everyday challenges

9. Your confidence increases

You may feel more confident in social situations, expressing your opinions, and taking on new challenges.

Wellbutrin’s ability to improve mood and reduce feelings of depression can contribute to an overall increase in self-esteem and a greater sense of self-worth.

This increase in confidence can positively impact various aspects of your life, including relationships, work, and personal goals.

10. You become better at coping

Here are three signs that indicate Wellbutrin is working:

• Increased resilience: You may adapt to and handle difficult situations with greater ease and resilience.
• Reduced emotional overwhelm: Wellbutrin can alleviate persistent feelings of sadness, hopelessness, and anxiety, allowing you to experience a greater sense of emotional stability and control.
• Enhanced problem-solving skills: As Wellbutrin improves your mood and mental well-being, you may notice an improvement in your ability to think clearly and find effective solutions to problems.

Side effects of Wellbutrin

As with any medication, Wellbutrin can cause side effects.

Common side effects of Wellbutrin include:

• Headaches
• Dry mouth
• Nausea
• Insomnia
• Mild agitation
• Increased heart rate
• Rhinitis (runny nose)
• Pharyngitis (inflammation of the throat)
• Tremors (shakiness)
• Blurred vision
• Dizziness
• Sweating
• Skin rash
• Weight loss
• Constipation

These side effects are generally mild and tend to improve over time as your body adjusts to the medication.

Serious side effects of Wellbutrin include:

• Risk of seizures (due to reduction of seizure threshold)
• Worsening suicidal ideation (as I explained above)

A word about seizures – these are rare, and many instances can be avoided.

In my practice, I have seen this happen when the medication is dosed inappropriately, or the starting dose is too high.

Clinical evidence suggests that the highest incidence of seizures seems to happen when the immediate-release bupropion is prescribed at a high dose or if the overdose is done intentionally. 

If you are prescribed bupropion, empower yourself by asking your doctor or pharmacist if the starting dose is appropriate and voice your concerns about getting seizures from starting Wellbutrin.

It’s important to note that not everyone will experience these side effects, and individual responses may vary.

If you experience any of these side effects, discussing them with your healthcare provider is recommended.

They can guide you in managing these side effects or adjust your dosage if necessary.

Remember to always communicate openly with your healthcare provider to ensure safe and effective use of Wellbutrin.

Other warnings about Wellbutrin

Other than the side effects I have mentioned above, there are other warnings you need to be aware of.

One of the biggest warnings is NOT to stop taking Wellbutrin suddenly!

Doing so can precipitate antidepressant withdrawal (also called antidepressant discontinuation syndrome).

Withdrawal symptoms include:

• Agitation and high irritability
• Headache
• Nausea (sometimes accompanied by vomiting)
• Dizziness
• Flu-like symptoms (sweating, body aches, fatigue)
• Anxiety
• Mania
• “Brain zaps” (electric shock-like sensation in the brain, brief blackout, buzzing sound, dizziness, disorientation, etc)

Wellbutrin contraindications

You must not take Wellbutrin if you have the following:

• Hypersensitivity or allergy to bupropion or its constituents
• Existing seizure disorder
• Factors that predispose you to seizures (alcohol or sedative discontinuation, severe head injury, brain tumor, stroke, CNS disease, etc)
• Taking monoamine oxidase inhibitors, linezolid, methylene blue

Wellbutrin monitoring

Wellbutrin does not need to be monitored with blood testing.

However, as with the majority of drugs, it is metabolized by liver enzymes and hence is prone to major drug interactions.

Always inquire about this with your doctor or pharmacist, as I mention in the “Question to ask your provider” section below.

Bupropion and its metabolites are excreted into breast milk, so it requires caution if you are nursing your baby or babies.

Signs Wellbutrin is not working

Symptoms don’t get better after many weeks or months

After many weeks or months of taking Wellbutrin, if your symptoms don’t show improvement, it may indicate that the medication isn’t working as expected.

It’s important to remember that individual responses to Wellbutrin may vary, and it may take time for the medication to reach its full effectiveness.

However, if you have been taking Wellbutrin for a significant period (more than 12 or so weeks) and your symptoms remain unchanged, it may be necessary to explore alternative treatment options.

Here are three signs that suggest Wellbutrin isn’t working for you:

1. Lack of improvement in mood: If your persistent feelings of sadness, hopelessness, and anxiety don’t alleviate, it may indicate that Wellbutrin isn’t the right medication for you.
2. Absence of increased happiness and interest in activities: Wellbutrin should boost your mood and motivation, but if you don’t experience an improvement in these areas, it suggests that the medication isn’t effective.
3. Continuation of suicidal thoughts or behaviors: Wellbutrin is intended to help reduce suicidal thoughts.

If you still experience these thoughts or notice an increase in them, it’s crucial to seek immediate help and consult your healthcare provider.

If you suspect that Wellbutrin isn’t working for you, it’s important to communicate your concerns with your healthcare provider to explore other options and ensure your mental health needs are met.

Unwanted side effects

Experiencing adverse reactions can indicate that Wellbutrin isn’t effectively working for you.

While some side effects are common and tend to improve over time, persistent or severe side effects may suggest that the medication isn’t the right fit for your body and brain chemistry.

These unwanted side effects can include headaches, dry mouth, nausea, insomnia, and mild agitation.

It’s important to communicate any concerns about side effects with your healthcare provider, as dosage adjustments or a medication change may be necessary.

If you’re experiencing persistent or worsening symptoms, discussing this with your healthcare provider to explore alternative treatment options based on your individual needs and responses is important.

Questions to ask your provider about signs that Wellbutrin is working

When discussing signs that Wellbutrin is working, it’s important to ask your healthcare provider about what specific changes to look for.

Your provider can guide you in understanding the expected effects of Wellbutrin and help you differentiate between its therapeutic effects and potential side effects.

Here are some important questions to ask your provider before you use Wellbutrin:

• What are the key signs Wellbutrin is working effectively?
• How long does it take for me to start noticing these signs?
• Are there any factors that may affect the timeline or effectiveness of Wellbutrin?
• Will Wellbutrin interact with my current medications, supplements, or OTC drugs?
• Is the starting dose appropriate?
• What adverse effects can I expect?
• How will I know if the side effects are serious?
• What should I do if I experience serious side effects?
• What should we do if I don’t start seeing benefits within the therapeutic time frame?
• Are you prescribing me the bupropion SR (twice daily) or bupropion XL (once-daily) formulation? Why one over the other?

By asking these questions, you can better understand the expected outcomes and timeline for Wellbutrin’s effectiveness.

Your healthcare provider can provide you with personalized information based on your individual needs and response to the medication.

Open communication with your provider is crucial in monitoring your progress and ensuring Wellbutrin works as expected.

Remember to discuss any concerns or lack of improvement with your provider, as they can explore alternative treatment options if necessary.

Conclusion

In conclusion, Wellbutrin (Bupropion) can be an effective medication for treating depression and seasonal affective disorder.

While individual responses may vary, most people experience gradual improvements within 2 to 6 weeks of starting the medication.

Signs that Wellbutrin is working include lifting the emotional burden, reducing feelings of sadness and anxiety, and increasing energy levels and motivation.

Possible side effects include nausea, headache, increased heart rate, dry mouth, dizziness, etc.

It’s important to continue taking Wellbutrin as prescribed and to seek help if you have any concerns or if your symptoms worsen.