Bupropion hydrochloride

(Wellbutrin XL®)

Wellbutrin XL®

Drug updated on 11/4/2024

Dosage FormCapsule (oral; 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg); Chewable tablet (oral; 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg)
Drug ClassAminoketones
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults and pediatric patients 6 years and older
  • Indicated for the treatment of moderate to severe binge eating disorder (BED) in adults.

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Summary
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  • This summary is based on the review of 11 systematic review(s)/meta-analysis(es). [1-11]
  • In treatment-resistant depression (TRD) and major depressive disorder (MDD), aripiprazole augmentation (A-ARI) achieved a higher response rate compared to bupropion augmentation (A-BUP) (RR (relative risk): 1.15; 95% CI (confidence interval): 1.05, 1.25; P = 0.0007) and a higher remission rate compared to switching to bupropion (S-BUP) (RR: 1.22; 95% CI: 1.00, 1.49; P = 0.05). No significant differences in remission rate or MADRS (Montgomery-Asberg Depression Rating Scale) score improvement were observed between A-ARI and A-BUP.
  • In seasonal affective disorder (SAD), fluoxetine showed a numerically superior clinical response over placebo (RR 1.62, 95% CI 0.92 to 2.83), though the confidence interval includes no effect. Fluoxetine and light therapy had similar efficacy in treating seasonal depression (RR of response 0.98, 95% CI 0.77 to 1.24; RR of remission 0.81, 95% CI 0.39 to 1.71).
  • For smoking cessation, bupropion significantly increased long-term cessation rates (RR 1.64, 95% CI 1.52 to 1.77), with comparable effectiveness to nicotine replacement therapy (NRT) and nortriptyline, though less effective than varenicline.
  • In cognitive impairment associated with MDD, both bupropion and vortioxetine exhibited procognitive effects relative to SSRIs and SNRIs.
  • In treatment-resistant depression (TRD) and major depressive disorder (MDD), no significant differences in adverse events and serious adverse events were observed among the treatment strategies: aripiprazole augmentation (A-ARI), bupropion augmentation (A-BUP), and switching to bupropion (S-BUP).
  • For seasonal affective disorder (SAD), adverse events were comparable between fluoxetine and placebo, as well as between fluoxetine and light therapy.
  • In smoking cessation, bupropion was associated with a higher dropout rate due to adverse events compared to placebo (RR 1.37, 95% CI 1.21 to 1.56) and a greater likelihood of psychiatric adverse events (RR 1.25, 95% CI 1.15 to 1.37), with insufficient evidence to confirm a difference in serious adverse events (RR 1.16, 95% CI 0.90 to 1.48).
  • There is no population types or subgroups information available in the reviewed studies.

Product Monograph / Prescribing Information

Document TitleYearSource
Wellbutrin XL (bupropion hydrochloride) Prescribing Information.2024Bausch Health Companies Inc., Bridgewater, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Efficacy and safety of aripiprazole or bupropion augmentation and switching in patients with treatment-resistant depression or major depressive disorder: A systematic review and meta-analysis of randomized controlled trials2024Plos One
Individualized antidepressant therapy in patients with major depressive disorder: Novel evidence-informed decision support tool2022Canadian Family Physician Medecin De Famille Canadien
Novel Antidepressants in the Pipeline (Phase II and III): A Systematic Review of the US Clinical Trials Registry2022Pharmacopsychiatry
Efficacy of dextromethorphan for the treatment of depression: a systematic review of preclinical and clinical trials2021Expert Opinion on Emerging Drugs
Second-generation antidepressants for treatment of seasonal affective disorder2021The Cochrane Database of Systematic Reviews
Childhood maltreatment history for guiding personalized antidepressant choice in major depressive disorder: Preliminary results from a systematic review2021Progress in Neuro-psychopharmacology & Biological Psychiatry
The impact of antidepressants on depressive symptom severity, quality of life, morbidity, and mortality in heart failure: a systematic review2020Drugs in Context
Procognitive Effects of Antidepressants and Other Therapeutic Agents in Major Depressive Disorder: A Systematic Review2020The Journal of Clinical Psychiatry
Antidepressants for smoking cessation2020The Cochrane Database of Systematic Reviews
Novel Phenethylamines and Their Potential Interactions With Prescription Drugs: A Systematic Critical Review2020Therapeutic Drug Monitoring
Antidepressants in Spine Surgery: A Systematic Review to Determine Benefits and Risks2019Asian Spine Journal

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