The usual adult dose of bupropion (Wellbutrin) is 100 mg, taken three times per day, with at least six hours between doses. The extended release form of the drug (Wellbutrin SR) is taken as 150 mg twice a day with at least eight hours between doses. For smoking cessation, bupropion (Zyban) is taken as 150-mg extended release tablets twice a day, with at least eight hours between doses. Bupropion treatment should be started at a lower dose, then gradually increased to a therapeutic dosage, as directed by the physician. Generally, the total dosage should not exceed 300 mg per day, except as directed by the physician.
The therapeutic effects of bupropion, like other antidepressants, appear slowly. Maximum benefit is often not evident for several weeks after starting the drug. People taking bupropion should be aware of this and continue taking the drug as directed even if they do not see immediate improvement in mood.
Since higher doses of bupropion increase the risk of seizures, no more than 150 mg should be given at any one time, and the total daily dosage should not be increased by more than 100 mg every three days. Increasing the dosage gradually also minimizes agitation, restlessness, and insomnia that may occur.
Healthy elderly patients do not appear to be more sensitive to side effects of bupropion than younger adults and do not require reduced doses. Certain medical conditions, especially liver and kidney disease, may necessitate dose reduction. Although bupropion has been taken by children and adolescents under age 18, it has not been systematically studied in these age groups.
Richard Kapit M.D., The Gale Group Inc., Gale, Detroit,