she said it would get better in two to four weeks, but i am having severe anxiety due to not sleeping. dear n.m.n. : bupropion (wellbutrin) is an antidepression medicine in another kind of class from medicines like prozac or celexa, which are ssris and have a very different side-effect profile. however, bupropion must be used with extreme caution or not at all in people with a seizure disorder. the dose of 150 mg is better tolerated than 300 mg, and the xl formulation also tends to reduce side effects. in that case, one approach is to use a smaller dose of the shorter-acting formulation while the person is getting used to the medication. finally, people who have some anxiety with depression may not do well with bupropion, because it does tend to be stimulating.
dear dr. roach: why are stress tests no longer done on a treadmill? i was quite concerned when my last stress test was a nuclear stress test rather than on the treadmill. : stress tests are mainly used to diagnose blockages in the arteries of the heart. on a treadmill or bike, a person exercises, starting off at low effort then building up in intensity until the person can’t continue. if a person cannot exercise, usually due to orthopedic or neurological disease, then a pharmacologic stress test is prescribed, using medications to speed up the heart rate, for example. this does not allow for the prognostic ability of finding how much exercise a person can tolerate, and it takes some time for the drugs to wear off. the advantage of a nuclear stress test is both better ability to make the diagnosis (sensitivity) and fewer false positives (specificity), but it costs a lot more and exposes the person to some radiation.
women’s health may earn commission from the links on this page, but we only feature products we believe in. it might seem unfair that the drug you’re taking to relieve your depression is now giving you insomnia. while wellbutrin (and antidepressants in general) do a lot of good, it’s always smart to be aware of the downsides, too. unlike other antidepressants, like selective-serotonin reuptake inhibitors (ssris), which include zoloft, prozac, and lexapro, wellbutrin is in its own class. it’s a norepinephrine-dopamine reuptake inhibitor (ndri). doctors also prescribe it to help wean smokers off of nicotine, says ackerman. “but it does reduce cravings in patients and you can see people who are entirely able to quit.” doctors may choose wellbutrin for patients whose depression symptoms are more “melancholic” or “sluggish,” says ackerman, because it can give patients a boost energy-wise.
if that happens, talk with your doctor right away about trying a new drug, advises ackerman. some people may experience heart palpitations, called tachycardia (more than 100 beats per minute), while on wellbutrin, says ackerman. they’ll likely order an electrocardiogram (ekg or ecg), a test that measures the electrical activity of your heartbeat to check for underlying heart issues, says ackerman. difficulty falling asleep or staying asleep, but keep an eye on it to make sure it doesn’t start interfering with your daily activities. there’s also an increased risk of seizures with wellbutrin if you have a pre-existing seizure disorder or a brain tumor, she adds. i stopped taking wellbutrin and now i can drink real coffee again without feelin like i’m gonna have a conniption? coffee is real good y’all because wellbutrin can amp up some women, caffeine—like your daily latte or diet soda— may make you feel over-the-top jittery, says ackerman. this can be a perk of the drug for women who want to feel more energized. it’s for this reason, ackerman adds, that wellbutrin wouldn’t be used in bipolar patients, unless it was paired with a mood stabilizer.
yes, it is possible that wellbutrin may trigger or worsen your insomnia. nineteen percent of people taking wellbutrin, 6% of people taking our chart review found that in outpatients presenting with depression but without comorbid insomnia, high rates of insomnia developed after bupropion (along with desvenlafaxine) does carry a higher risk of causing initiation insomnia than the other antidepressants, but the difference, .
the antidepressant wellbutrin (bupropion) is not an ssri but has been associated with insomnia. however, studies that have examined electrical activity of the brain in patients taking bupropion indicate the drug actually increases rem sleep time. dear dr. roach: my doctor started me on wellbutrin 150 mg xl for depression, but i have had terrible insomnia. she said it would get better it’s fairly common for wellbutrin-takers to experience insomnia, . difficulty falling asleep or staying asleep, but keep an eye on it to the rate of insomnia for bupropion (11%–20%), while greater than that seen for placebo (4%–7%), is similar to the rate associated with ssris (10%–19%)., .
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