# Novo-Bupropion SR



## just mary (Jun 5, 2007)

Hello,

I started taking Novo-Bupropion SR last week and so far, so good.  But I had question or two for anyone who might be able to answer.

I'm taking 150 mg twice a day.  The only noticeable side effects have been the occasional headache and I can't seem to get a decent night's sleep (i.e. I wake up every hour).  Does anyone have some ideas that might help me get a better night's sleep while on a medication like this?

I've also noticed and I don't want to get too excited or get my hopes up but I don't feel like drinking.  I don't think about drinking.  I'm home alone tonight and the idea did flit through my mind but I just didn't feel like it.  I hope this feeling lasts because I drink too much as it is.  And it's nice not to think about it so much.  I know this drug is supposed to help people quit smoking but could it help with other addictions?

On another note I tried Paxil last October or November and had some horrible side effects.  I actually felt like drinking _more_ on this medication.  I quit it and was afraid to try another medication.  But I'm so glad and totally relieved that I got over that fear and tried something else.  The side effects are miniscule compared to Paxil and it seems to be helping me. 

And I don't want to say anything bad about Paxil, if it works for you that's great.  I was just trying to make the point that sometimes we have to keep trying even if we're scared.  But I'm sure most of you understand that.


Thanks and take care,

jm


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## David Baxter PhD (Jun 5, 2007)

Bupropion is Wellbutrin, aka Zyban. It's not an SSRI per se, but probably exerts its primary effect on dopamine.

As Zyban, it's marketed to inhibit cravings for nicotine during withdrawal from smoking. While I've never heard of it being used to inhibit cravings for alcohol, it makes a certain amount of sense that it might help there too.

One of the problems (or benefits depending on your point of view) is that it tends to be energizing (or in some cases even agitating). Talk to your doctor about taking it earlier in the day so it doesn't interfere with sleep. Alternatively, I think the SR version is "slow release" or "extended release" - perhaps switching to the standard version may interfere less with sleep.


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## HA (Jun 5, 2007)

Hi Mary,

I'm so glad you are taking the same drug as me.....sounds weird, but misery loves company. :huh:

I don't know if it has effects on other addictions besides nicotine but I'll see what I can find. 

The headaches will fade and as far as not being able to sleep....I don't know. You could call a pharmacist and ask their immediate opinion or recommendations.

You are right about different med trials to find the one that works for you. I have a very close friend who takes Paxil and she finds it really helpful. My brother takes Paxil and seems to like it. 

I don't want to get your hopes up either but if it's working then...it's working.

:grouphug:


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## Retired (Jun 5, 2007)

> Novo-Bupropion SR



The name NOVO before the generic name Bupropion indicates this is the generic form of the medication made by Novo Drug.

Whether you want or prefer the brand name (Wellbutrin) or generic is a choice you can discuss with your doctor and pharmacist.  It should be stressed that this choice is yours to make, unless your particular insurance plan determines which form of the medication it will pay for.


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## ThatLady (Jun 6, 2007)

Headache is a common side-effect of bupropion. The headaches usually go away after you've taken the medication for several weeks, as prescribed. While it's not normally used to reduce alcohol ingestion, I have heard some doctors whose patients have received this benefit from taking the drug. If you think about it, cigarette smoking is an addiction just like regularly drinking too much alcohol is an addiction, so it makes sense that what works for one might very well work for the other. 

You might find that, as David said, switching to the regular form of the drug, as opposed to the extended release form, might help with the sleeping problems. Or, perhaps taking the drug earlier in the day (the extended release form *must* be taken with doses being no less than 8 hours apart) and adding a sleeping aid to your regimen would help. It's something to bring up with your doctor, most certainly. We all gotta sleep! 

I'm really glad this medication is helping you, mary! That's good news! Now, we just gotta get rid of the headaches and get you some sleep. I wonder ... have you ever tried playing one of those "white noise" tapes?  Some of them are like the sound of waves against a shore, others like rain hitting the leaves of trees. There are all different kinds of them, and little machines that play them constantly. I've never tried one, but they sound great! It might be something to look into. :hug:


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## just mary (Jun 6, 2007)

Thank-you for the information and the hugs, it helped. 

HeartArt, I knew you were on the same drug too, I read some of your earlier posts on the drug. They were interesting. Thanks for posting them. 

I am trying to take the second dose as early as possible. I generally wait until I get home after work which is around 4:30 or 5:00 PM.  Since I take my first dose around 5:30 AM, maybe I should bring the second dose to work and then I could take it as early as 1:30 PM, which might help.  

I almost talked to a pharmacist today but chickened out.  I'm not sure what I was afraid of, maybe I thought he would yell at me or something. Anyway, I'll give it another shot tomorrow and I'll see my doctor in three weeks.  I'm just a little nervous about sleeping pills and I'm not sure why, considering how much I've drank in the past to "help me sleep". Sheesh, I'm a walking contradiction.

Thanks again and take care,

jm


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## Into The Light (Jun 6, 2007)

i am glad you've found something that seems to work for you, that is good news jm!!  good luck with solving the sleep issues, i am sure something will work out for you.


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## HA (Jun 6, 2007)

Mary,

I think your sleep problems are related to the buproprion as this can be a common side effect. I take 2 100mg tabs in the morning and if I am having a particularily stressful time  then I take an additional one 8 hrs later.

I do remember feeling embarrased about taking a medication for my depression. Yet, when I was taking it to quit smoking it did not phase me in the slightest. Funny, eh? Now that's stigma. So if you are afraid or embarrased then call any pharmacy and ask the question over the phone. You are only asking how to deal with the side effect it has by keeping you awake. If it helps start the conversation with, "I just starting taking buproprion to quit smoking blah blah blah."

If there is an 8 hr time frame between the doses then, yes, take your meds to work and take it at 1:30. You will probably solve the sleep problem by doing this.

As a side note....I'm sure you have read that buproprion decreases your seizure threshold and alcohol combined with this drug can decrease that threshold even further. 

I have found only one reference to alcohol cessation with buproprion. I have copied it below. I do recall hearing someone who has recovered from alcohol addiction and works in the field now as an addictions counsellor, talk about what he saw as a really good success rate for people who use antidepressants.

*Bupropion Related Alcohol Cessation​* Timothy R. Berigan, D.D.S., M.D.
Jeffrey Harazin, M.D. 

ABSTRACT: 
Bupropion hydrochloride, an atypical antidepressant is sometimes used as a pharmacotherapeutic agent in tobacco cessation. Two cases are presented of bupropion related alcohol cessation -  a possibly beneficial side effect not previously described in the literature.

INTRODUCTION:
Bupropion hydrochloride is an antidepressant used as an adjunct in the treatment of smoking cessation (Hughes 1999). By virtue of its dopaminergic and adrenergic actions it is thought to decrease the cravings associated with nicotine dependence (Gastfriend 1998). Two cases are presented in which patients enrolled in a smoking cessation program taking bupropion noted a complete discontinuation of alcohol consumption due to the effects of bupropion.

CASE REPORT:
The first patient is a 24 year-old female diagnosed with nicotine dependence having smoked a pack per day for seven years. She enrolled in smoking cessation for health reasons and at the urging of her family. She had tried to quit several times in the past trying abrupt cessation (cold turkey), or nicotine patch and had never been able to abstain longer than 2 weeks. At the time of enrolment she was taking oral birth control pills and no other prescription medications. She described herself as a social drinker going out one time per week and consuming 1 to 3 beers. She began bupropion hydrochloride sustained release (SR) at 150mg per day for the first three days and then increased it to 150mg b.i.d. after three days. One week later, at the first of four behavioural modification sessions, she described that on about day three of the medication she went out with friends and tried drinking a beer. 

She stated that there was a "foul" taste associated with the beer and had a friend try it to see if it was the beer. The beer apparently was all right and she tried it again and noted a similar bad taste. The bad taste was also associated with smoking. By week two she had set her quit date and successfully finished the 4-session behavioural modification program tobacco free. She described a similar experience with a bad taste associated with alcohol while on the bupropion but nicotine free and did not return to social drinking until after finishing the 10 week course of medication. The patient finished a course of ten weeks on the bupropion and had no difficulties associated associated with its discontinuation. At a one-month telephonic follow up the patient remained tobacco free and noted the taste of alcohol had returned to its pre-bupropion level.

The second patient is a 22 year-old male with a pack a day habit for 8 years as well as a can of smokeless tobacco every 2-3 days. He had made several attempts to quit his habits and was interested for financial as well as health reasons to quit. He described himself as a moderate drinker consuming 1 to 4 beers on weekend nights. He started on bupropion SR 150mg daily raised to 150mg b.i.d. on day 4 of treatment and noted at that dose a "metallic"taste not only decreasing the pleasure in his cigarettes, his smokeless tobacco but alcohol as well. He felt this poor taste was instrumental in not wanting to smoke or dip and was able to successfully complete the program. After he discontinued bupropion at 9 weeks he also noted a return of the taste of alcohol completely to its pre-bupropion treatment state.

DISCUSSION:
The neurobiology of the alcohol reward system involves several neurotransmitters including the opioid, serotonin, gamma-amino-butyric acid (GABA) and dopamine (Meyer 1998). The effect of alcohol on the dopamine system apparently causes an increase in the synthesis and release of dopamine from the nucleus accumbens (Valenzuela 1997). The particular pathway involved appears to be the mesolimbic which extends to the prefrontal cortex (Valenzuela 1997) the very same pathway proposed by Leshner (Leshner 1996) to be the reward pathway of nicotine, cocaine, amphetamines, marijuana, and alcohol. The clinical observation that the patient's perceived pleasure of alcohol as well as of nicotine diminished while taking bupropion probably is explained by the manipulation of dopamine contributing to a decrease in self-administration. The exact mechanism however is not yet fully defined. 

There are also dopaminergic projections ascending from the nucleus accumbens into the frontal lobe which may also play a role in the goal directed behaviour of the substances (Pontieri 1996). Along with the dopaminergic influence exerted in the nucleus accumbens the addictive substances may alter the locus coeruleus and noradrenergic balances through out the central nervous system contributing to the addictive properties (Leshner 1996). Although it appears that bupropion may possibly decrease the pleasure associated with alcohol consumption which could be a possible adjunct in alcohol cessation it should be further studied in a more controlled manner. We also advocate that all patients, prior to initiating bupropion for nicotine cessation or any use undergo a thorough assessment of their medical history as to rule out any condition, which would be a contraindication to use of bupropion.

References:
     Hughes JR, Goldstein MG, Hurt RD, Shiffman S. Recent Advances in the Pharmacotherapy of Smoking. JAMA. 1999; 281: 72-6. 

Gastfriend DR, Elman I, Solhkhah R. Pharmacotherapy of Substance Abuse and Dependence, in The Psychiatric Clinics of North America Annual of Drug Therapy. Edited by Dunner DL, Rosenbaum JF. Philadelphia, W.B. Saunders Company, 1998, pp. 211-229. 

Meyer RE, Berger SP. Biology of Psychoactive Substance Dependence Disorders: Cocaine, Opiates, and Ethanol, in The American Psychiatric Press Textbook of Psychopharmacology 2nd Edition. Edited by Schatzberg AF,Nemeroff CB. Washington, D.C., American Psychiatric Press Inc., 1998, pg. 656     

Valenzuela CF, Harris RA. Alcohol: Neurobiology, in Substance Abuse A Comprehensive Textbook 3rd Edition. Edited by Lowinson JH, Ruiz P, MillmanRB, Langrod JG. Baltimore, Williams and Wilkins, 1997, pg. 130. 

Leshner AI. Understanding Drug Addiction: Implications for Treatment. Hospital Practice October 1996: 47-59. 

Pontieri FE, Tanda G, Orzi F, Di Chiari G. Effects of nicotine on the nucleus accumbens and similarity of addictive drugs. Nature July 1996 (382): 255-7. 

The authors certify that the work done here was done as part of our work with the US Government and as such belongs in the public domain.


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## David Baxter PhD (Jun 6, 2007)

There is another option, of course, especially with the extended release version, and that is to take both tabs - the full dose - in the morning. In truth, most people won't notice much difference, if any. I think it's more to minimize potential side-effects.


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## just mary (Jun 7, 2007)

Thanks again,  .

That was interesting article HeartArt.  I must say I haven't been completely alcohol free since I started the Bupropion.  I had a BBQ on the weekend and I did have a few beers but they didn't taste right, something was missing.  I wouldn't say it was a metallic taste, it was more "lack of taste", it was bland.

And I did read about the theshold level for seizures while on this medication and how it could be lowered even more when combined with alcohol. I thought that perhaps the fear of a seizure was putting me off alcohol but I'm not sure why this would scare me enough to quit. There are tonnes of other dangers associated with drinking too much and they never put me off.  I also wondered why my doctor would prescibe a drug like this for me, I've told him about my drinking behaviour.  Maybe he doesn't like me very much?

I know, I know, I'm thinking too much, I should just run with it and stop worrying.  

Thanks again and take care,

jm


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## Cat Dancer (Jun 7, 2007)

jm, I wish you the best with this medication. 

 :hug:


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## HA (Jun 7, 2007)

Mary, does that mean that my doctor prescribed this drug for me because she does not like me very much? I don't think so. Next appointment ask why this drug was prescribed and you will get your answer. 

I don't think you will have a seizure from having a beer or two. It would be consuming enough to get intoxicated that would increase your risk. Mind you....2 beer would do it for me. 

I hope this medication helps you. Are you seeing a therapist as well? My doctor made sure I also was receiving therapy. It was the combination which has helped me.

:friends:


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## Banned (Jun 8, 2007)

I'm way late on this thread but I'll jump in.  I was on Wellbutrin 150mg twice a day and couldn't sleep at all...I switched to the extended release or whatever it's called and now I only take one in the morning - it helped immensley (apparently I can't spell that word!) with me getting some decent levels of sleep.  

I'd suggest to try switching to the one-a-day one, and take it first thing in the morning.

The only other side effect I had was dry mouth which went away pretty quickly.


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## HA (Jun 8, 2007)

Hey LadyBug, that makes 3 of us taking Buproprion! :friends: We should start a new misery loves company support group.....the Bupe Group.....the Prions....the Bupees....

Never mind....I'm glad you are with us though :dance:

I take the slow release (SR).


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## Into The Light (Jun 8, 2007)

:lol: that would be bg, heartart. i'm not on bupropion


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## HA (Jun 8, 2007)

:lol:  LadyBug...Well, you could go ask for this med.....

I knew it was BG but thought LB instead I guess...thanks for pointing that out!


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## David Baxter PhD (Jun 8, 2007)

LOL @ The Bupees...


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## just mary (Jun 9, 2007)

Bupees... 

But to me, BG, HA and JM, looks more like the BiG HAJeeMies from Bupee...

Anyway...

I talked to a pharmacist last night and she recommended I use the one-a-day Wellbutrin if I'm having trouble sleeping.  I did take it earlier yesterday and today.  Yesterday wasn't a good day to see if it worked or not so I'll check it out tonight.  



> Mary, does that mean that my doctor prescribed this drug for me because she does not like me very much?



No, it doesn't, you don't have a drinking problem.  I told my doctor I drank too much and gave him a rough idea on the number of drinks per week.  I just thought it was weird that he didn't warn me about the increased possibility of seizure when this drug is combined with alcohol.  



> Are you seeing a therapist as well?



No, I'm not.   My :doctor: (just had to use that smilie) has not recently talked about seeing a therapist. He mentioned it months ago but since then he hasn't brought it up.  

And BG, thanks for the info and I didn't think you were way late, you had perfect timing.  It looks as though I'm having the same experience you did though and that's nice to know.  Have you noticed any aversion to alcohol?

Take care,

jm


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## Banned (Jun 9, 2007)

Hi JM,

I haven't noticed anything with alcohol but at the best of times I have maybe half a dozen drinks per year....so I don't drink enough for them to mix very well, I don't think.  It does warn about it on the written info I got, but I haven't pushed it far enough to know


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## just mary (Jun 10, 2007)

Just thought I'd let you know that I slept through the last two nights, no wake-ups!  I even slept in a bit this morning. 

Taking it earlier in the day really helped.  Thanks everyone!

jm


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## Banned (Jun 10, 2007)

I'm glad JM.  I know for me I couldn't believe the solution was so simple!  Enjoy your sleep .


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## Into The Light (Jun 10, 2007)

that's great news jm!! :yahoo:


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## HA (Jun 10, 2007)

That's a relief, JM. I think your doctor may have forgotten to suggest this, Mary. It is highly recommended though. You might as well get the best treatment you can to sort out whatever troubles you are dealing with.

Try a new therapist from your last one if you think that may be helpful. The combination will be a quicker route to a healthier, happier you.


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## Halo (Jun 10, 2007)

Glad that you got the sleep thing figured out JM


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## Miette (Jun 12, 2007)

I'm glad you got everything sorted.  I take 300 mg wellbutrin XL, the extended-release form, in the morning and still have trouble sleeping (not sure if it's completely related to this medication).  I take sleeping pills.  I'm glad that you were able to sort it out on your own!


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## HA (Jun 12, 2007)

Hey Miette, Welcome to the Bupee group!

I never had a problem sleeping even when taking my SR at supper time or later.

I wonder what the difference is between slow release and extended release?


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## Miette (Jun 13, 2007)

Yeah, I don't really know.  I was just so crappy at remembering to take the SR form twice a day that I had my psychiatrist write me a prescription for the XL form before it was even available here so I could take it right away when it came out!

Thanks for the welcome... bupees... I love it!


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## just mary (Jun 25, 2007)

I know you've all been waiting breathlessly for my reply...

Well, I've been on the Bupropion for four weeks now and the alcohol cravings are still at bay :dance: , which makes me feel good.  Am I happier?  I don't know.  But not drinking so much has been a help.  I don't feel so tired and ashamed all the time, I feel a little stronger, that maybe if I really wanted to, I could make some changes.  I feel bolder and I don't worry about things as much.  I'm still pretty isolated and sometimes I feel down but even though my life seems pointless, it doesn't make me feel so bad anymore.  I don't know if that's good or not but the really dark thoughts seem to be subsiding.

Thanks everyone and take care,

jm


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## David Baxter PhD (Jun 26, 2007)

Good news, just mary.


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## ThatLady (Jun 26, 2007)

Sounds good to me, Mary. I imagine it will take time to really recognize all the good things that come from not drinking so much. When something that hurts us has been going on for awhile, it takes another "while" to get over the effects. Good going on your part! :yahoo:


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## HA (Jul 10, 2007)

Mary,

I have been thinking about you and wondering how things were going. That is great news! I hope things just continue to get better for you.

My doctor switched me to the Wellbutrin (Buproprion) extended release (XL) yesterday. These only need to be taken once per day so the difference between these and slow release (SR) is the extended time of drug effect.


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## just mary (Jul 10, 2007)

Thanks for the kind words and encouragement.  I saw my doctor about a week ago and he wrote me a presription for the once-a-day tablet too.  But I still have to finish off the twice-a-day pills.

You know, I think he was concerned about my drinking and the increased probability of seizures.  When I asked for the Wellbutrin initially, he was hesitant to prescribe it to me.  He mentioned that it was hard to remember two pills a day, that it may help but he just didn't seem that enthused.  In fact, his body language was strange too.  He was fidgety, moving around in his chair and at one point he actually sat on his hands, like he was trying to restrain himself.  I thought I had done something wrong.  

When I compare the above behaviour to my most recent appointment with him, he has done a complete 180 degrees.  Suddenly he could prescribe the once-a-day pill and he talked about how Wellbutrin focuses directly on the addiction centre of the brain, he seemed really enthused now. Maybe because I didn't have any ill effects (i.e. seizures etc.) he relaxed and felt better about prescribing it to me.

Or am I just reading too much into everything? 

Anyway, it was just odd.

Take care,

jm


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## HA (Jul 10, 2007)

Who knows what your doctor was thinking, jm. Maybe he was just so happy that this was a very helpful treatment for you. It is probably more difficult as a doctor to prescribe a medication that does not have a blood test to help make the decision about what, when and how much and to tell him if it is working or not. 

I am going to start mine tomorrow. I was relieved to leave my yearly checkup with good health and only this minor brain thing to worry about. 

Cheers


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