Bupropion Information

Dosage and Administration

General Dosing Considerations:
It is particularly important to administer bupropion in a manner most likely to minimize the risk of seizure (see WARNINGS). Increases in dose should not exceed 100 mg/day in a 3-day period. Gradual escalation in dosage is also important if agitation, motor restlessness, and insomnia, often seen during the initial days of treatment, are to be minimized. If necessary, these effects may be managed by temporary reduction of dose or the short-term administration of an intermediate to long-acting sedative hypnotic. A sedative hyponotic usually is not required beyond the first week of treatment. Insomnia may also be minimized by avoiding bedtime doses. If distressing, untoward effects supervene, dose escalation should be stopped.

No single dose of bupropion should exceed 150 mg. Bupropion should be administered t.i.d., preferably with at least 6 hours between successive doses.

Usual Dosage for Adults:
The usual adult dose is 300 mg/day, given t.i.d. Dosing should begin at 200 mg/day, given as 100 mg b.i.d. Based on clinical response, this dose may be increased to 300 mg/day, given as 100 mg t.i.d., no sooner than 3 days after beginning therapy (see table below).

Dosing Regimen

Increasing the Dosage Above 300 mg/Day:
As with other antidepressants, the full antidepressant effect of bupropion may not be evident until 4 weeks of treatment or longer. An increase in dosage, up to a maximum of 450 mg/day, given in divided doses of not more than 150 mg each, may be considered for patients in whom no clinical improvement is noted after several weeks of treatment at 300 mg/day. Dosing above 300 mg/day may be accomplished using the 75 or 100 mg tablets. The 100 mg tablet must be administered q.i.d., with at least 4 hours between successive doses, in order not to exceed the limit of 150 mg in a single dose. Bupropion should be discontinued in patients who do not demonstrate an adequate response after an appropriate period of treatment at 450 mg/day.

Elderly Patients:
In general, older patients are known to metabolize drugs more slowly and to be more sensitive to the anticholinergic, sedative, and cardiovascular side effects of antidepressant drugs. Clinical trials enrolled several hundred patients 60 years of age and older. The experience with these patients and younger ones was similar.

Maintenance:
The lowest dose that maintains remission is recommended. Although it is not known how long the patient should remain on bupropion, it is generally recognized that acute episodes of depression require several months or longer of antidepressant drug treatment.