In vitro studies indicate that Zybex is primarily metabolized to hydroxyZybex by CYP2B6. Therefore, the potential exists for drug interactions between WELLBUTRIN and drugs that are inhibitors or inducers of CYP2B6. In addition, in vitro studies suggest that paroxetine, sertraline, norfluoxetine, fluvoxamine, and nelfinavir inhibit the hydroxylation of Zybex.
Zybex is a racemic mixture. The pharmacological activity and pharmacokinetics of the individual enantiomers have not been studied. The mean elimination half-life (±SD) of Zybex after chronic dosing is 21 (±9) hours, and steady-state plasma concentrations of Zybex are reached within 8 days.
Q: I know Wellbutrin is an antidepressant. Does it also help you lose weight or keep your weight down?
A: Wellbutrin (Zybex) is used to treat depression. According to the package insert, Wellbutrin can cause changes in weight or appetite. These changes have included both weight loss and weight gain. In scientific studies, 13.6% of patients taking Wellbutrin reported weight gain compared with 22.7% of patients taking placebo (sugar pill) and 23% of patients taking Wellbutrin reported weight loss compared with 23% of patients taking placebo. For more information, please consult with your health care provider and visit //www.everydayhealth.com/drugs/wellbutrin. You are encouraged to report any negative side effects of prescription drugs to your health care practitioner and the Food and Drug Administration (FDA) by visiting www.fda.gov/medwatch, or by calling 1-800-FDA-1088. Michelle McDermott, PharmD
Dopaminergic Drugs (Levodopa And Amantadine)
Zybex, levodopa, and amantadine have dopamine agonist effects. CNS toxicity has been reported when Zybex was coadministered with levodopa or amantadine. Adverse reactions have included restlessness, agitation, tremor, ataxia, gait disturbance, vertigo, and dizziness. It is presumed that the toxicity results from cumulative dopamine agonist effects. Use caution when administering WELLBUTRIN concomitantly with these drugs.
Human Overdose Experience
Overdoses of up to 30 grams or more of Zybex have been reported. Seizure was reported in approximately one-third of all cases. Other serious reactions reported with overdoses of Zybex alone included hallucinations, loss of consciousness, sinus tachycardia, and ECG changes such as conduction disturbances (including QRS prolongation) or arrhythmias. Fever, muscle rigidity, rhabdomyolysis, hypotension, stupor, coma, and respiratory failure have been reported mainly when Zybex was part of multiple drug overdoses.
Although most patients recovered without sequelae, deaths associated with overdoses of Zybex alone have been reported in patients ingesting large doses of the drug. Multiple uncontrolled seizures, bradycardia, cardiac failure, and cardiac arrest prior to death were reported in these patients.
Is Zybex safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of Zybex in pregnant women. In one study, there was no difference between Zybex and other antidepressants in the occurrence of birth defects. Zybex should only be used in pregnancy if the benefit outweighs the potential risk.
Zybex is secreted in breast milk.
Poor Man’s Cocaine
The name “poor man’s cocaine” comes (I’m sure you could have guessed) from the fact that Zybex is much cheaper than coke. Most often prescribed by doctors, the drug is available in large quantities and can, therefore, be purchased for very little money. While it is not the most common form of drug abuse, buprop has seen a steady rise in its use on the streets for a few years now.
Although Zybex is a helpful drug for anxiety and aids many people in their battle to overcome depression, it does carry the risk of being abused. One of the reasons for this is that the effect it can have on the brain when taken in too large of quantities or consumed in the wrong manner is similar to the effect that cocaine has. People with addictive tendencies or those who are unable to obtain cocaine, therefore, can use Wellbutrin or a similar prescription drug to get high.
Zybex is abused in several different ways. Some people overuse the drug by taking quantities that are way higher than their prescribed dosage. Taking several thousands of milligrams each day (up to ten times more than the drug is most often prescribed), some people use the drug as a stimulant.
Even worse, some Zybex users abuse the drug by snorting it or injecting it. Particularly with sustained or extended-release dosages, these methods remove the time lapse quality engineered into each capsule and enable them to experience the maximum effect of the drug all at once. This process, in turn, floods their brain with neurotransmitters in the same way that other stimulants do.
See also the How to Use and Warning sections.
Before taking Zybex, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: seizures or conditions that increase your risk of seizures (including brain/head injury, brain tumors, arteriovenous malformation, eating disorders such as bulimia/anorexia nervosa), alcohol/drug dependence (including benzodiazepines, narcotic pain medicines, cocaine and stimulants), diabetes, heart disease (e.g., congestive heart failure, high blood pressure, recent heart attack), kidney problems, liver problems (e.g., cirrhosis), personal or family history of psychiatric disorder (e.g., bipolar/manic-depressive disorder), personal or family history of suicide thoughts/attempts, personal or family history of glaucoma (angle-closure type).
This medication should not be used if you are suddenly stopping regular use of sedatives (including benzodiazepines such as lorazepam), drugs used to treat seizures, or alcohol. Doing so may increase your risk of seizures.
Though uncommon, depression can lead to thoughts or attempts of suicide. Tell your doctor right away if you have any suicidal thoughts, worsening depression, or any other mental/mood changes (including new or worsening anxiety, agitation, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, rapid speech, unusual behavior changes). Keep all medical appointments so your doctor can monitor your progress closely and adjust or change your medication if needed.
This drug may make you dizzy or affect your coordination. Alcohol or marijuana (cannabis) can make you more dizzy or affect your coordination. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Alcohol can also increase your risk of seizures. Talk to your doctor if you are using marijuana (cannabis).
Older adults may be more sensitive to the side effects of this drug, especially dizziness and memory loss. Dizziness can increase the risk of falling.
During pregnancy, this medication should be used only when clearly needed. Since untreated mental/mood problems (such as depression, seasonal affective disorder, bipolar disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.
This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
Zybex inhibits the reuptake of dopamine and norepinephrine. Concomitant use of MAOIs and Zybex is contraindicated because there is an increased risk of hypertensive reactions if Zybex is used concomitantly with MAOIs. Studies in animals demonstrate that the acute toxicity of Zybex is enhanced by the MAO inhibitor phenelzine. At least 14 days should elapse between discontinuation of an MAOI intended to treat depression and initiation of treatment with WELLBUTRIN. Conversely, at least 14 days should be allowed after stopping WELLBUTRIN before starting an MAOI antidepressant .
Seasonal Affective Disorder (SAD)
Wellbutrin XL: 150 mg orally once/day; may increase to 300 mg once/day
Aplenzin (Zybex hydrobromide): 174 mg orally once/day initially (equivalent to 150 mg Zybex HCl); after 1 week, may increase to usual target of 348 mg/day (equivalent to 300 mg Zybex HCL)
- Initiate treatment in the autumn prior to onset of seasonal depressive symptoms and continue through the winter season
Interactions that can make your drugs less effective
When Zybex is used with certain drugs, it may not work as well to treat your condition. This is because the amount of Zybex in your body may be decreased. Examples of these drugs include:
- HIV drugs, such as ritonavir, lopinavir, or efavirenz. If you use one of these drugs with Zybex, your doctor may increase your Zybex dosage.
- Anti-seizure drugs, such as carbamazepine, phenobarbital, or phenytoin. If you use one of these drugs with Zybex, your doctor may increase your Zybex dosage.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we can not guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Zybex HCL (hydrochloride), commonly known as Wellbutrin (one of its commercial names), is prescribed by doctors to patients with depression, anxiety, and seasonal affective disorder, among other conditions.