How does Bupropion help me lose weight?
In non-technical terms, Bupropion helps patients who have stress-related eating far better than those who have boredom-related eating. If you merely have bad eating habits, this may not be the best choice for you. If you are an emotional eater, this may be a great medicine for you. It stimulates noradrenaline, dopamine, and (less-so) serotonin receptors. This gives you more energy, suppresses your appetite, and enhances your mood. Stress increases cortisol and ghrelin which stimulate your appetite. Dopamine and noradrenaline suppress your appetite. Because the medicine improves stress and mood, it was originally invented as an anti-depressant. However, later studies showed that it helped people quit smoking, so Bupropion has been FDA-approved to help with smoking cessation. Further studies showed that it helps provide better weight loss than diet alone. Even back in 2001, it was shown in a study at Duke of non-depressed women trying to lose weight … that 3 times as many taking Bupropion saw success as those who were taking placebo (a fake pill). As a result, Bupropion is one of the components of the #1 most prescribed FDA-approved brand-name medication for weight loss, Contrave.
What are the risks of Bupropion?
You may quit smoking if you are taking this medicine. Many patients tell me that their spouses are happier and their bosses report they seem less stressed and are nicer to be around as well as more productive at work. Rarely, a patient will tell me that the opposite happened and they became anxious or crabby or mean. If that happens, stop taking the medicine and call us to let us know you stopped. You can stop taking Bupropion immediately without having to wean off of it like other medicines. You absolutely should not take Bupropion if you have had a diagnosis of anorexia or seizures or if you’re allergic to Bupropion or if you take MAO-inhibitors. In Aug 2009, the FDA added a warning label to many medications saying that they can cause rare cases of depression and suicidal thoughts. The FDA added this warning label to so many medications, including ones that doctors have used safely for years, that I’m not sure how seriously doctors and patients have taken this warning, so my best advice is to immediately tell your doctor if you start developing depressive symptoms after you start any medication – blood pressure, diabetes, aspirin, tylenol, anti-depressant, birth control pills … any medication.
What are some side-effects?
According to the prescribing information, patients who took Bupropion had more of the following symptoms than patients who took placebo (fake pills): agitation, palpitations, insomnia, dry mouth, constipation, nausea, dizziness, and ringing in the ears. Interestingly, the patients taking Bupropion had FEWER of the following symptoms than patients who took placebo: fewer abnormal dreams, less accidental injuries, less acne, less appetite, less back pain, less episodes of bronchitis, more normal menstrual cycles, less flatulence, less flu syndrome, less hypertension, less neck pain, less respiratory complaints, less rhinitis, and fewer tooth problems. Please read the entire handout that the pharmacist gives you when you pick up the prescription; this handout is not a substitute for the pharmacist’s handout/counseling.
What are the personal statistics you have at The Institute?
19 out of 20 patients thank me and love it, telling me about added benefits with improved energy, better sex life, happier marriages, and better work-life. 1 out of 20 tells me they dislike it and they need to stop it. 1 (out of more than 1,000) had a seizure and that patient is normal now but was understandably upset by that unexpected rare event. 1 (out of more than 1,000) had elevated blood pressure and that patient is normal now. 1 (out of more than 1,000) became very manic and anxious. The only permanent effects my patients have experienced have been weight loss.