Wellbutrin is not, as some commonly think, an SSRI (Selective Serotonin Reuptake Inhibitor, like Prozac), nor is it an MAOI. GlaxoSmithKline's info on the drug(1) mentions that, while Wellbutrin does slightly affect serotonin reuptake, its effects probably derive from its effects on dopamine reuptake.

An interesting note: Wellbutrin was briefly pulled from the market due to a study that indicated it may cause more seizures than SSRI's (on the order of 4 per 1000 patients, as opposed to 2). This result has been called into question, and in any case the seizures mostly occurred among patients who were already seizure-prone. Still, the risk appears on the warning label.

A word about interactions with psychotropic drugs: It's well-known that Wellbutrin doesn't always play well with other antidepressants, and that it may reduce tolerance to alcohol, but risks with respect to other psychotropic drugs are not well documented. GlaxoSmithKline's documentation, as well as some evidence floating around the 'net(2), suggests a few rough guidelines. NOTE! If you are doing to do recreational drugs, read up extensively. Information herein may be inaccurate, and it's certainly incomplete. IANA MD.

  • Wellbutrin has been linked to seizures in a small portion of patients. Of course, you probably shouldn't take it if you're seizure prone. Cocaine, other stimulants, and depressants (including alcohol, opiates, etc.) appear to increase the risk. Heavy usage of any of the previous indicates you may need rehab, not antidepressants.
  • Don't go through alcohol withdrawal while on Wellbutrin. (Hangovers aren't withdrawal, I'm talking delirium tremens.) Again, seizures.
  • A number of folks have reported that Wellbutrin, as well as SSRIs, decrease the effectiveness of Ecstacy. This does NOT mean that you should take more; bear in mind that Ecstacy often has chemicals other than MDMA in it, many of which might cause trouble in large doses (or at all). Let the buyer beware. (Also note: It sucks to come down from MDMA if you're depressed.)
  • While I haven't heard of many negative reports regarding LSD and Wellbutrin, many claim the latter inhibits the former somewhat. Again, don't run and take 3x the normal dose, lest you act like a moron for a week straight. If you happen to also be using lithium or another tricyclic, do not take LSD.
  • Marijuana (and, presumably, hashish) does not appear to cause problems. You may, however, wish to be cautious with dosages.

The moral of the story: Don't do all the crap you usually shouldn't do, like coke or oxycontin or entire bottles of Jack Daniels.

Bupronin was released as a smoking-cessation aide under the name Zyban thanks to Wellbutrin's mostly unfounded reputation as seizure-inducing. GlaxoWellcome panicked somewhat after inconclusive studies claimed that Wellbutrin caused more seizures than other antidepressants; as it turns out, the seizures occurred among .4% of patients, most of them already seizure-prone. But the reputation stuck with many physicians, so Glaxo "re-branded" bupronin.

Many HMO's, including BlueCross BlueShield, do cover Zyban and other drugs to combat nicotine addiction. This makes sense financially, since non-smoking customers tend to have lower rates of costly diseases like lung cancer.

Trouble is, some of those companies only cover Zyban for a few months, as there's little point to suppressing nicotine cravings when one hasn't smoked in months. Wellbutrin, on the other hand, is often covered indefinitely, as bouts of depression can last a great while.

Zyban is supposed to take 2 weeks to "kick in"; during that period, you may wish to use some type of nicotine (the patch, the gum, the inhaler, or the new smokable nicotine sticks) to stave off cravings. I've been on Zyban (actually, Wellbutrin -- screw you, HMO) for 2 weeks and have had a very easy time not smoking--in fact, I ditched the patch the other day--but this may be the placebo effect. YMMV. Just take it on a full stomach, because even placebos can upset your tummy.

Oh, and if you plan on using non-medicinal (read: illegal) psychotropic drugs, please read whatever else you can find, as there exist some bad combinations.