Zyban Vs. Wellbutrin

Introduction

Zyban and Wellbutrin are medications with the same chemical formula and the generic name Bupropion. However, Zyban and Wellbutrin are prescribed for different purposes and vary in their concentrations and side effects. Zyban is primarily prescribed as a smoking cessation aid for people that wish to stop smoking. On the other hand, Wellbutrin is primarily prescribed to patients that are suffering from depression and Seasonal Affective Disorder (SAD). According to the Centers for Disease Control and Prevention, over 30.8 million Americans smoke [1], and research suggests that around 12% of smokers are battling depression [2]. Similarly, over 17 million Americans suffer from depression [3], and around 20% suffer from mild SAD [4].

Despite their similar structure and use, Zyban and Wellbutrin have different mechanisms of action; Zyban helps prevent the reuptake of hormones that help ease the mind, while Wellbutrin helps stimulate their release. Zyban and Wellbutrin are both prescription medications that have received FDA approval.

Abouts Zyban and Wellbutrin

What is Zyban?

Zyban is a prescription medication that contains the active ingredient bupropion. It was originally approved by the U.S. Food and Drug Administration (FDA) in 1985 as an antidepressant, marketed under the brand name Wellbutrin. Later, it was approved as a smoking cessation aid under the brand name Zyban in 1999 [5]. Zyban works by preventing the reuptake of dopamine into the synaptic cleft, successfully "trapping" the hormone in mind. The hormone dopamine allows us to feel pleasure, mortification, and satisfaction.

What conditions are Zyban approved to treat?

Zyban is approved to treat the following conditions:

1. Smoking Cessation:

Zyban is primarily used as an aid to quitting smoking. It works by reducing cravings and withdrawal symptoms associated with nicotine addiction. Unlike nicotine replacement therapies, such as nicotine gum or patches, which replace nicotine in the body, Zyban helps regulate brain chemicals that play a role in addiction and withdrawal. It is typically prescribed for 7-12 weeks and is taken while the person smokes. This allows the medication to build up in the system before the person quits smoking.

2. Depression:

Zyban is also approved to treat depression. It is a type of antidepressant called a norepinephrine-dopamine reuptake inhibitor (NDRI). It works by blocking the reuptake of neurotransmitters in the brain, norepinephrine and dopamine, which regulate mood. By increasing the levels of these neurotransmitters in the brain, Zyban can help improve symptoms of depression.

3. Seasonal Affective Disorder (SAD):

Zyban is also approved to treat seasonal affective disorder (SAD), a type of depression that occurs during winter when there is less natural sunlight. It is believed that the lack of sunlight can disrupt the body's internal clock and lead to changes in the levels of neurotransmitters in the brain. Zyban can help regulate these neurotransmitters and improve symptoms of SAD.

How does Zyban work for smoking cessation?

Zyban works by blocking the reuptake of dopamine and norepinephrine, two neurotransmitters in the brain that affect mood and energy levels [6]. By increasing the levels of these neurotransmitters in the brain, Zyban can reduce cravings and withdrawal symptoms associated with smoking cessation.

Zyban works antagonistically on the nicotine acetylcholinergic receptor (AChR) and helps reduce the effects of nicotine [7], the primary component in cigarette smoke responsible for addiction. In simple terms, Zyban binds to the receptor instead of nicotine. This allows Zyban to produce stimulatory effects like nicotine on the Central Nervous System, making it a suitable alternative to cigarette smoke [8].

What is Wellbutrin?

Wellbutrin, also called Bupropion, is an antidepressant medication that works by increasing the levels of dopamine and norepinephrine in the brain. By increasing the levels of these neurotransmitters, Wellbutrin can improve symptoms of depression and SAD. Wellbutrin received FDA approval in 2003 [9].

What conditions is Wellbutrin approved to treat?

Wellbutrin is approved by the U.S. Food and Drug Administration (FDA) to treat the following medical conditions:

1. Major Depressive Disorder (MDD)

Wellbutrin is primarily used to treat MDD, a condition characterized by sadness, hopelessness, and loss of interest in activities. It is a serious condition that can affect a person's quality of life and ability to function. Wellbutrin helps to increase the levels of neurotransmitters in the brain that are responsible for regulating moods, such as dopamine and norepinephrine.

2. Seasonal Affective Disorder (SAD)

SAD is a type of depression that is related to changes in seasons. It typically occurs in the fall and winter when there is less sunlight. Wellbutrin is an effective treatment for SAD as it helps to regulate the levels of neurotransmitters in the brain that are responsible for regulating mood.

3. Smoking Cessation

Wellbutrin is also approved as a smoking cessation aid. It is believed to work by reducing cravings and withdrawal symptoms associated with quitting smoking. Wellbutrin is usually prescribed with a smoking cessation program that includes counseling and support.

4. Attention Deficit Hyperactivity Disorder (ADHD)

Wellbutrin is sometimes used off-label to treat ADHD. ADHD is a condition that is characterized by symptoms such as hyperactivity, impulsivity, and difficulty concentrating. Wellbutrin is believed to work by increasing the levels of dopamine and norepinephrine in the brain, which can improve focus and concentration.

How does Wellbutrin work for depression?

Wellbutrin works as a norepinephrine/dopamine reuptake inhibitor (NDRI) that inhibits the enzymes responsible for the uptake of these hormones into the synaptic cleft, making these hormones available in the brain for longer [10]. Wellbutrin does so by binding to the dopamine transporter (DAT) and the norepinephrine transporter (NET) [11]. These neurotransmitters play a role in regulating mood, and it is believed that increasing their availability in the brain can help improve symptoms of depression.

Unlike other antidepressants, Wellbutrin does not affect serotonin reuptake, another neurotransmitter involved in regulating mood [12]. This means that it may be a good option for people who have not responded well to other antidepressants or who experience side effects.

Effectiveness

How Effective are Zyban and Wellbutrin for Treating Depression?

Zyban and Wellbutrin have been extensively studied for their efficacy and safety in treating patients suffering from depression. One study found that Zyban and Wellbutrin were highly effective in treating patients with depression compared to a placebo [13]. Another study compared the effects of Bupropion with Zoloft, a popular medication for the treatment of depression, and found no difference between the two medications [14]. Another study thoroughly reviewed several clinical studies on Bupropion and concluded that the medication plays and will continue to play an important role in treating major depressive disorder [15]. The American Academy of Family Physicians (AAFP) found that extended-release Zyban and Wellbutrin can prevent recurring symptoms in patients suffering from SAD [16].

Dosage Information

How is Zyban administered for depression?

Zyban is administered orally for patients suffering from depression and is available as a 150 mg tablet. The tablet is round, purple, and film-coated, with "Zyban 150" printed. The Zyban tablet should be swallowed whole. D.O. not crush, divide, or chew the tablet as it could lead to adverse effects.

How is Wellbutrin Administered for Depression?

Wellbutrin is administered orally in the form of tablets that are available in two concentrations:

  • 75 mg tablets: yellow, round, and printed with “Wellbutrin 75”.
  • 100 mg tablets: red, round, and printed with “Wellbutrin 100”.

Side Effects

What are the most common side effects of Zyban?

The most common side effects of Zyban include the following:

  • Dry mouth
  • Insomnia
  • Dizziness
  • Drowsiness
  • Nausea
  • Diarrhea
  • Increased rate of sweating
  • Stomach pain
  • Blurred vision
  • Constipation
  • Fatigue
  • Loss of interest in sex
  • Sore throat
  • Skin rash
  • Increased urination
  • Loss of appetite

Are there any potentially serious side effects of Zyban?

If you experience the following serious side effects of Zyban, seek medical help immediately.

  • Chest pains
  • Heart palpitation
  • Fainting
  • Abnormal mood changes
  • Anxiety and memory loss
  • Muscle aches
  • Headache
  • Tremors
  • Ringing in ears
  • Thoughts of Suicide

What are the most common side effects of Wellbutrin?

Some of the most common side effects of Wellbutrin include:

  • Agitation or anxiety
  • Dry mouth
  • Headache
  • Insomnia
  • Nausea and vomiting
  • Constipation
  • Stomach pain
  • Blurred vision
  • Loss of libido
  • Sore throat
  • Skin rash
  • Increased sweating

Are there any potentially serious side effects of Wellbutrin?

If you experience any serious side effects of Wellbutrin, seek medical help immediately.

  • Seizures
  • Muscle aches
  • Tremors
  • Ringing in ears
  • Fainting
  • Memory loss
  • Trouble breathing

Contraindications and Interactions

Warning and General Precautions for Zyban and Wellbutrin

Below are some warnings and general precautions for Zyban and Wellbutrin to consider before you take Zyban or Wellbutrin.

  • Do not take Zyban and Wellbutrin if you are pregnant or have plans to do so.
  • Do not breastfeed if you are taking Zyban and Wellbutrin.
  • Do not give Zyban and Wellbutrin to children or adolescents under 18.

Contraindications and Important Interactions for Zyban and Wellbutrin

Contraindications

Zyban

In patients with a seizure disorder

In patients with a current or past diagnosis of bulimia or anorexia nervosa

In patients undergoing withdrawal symptoms from alcohol, benzodiazepine, antiepileptic drugs, and barbiturates.

In patients using Monoamine oxidase inhibitors (MAOIs)

In patients with known hypersensitivity to Bupropion or other active agents in Zyban.

Wellbutrin

In patients with a seizure disorder

In patients with a current or past diagnosis of bulimia or anorexia nervosa

In patients undergoing withdrawal symptoms from alcohol, benzodiazepine, antiepileptic drugs, and barbiturates.

In patients using Monoamine oxidase inhibitors (MAOIs)

In patients with known hypersensitivity to Bupropion or other active agents in Wellbutrin.

Drug/Medication Interactions

Zyban

  • Amitriptyline
  • Citalopram
  • Cymbalta (duloxetine
  • Mirtazapine
  • Prednisone
  • Ritalin (methylphenidate)
  • Seroquel (quetiapine)
  • Tramadol
  • Zoloft (sertraline)
  • Clonazepam
  • Diazepam
  • Propranolol
  • Xanax (alprazolam)

Wellbutrin

  • Abilify (aripiprazole)
  • Adderall (amphetamine)
  • Cymbalta (duloxetine)
  • Lexapro (escitalopram)
  • Prozac (fluoxetine)
  • Seroquel (quetiapine)
  • Tramadol
  • Trazodone
  • Zoloft (sertraline)
  • Clonazepam
  • Klonopin
  • Lisinopril
  • Xanax (alprazolam)

Food/Beverage/Supplement Interactions

Zyban/Wellbutrin

Alcohol

Cost Comparison

How Much do Zyban and Wellbutrin Cost?

Although the generic medication is available for Bupropion, it is mainly for brand names Wellbutrin XL, Wellbutrin S.R., and Forfivo XL. Thus, you must consult your doctor before buying the brand names or the generic brand.

150 mg/12-hour extended-release oral tablets for Zyban are available from $46.55 for 30 tablets ($1.55 per unit). According to Label, most patients take Zyba for at least seven weeks [17]. This means that an average patient taking a 150mg/day course would spend $75.95 on a complete course of Zyban.

75 mg oral tablets for Wellbutrin are available from $86.22 for 30 tablets ($2.89 per unit). According to CDC, an average patient should take Wellbutrin for up to 12 weeks [18]. This means that an average patient taking a 300 mg/day course would spend approximately $971.04 on a complete course of Wellbutrin.

The popularity of Zyban and Wellbutrin

Bupropion (the generic name for Zyban and Wellbutrin) is one of the first choice medications for treating depression and cigarette cessation. In 2020, there were around 5.8 million patients for Bupropion, and the estimated number of prescriptions in the United States was nearly 29 million [19].

Conclusion

Takeaway

Zyban and Wellbutrin are two brand names for the same medication, Bupropion. While they are marketed for different purposes, they are chemically identical. Zyban is typically prescribed at a higher dose and for a shorter period than Wellbutrin. Both drugs can cause similar side effects, although Zyban may be more likely to cause agitation, anxiety, and irritability. Anyone taking Bupropion should be closely monitored for signs of suicidal thoughts or behavior.