Wellbutrin XL Versus Bupropion SR – Insomnia Rates

JS is a 45 year-old male who has been taking bupropion SR 150 mg twice daily for about 4 weeks. He has been taking it for depression. He reports that depressive symptoms have started to improve but he does notice that he has a harder time getting to sleep and staying asleep since beginning the medication. In this article, we will compare Wellbutrin XL versus Bupropion SR in relation to the incidence of insomnia.

Wellbutrin XL Versus Bupropion SR – Insomnia Incidence

Insomnia is an adverse effect of both the XL and SR formulations but when comparing Wellbutrin XL versus bupropion SR, the incidence of insomnia is significantly higher with bupropion SR. This makes sense to me as SR is going to have a higher peak concentration because of the quicker absorption. According to the literature, Wellbutrin XL has an insomnia rate of approximately 20% while bupropion SR 300 mg total daily dose has an incidence of approximately 40%

Case Options

The case scenario above represents an excellent situation where understanding dosage form differences can help you improve the lives of your patients. It appears that bupropion use has been beneficial for this patient and it appears he’d like to continue but would like to have less insomnia. Changing to a different medication doesn’t seem appropriate when we have other options available. The first option would be to reduce the SR dose. This could lead to a worsening of depression symptoms and not be an adequate dose for the patient. The other option would be to switch to the extended-release formulation (Wellbutrin XL) at 300 mg once daily in the morning to see if that helps reduce the insomnia issue. Another option would be to find a different medication to treat his depression.

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