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NDRI Antidepressants: Side Effects

Medically Reviewed by Smitha Bhandari, MD on July 22, 2020

Norepinephrine and dopamine reuptake inhibitors (NDRIs) are medications to treat depression. They’re newer than the first-generation antidepressants.

Different antidepressants work a little differently. One advantage with NDRIs is that they usually don’t cause side effects that can be common to antidepressants. Those include weight gain or lowered sex drive.

Side Effects

All antidepressants generally work by targeting brain chemicals called neurotransmitters that control your mood. But each medication may work on different neurotransmitters or in different ways. That means the antidepressants may come with different side effects.

Bupropion (Aplenzin, Wellbutrin,) is the only NDRI sold on the market. Your doctor may prescribe it or add it to your therapy if you haven’t felt better with other treatments. Doctors also prescribe bupropion under a different brand name, Zyban, to help people quit smoking.

Most NDRI side effects are mild and usually get better after you’ve taken it for a few weeks. Common ones include:

Dry mouth. This is the most common complaint about NDRIs. To moisten your mouth, sip water, suck on ice chips, brush your teeth often, and cut down on alcohol, caffeine, and smoking.

Nausea. It may help to take your medication with food.

Insomnia. NDRIs can energize you and may make it hard to sleep. If this is a problem for you, avoid taking your final dose of the day just before bedtime.

Headache. These usually stop a few days after you start taking NDRIs.

Weight loss. Some antidepressants can add weight. But NDRIs may lead you to lose a few pounds.

Some side effects are less common with NDRIs:

Anxiety. Regular exercise can help calm you. So can relaxation practices such as deep breathing yoga, and meditation.

Dizziness. This can happen if you stand too quickly. Rise up slowly and drink lots of water.

Constipation. High-fiber diet, regular exercise, and plenty of fluids may help you poop.

NDRIs can also cause:

Serious Side Effects

Seizures. For most people, the risk is low. You’re more likely to have a seizure if you have:

High blood pressure. Your doctor may check your levels regularly, especially if you use nicotine patches to help you quit smoking.

Angle-closure glaucoma. This sudden eye condition can cause vision loss. Tell your doctor right away if you have eye pain, vision changes, or swelling or redness in or around your eyes.

Suicidal thoughts. NDRIs and other antidepressants can make some people more depressed or think about killing themselves. Call your doctor right away if you feel very angry, confused, sad, fearful, or other strong negative emotions.

Interactions

Tell your doctor about all the vitamins, supplements, and prescription and over-the-counter medications that you take. Some can raise your risk of seizures. Others can make NDRIs work less well.

Ask your doctor if it’s safe for you to also take or use:

  • Monoamine oxidase inhibitor (MAOI) antidepressants taken within 2 weeks of an NDRI
  • Other antidepressants
  • Alcohol and other drugs
  • Antipsychotics
  • Medications used to ward off seizures
  • Stimulants
  • Steroids
  • Insulin and other diabetes medications
  • Some antibiotics
  • Beta-blockers
  • Medications for irregular heartbeat
  • Codeine
  • Sedatives
  • Sleeping pills
  • Nicotine patches

You should never take more than one bupropion medication at a time. If you take too much, it can make your side effects worse, raise your risk for a seizure, or cause an overdose.

When to Talk to Your Doctor

Let your doctor know if you have any side effects, even if they’re mild. They may adjust your dose or prescribe other medications to ease the side effects.

Tell your doctor if you are or plan to get pregnant or to breastfeed.

You should call your doctor immediately or seek emergency medical care if you have any of these symptoms of an NDRI overdose:

WebMD Medical Reference

Sources

SOURCES:

Therapeutic Advances in Psychopharmacology. “Bupropion: a systematic review and meta-analysis of effectiveness as an antidepressant.”

UpToDate: “Atypical antidepressants: Pharmacology, administration, and side effects.”

Medline Plus: “Bupropion.”

National Alliance on Mental Health: “Bupropion (Wellbutrin).”

Mayo Clinic: “Antidepressants: Get tips to cope with side effects,” “Bupropion (Oral Route).”

Harvard Health Publishing: “Antidepressant side effects: Feeling better, but not quite right?”

Handbook of Experimental Pharmacology: Antidepressants: “Other Antidepressants.”

Treatment Resistance in Psychiatry: Risk Factors, Biology, and Management.

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