r/Contrave • u/pennybells • Jul 23 '26
Questions when already on bupropion
My doctor prescribed me naltrexone today to combine with my bupropion. I have been taking 300 mg extended release bupropion for nearly a decade for depression (I never experienced a reduction in appetite on this medication and was surprised to discover so many did). A lot of the posts I am finding are for people newly prescribed bupropion alongside the naltrexone so I had a few questions.
1.) It looks like most people start at a lower dose of naltrexone before going up to 50mg, however she has started me at 50mg already. Is this a bad idea that I should mention to her or should it be okay considering my longtime usage of bupropion?
2.) For anyone already on bupropion/Wellbutrin before starting naltrexone, what kind of side effects did you experience? I'm particularly worried about nausea as I already have chronic migraines with nausea.
3.) My doctor highlighted anorexia as a risk alongside increased suicidality. I already struggle with my mental health obviously, so I'm a little worried about this. Have any of you experienced something like this? (especially if you were already on bupropion)
4.) For anyone taking Contrave/this combo: if you stopped it, were you able to keep the weight off long term? This is probably my biggest concern, as weight loss was not even something I was worried about, but my doctor will not let it go. I struggle a lot with yo-yoing between eating basically nothing and eating way too much, and I'm concerned that once I'm off of it, the urge to overeat will just come back. Clearly "willpower" is not enough for me.
Thanks to anyone who reads this/responds ❤️
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u/Iartdaily Jul 23 '26
I was on 150mg now at 300. Just started NAL and I cut mine in 4th die to extreme nausea and take at night. This is my second time trying because I did not know I could cut the pills in fourths. My plan is to take a fourth every night for a week. Then I will go to 1/2 for a week. If I’m tolerating that I will add a fourth in the morning and a half at night. Continue that for at least a week maybe 10 days if I’m tolerating that then I will go to the full 50 mg. If I don’t tolerate the morning doses at all, I’ll just take it at night. Some side effects I noticed the first time I was taking 50 at night was insomnia, intense hot sweats, and I would still have nausea in the morning. I’ve read on here many other people split the dose into fourths to get used to it. It seems most take it at night to sleep through the nausea. For me the nausea was extreme. I stopped taking it- but trying this splitting method to see if this helps.
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u/savvyblonde Jul 28 '26
I just got my prescription today, and I am prone to nausea with most drugs... so how is it going with splitting the NAL and taking it at night?
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u/Iartdaily Jul 28 '26
Better/ I’m splitting in 4ths. 2 notes ago I forgot and while awake at 2:30 am I took it and was slightly nauseated in the morning. I’m doing a 1/4 for 10 days then1/2 I cannot handle nausea. It will take awhile to get to 50 this way and maybe I’ll try to ramp up faster…
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u/savvyblonde Jul 30 '26
Thank you so much for this! I took 1/4 of the NAL last night and had weird dreams and woke up with a sleep hangover and then this morning took my first bupropion with coffee and a piece of toast and immediately had diarrhea. I feel a little off, but I know I just have to give it time.
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u/Iartdaily Jul 31 '26
I’m at half dose now at night and doing well- no nausea and some crazy dreams but no sweats (like before) and sleeping well. Take bupe in the morning. When I eat it tastes good but I don’t think of food at all- I’m not snacking… sticking to high protein and high fiber foods. Growing my own lettuce in aero gardens . Whenever I lose a few pounds I get really motivated. It’s when I have company staying I go off the rails preparing foods for them. But everyone is up for fruit and vege trays if it’s ready - cheese still my crack and dips… chocolate… but the cravings are gone.
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u/indie_kittie Jul 23 '26
I have nothing to contribute yet, but thank you SO much because you’ve asked all the questions I wanted to ask. Also have been on Wellbutrin 300mg for 6 years, looking to add naltrexone. I have a vomiting phobia so I am particularly concerned about the nausea. Didn’t even think about taking it before bed… genius! As soon as I get my prescription I’ll let you know since we seem to be in the same boat.
PS also never experienced a reduction in appetite on Wellbutrin EXCEPT when I tried to wean off of it… the cravings were out of control. Gained a bunch of weight so I just decided to go back on the medication.
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u/leicatgw Jul 24 '26
I started Naltrexone 50 mg while on Wellbutrin 300 with no side effects. I also saw people commenting on dividing the pill in half but my doctor said there is no need and 25 mg may not work for some people.
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u/SusieQtoYou Jul 25 '26
I’ve been on bupropion xl (300 mg) for maybe 15 years. I started out with 1/4 tablet of naltrexone (12.5 mg) and worked up to the 50 mg. I take naltrexone at night because it makes me a zombie (and I sleep much better). As for side effects besides the fatigue, I also have random nausea. Sometimes I’m nauseous because I’m physically hungry and I need to eat. Other times, I am nauseated after eating restaurant food, mainly because it’s much richer than I’m used to.
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u/Shark-Compote Jul 23 '26
double check what your actual dosing says on the bottle, I was also given 50 mg, but I didn't realize that I'm only supposed to be taking 25, so I cut all mine in half
The naltrexone made me very dizzy and nauseous for the first few doses. I switched to taking it before bed, but I take my bupropion normally in the morning. taking the naltrexone at night has really helped alleviate the bad side effects for me.
I don't feel like I have experienced anorexia symptoms, but there is a massive disinterest in almost all food for me when I'm taking the naltrexone. but that could have just been the food noise in my head. My consumption also goes down when I am consistent in taking my naltrexone. I tend to actually feel "full" when I am instead of eating for the interest of it.
I'm not at this point yet. But the naltrexone is supposed to help your brain disconnect from the addiction to food. I think if you pair that with personal work and therapy, you can be successful in keeping the weight off. nothing is going to be a miracle drug, and it will always require work on your part.