Wellbutrin (bupropion): uses, side effects, and what to expect

If you've been prescribed bupropion or you're researching it on your own, you probably have questions about how it works, what it treats, and what to expect. Wellbutrin (bupropion) is a norepinephrine-dopamine reuptake inhibitor (NDRI), a type of antidepressant primarily used for depression and seasonal affective disorder. It stands out from many other antidepressants because of its activating effects and lower risk of sexual side effects or weight gain.

Key takeaways

• Wellbutrin (bupropion) is an NDRI antidepressant used to treat major depressive disorder and seasonal affective disorder.
• It works by increasing levels of norepinephrine and dopamine, two brain chemicals involved in motivation, energy, and focus.
• Full effects may take four weeks or longer to develop, though some people notice changes in energy sooner.
• People with a history of seizures or certain eating disorders should not take bupropion because it can increase seizure risk.

What is Wellbutrin?

Wellbutrin is a brand name for the generic medication bupropion. It is also sold under the brand names Wellbutrin SR, Wellbutrin XL, Aplenzin, and Zyban. Bupropion belongs to a class of medications called norepinephrine-dopamine reuptake inhibitors (NDRIs). It is primarily prescribed for depression and seasonal mood changes, though it has several other clinical uses as well.

What does Wellbutrin treat?

Bupropion is FDA-approved for specific conditions and is also prescribed for other uses based on clinical judgment.

On-label uses

• Major depressive disorder (MDD)
• Seasonal affective disorder (SAD)
• Smoking cessation (under the brand name Zyban)

Off-label uses

Psychiatrists sometimes prescribe bupropion off-label, meaning for conditions beyond its FDA-approved uses. These may include:

• Attention-deficit/hyperactivity disorder (ADHD)
• Counteracting sexual side effects, fatigue, or apathy caused by other antidepressants
• Anxiety disorders

How does Wellbutrin work?

Bupropion works differently from many common antidepressants. Instead of targeting serotonin, it acts on two other brain chemicals: norepinephrine and dopamine. By keeping more of these chemicals available in the brain, bupropion can help improve energy, motivation, and concentration.

• Boosts norepinephrine and dopamine levels. Bupropion slows the reuptake of these brain chemicals so there is more of them to aid in motivation, energy, and focus.
• Strengthens motivation and reward pathways. By increasing dopamine activity, it can help improve drive, concentration, and interest in activities.
• Supports mood and energy. These effects can help reduce depressive symptoms like low motivation, fatigue, and difficulty concentrating.

3 things a Talkiatry psychiatrist wants you to know about Wellbutrin

• It can increase energy and focus. Unlike many antidepressants, bupropion often feels more activating and may help with low energy or brain fog.
• It usually doesn't cause sexual side effects. Compared with many antidepressants, sexual side effects are much less common with bupropion.
• Certain medical histories matter. People with a history of seizures or certain eating disorders typically should not take bupropion because it can increase seizure risk.

Common side effects of Wellbutrin

Most side effects of bupropion are mild and may improve as your body adjusts to the medication. Common side effects may include:¹

• Anxiety or agitation
• Difficulty falling or staying asleep
• Dry mouth
• Nausea
• Abdominal pain or discomfort
• Constipation
• Dizziness
• Headache
• Tremors or uncontrollable shaking
• Decreased appetite
• Excessive sweating
• Drowsiness or sedation
• Ringing in the ears
• Sore throat

Talk to your psychiatrist if any of these feel persistent, severe, or get in the way of your day.

Serious side effects of Wellbutrin and when to seek help

Serious side effects are less common but require prompt medical attention. Contact your doctor or seek emergency care if you experience any of the following:¹

• Seizures; seek immediate medical attention
• Confusion or hallucinations
• Irrational or unfounded fears
• Rapid, pounding, or irregular heartbeat
• Greatly increased energy or severe trouble sleeping combined with racing thoughts
• Reckless behavior or unusually grandiose ideas
• Excessive happiness alternating with severe irritability
• Talking more or faster than usual
• Fever with rash, blisters, itching, or hives
• Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• Hoarseness
• Difficulty breathing or swallowing
• New or worsening depression; suicidal thoughts, plans, or attempts
• Extreme worry, panic attacks, or aggressive behavior
• Irritability or acting without thinking
• Severe restlessness or frenzied abnormal excitement

Call your psychiatrist right away or seek emergency care if you experience any of these symptoms.

What to watch for when starting Wellbutrin

Starting a new medication comes with a transition period. Here are a few things to keep in mind:¹

• Full therapeutic benefit may take four weeks or longer to develop.
• It may increase blood pressure. Your psychiatrist may monitor this during treatment.
• It may cause angle-closure glaucoma. Discuss an eye examination with your doctor before starting.
• Take bupropion with food if it causes an upset stomach.
• It may cause difficulty sleeping and is typically taken in the morning to help reduce this side effect. Discuss medication timing with your provider.
• Discuss safe alcohol use with your doctor.
• When taking any new medication, it's best to see how it affects you before driving or operating machinery.
• Continue taking bupropion even if you feel well. Do not stop abruptly without medical guidance.

What to do if you miss a dose of Wellbutrin

If you miss a dose of bupropion, skip the missed dose and continue your regular dosing schedule. Allow the full scheduled time to pass between doses. Do not take a double dose to make up for a missed one.¹

Who should talk to a psychiatrist before taking Wellbutrin

Some health conditions, medications, and life situations change how Wellbutrin is prescribed. Tell your psychiatrist if any of the following apply to you:¹

• History of seizures, anorexia nervosa, or bulimia
• Current heavy alcohol use or plans to stop drinking suddenly
• Taking sedatives or seizure medications with plans to suddenly discontinue
• History of heart attack, head injury, or brain or spinal tumor
• High blood pressure
• Diabetes
• Liver, kidney, or heart disease
• Pregnant, planning to become pregnant, or breastfeeding
• Allergy to bupropion or other medications
• Currently taking or have taken MAO inhibitors within the past two weeks
• History of heavy alcohol use, street drug use, or prescription medication overuse