Here’s What Experts Say About Wellbutrin Side Effects

Starting Wellbutrin and curious what to expect? Keep reading to learn more about common (and not-so-common) Wellbutrin side effects and more.

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Wellbutrin, the brand name for bupropion, is an atypical antidepressant that mental health clinicians prescribe to relieve symptoms of major depressive disorder and seasonal affective disorder. Outside of these FDA-approved indications, providers may prescribe Wellbutrin off-label for attention-deficit/hyperactivity disorder (ADHD), antidepressant-induced sexual dysfunction, and more.

Regardless of why you’re prescribed Wellbutrin, you may be curious about the side effects of the medication and wondering what to expect in your early days of taking it.

Read on to learn more about Wellbutrin side effects, how long they last, which side effects are most common, and when to contact your provider.

What are the side effects of Wellbutrin?

The side effects of Wellbutrin vary from gastrointestinal side effects like nausea and constipation to more activating side effects like nervousness or insomnia. Some people may experience multiple adverse effects, while others may experience none.

According to FDA drug data, the most common side effects of Wellbutrin include:

• Nervousness
• Trouble sleeping
• Dry mouth
• Shakiness (tremor)
• Headache
• Dizziness
• Nausea
• Vomiting
• Constipation
• Sweating
• Fast heartbeat
• Blurred vision

It’s important to note that there are different formulations of Wellbutrin and its generic bupropion. These include:

• Wellbutrin XL (Wellbutrin brand name extended-release tablets)
• Bupropion XL (Generic extended-release tablets)
• Wellbutrin SR (Wellbutrin brand name sustained-release tablets)
• Bupropion SR (Generic sustained-release tablets)
• Bupropion IR (Generic immediate-release tablets)

All brand-name and generic versions of Wellbutrin contain bupropion hydrochloride (or bupropion HCL) as the active ingredient, regardless of whether the medication is immediate, sustained, or extended-release. 

“Side effects are generally dose-dependent and more common with immediate and sustained release formulations than the extended release formulation, especially when taken late in the day,” says Tara Fuller, a Psychiatric-Mental Health Nurse Practitioner (PMHNP) and Director of Advanced Practice Psychiatry at Charlie Health. 

Wellbutrin side effects in the first week

“Insomnia, dry mouth, nausea, and headache are among the side effects most likely to occur during the first week of treatment,” Fuller says. These side effects may be most apparent at the beginning of treatment, as your body adjusts to a new medication. Providers often prescribe a lower dose of the medication to start with to minimize intense side effects and give your body time to adjust. 

When do Wellbutrin side effects go away?

There is no one-size-fits-all answer for when Wellbutrin side effects will go away, since everyone is different and some people may experience more intense side effects than others. However, many of the activating side effects settle after one to two weeks, Fuller says. 

An important consideration is that bupropion side effects are often dose-related rather than duration-related, Fuller adds, meaning if you’re on a dose that’s too high for your body, you may experience the side effects even after more time has passed. This is especially common for people experiencing irritability or anxiety at higher doses of Wellbutrin, Fuller says. 

Additionally, if you experience insomnia as a side effect, you may need to take your medication at a different time, she adds.

Wellbutrin long-term side effects

For most people, Wellbutrin is considered safe and well-tolerated when taken long-term. 

However, some research shows that chronic bupropion use can lead to high blood pressure. It’s important to have regular check-ups with your primary care physician to monitor your blood pressure and overall health whenever you’re taking any prescription drug long-term.

Additionally, as Fuller mentioned, some side effects may be dose-related rather than duration-related. So, if you’re on a higher dose that’s causing you anxiety, this might occur until your prescriber adjusts the dose to be lower. Or, insomnia could persist long-term if you are taking the bupropion at night rather than in the morning. 

Does Wellbutrin cause sexual side effects?

It is not common for Wellbutrin to cause sexual side effects. In fact, many clinicians prescribe Wellbutrin to combat sexual side effects that people experience from other antidepressants. 

For example, SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) are two common antidepressant classes that may cause sexual side effects, including:

• Decreased libido
• Difficulty orgasming
• Inability to have an orgasm
• Erectile dysfunction

For some people, adding Wellbutrin to an SSRI or SNRI, or switching to Wellbutrin, can increase sex drive and counteract these sexual side effects.

It’s possible for Wellbutrin to cause sexual side effects, but it isn’t common, and much less likely to cause sexual dysfunction than a selective serotonin reuptake inhibitor or serotonin and norepinephrine reuptake inhibitor.

How long does it take for Wellbutrin to work?

When you first start taking Wellbutrin, it doesn’t act on symptoms immediately. It takes a bit of time to build up and cause changes in neurotransmitter activity in your brain. Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI), which means it affects levels of the brain chemicals norepinephrine and dopamine. 

You might notice a minor improvement in your symptoms as early as one to two weeks. But to experience a clinically significant reduction in depression symptoms, it could take around six to eight weeks. 

Try to stay patient during this time, and remember that the medication doesn’t work magically overnight. Plus, it might take some time to reach the clinical dose that’s best for you. 

Wellbutrin drug interactions

If you take certain medications, Wellbutrin might not be the best fit due to drug interactions. It’s crucial to tell your provider about all prescription medications you take so they can ensure that Wellbutrin is safe for you.

Some known drug interactions for Wellbutrin are:

• Certain HIV medications (ritonavir, lopinavir, and efavirenz)
• Certain anticonvulsants/seizure medications (carbamazepine, phenobarbital, and phenytoin)
• Certain antidepressants (venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, and sertraline)
• Monoamine oxidase inhibitors (MAOI) antidepressants (selegiline, isocarboxazid, phenelzine, and tranylcypromine)
• Certain antipsychotics (haloperidol, risperidone, and thioridazine)
• Certain cardiac medications (metoprolol, propafenone, and flecainide)
• Certain medications used for treating Parkinson’s (levodopa and amantadine)

Wellbutrin health contraindications

While Wellbutrin is safe for many people to take, people with certain health conditions may be advised not to take it due to an increased risk of serious adverse effects, including increased seizure risk.

These contraindications include:

• Seizure disorder
• Bulimia or anorexia nervosa (current or past diagnosis)
• Abruptly stopping drinking alcohol if you drink excessively
• Abruptly stopping benzodiazepines, barbiturates, or antiepileptic medications
• Taking an MAOI antidepressant medication within the last 14 days

Your prescriber should be aware of your medical history to ensure your safety while taking Wellbutrin. If the risks outweigh the potential benefits, your provider might recommend a different medication instead of bupropion.

When to contact your provider about side effects

While it’s normal to experience mild side effects like nausea or headaches when you first start taking Wellbutrin, it’s important to contact your provider if the side effects are severe or worsening over time. You want your medication to make you feel better, not worse.

Additionally, some more severe and rare adverse effects are possible when you take Wellbutrin. Fuller says to contact a healthcare provider if you experience any of the following:

• Suicidal thoughts
• Psychosis
• Mania
• Severe agitation
• Seizures
• High blood pressure
• Severe rash
• Hives (or any other sign of an allergic reaction)
• Eye pain or vision changes

Although these are possible side effects, they’re uncommon with Wellbutrin treatment. Still, it’s important to be aware of the possibility and reach out for medical advice ASAP.

Additionally, the risk of suicidal thoughts is highest in children, teenagers, and young adults under the age of 24, so these younger patients need to be closely monitored during the first few months of treatment or after any dose changes. 

How Charlie Health can help

If you or a loved one is struggling with mental health, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for people dealing with serious mental health conditions, including major depressive disorder and seasonal affective disorder.

Our compassionate care team incorporates evidence-based therapies into individual counseling, family therapy, and group sessions. We also offer medication management to clients as needed. Our clinicians can prescribe psychiatric medications (like Wellbutrin), monitor for adverse effects, and adjust dosages as needed. With a combination of medication and therapy, feeling better is within reach. Fill out the form below or give us a call to start healing today.