A Complete Guide to Bupropion (Wellbutrin, Zyban) Side Effects

A Complete Guide to Bupropion (Wellbutrin, Zyban) Side Effects
Mary Lucas, RN
Medically reviewed by Mary Lucas, RN Written by Our Editorial Team Last updated 7/19/2020

Sold under the brand name Wellbutrin®, bupropion is a medication that’s commonly prescribed to treat depression. Sold under the brand name Wellbutrin XL®, it’s also used to treat seasonal affective disorder (SAD) and, when sold as Zyban®, as a medication to help people quit smoking.

Although bupropion is less likely to cause certain side effects than other antidepressants, there are still numerous side effects that you should be aware of if you currently use bupropion or are considering this medication. 

Below, we’ve listed the side effects you may experience while using bupropion, with information on how frequently each side effect occurs, what you can do to manage it and your best options if any particular side effect persists. 

Common Bupropion (Wellbutrin, Zyban) Side Effects

Bupropion is an antidepressant. Its most common side effects are similar to those of many other medications prescribed to treat depression. As with other antidepressants, most side effects that are associated with bupropion occur in the first few weeks of treatment and go away over time.

Common side effects of bupropion include:

  • Agitation
  • Dry mouth
  • Insomnia
  • Headache or migraine
  • Nausea and vomiting
  • Constipation
  • Tremor
  • Dizziness
  • Excessive sweating
  • Blurred vision
  • Tachycardia
  • Confusion
  • Rash
  • Hostility
  • Cardiac arrhythmia (irregular heartbeat)
  • Weight loss
  • Auditory disturbance

Of these, the most common side effects reported in clinical trials of bupropion were constipation, dizziness, dry mouth, headaches/migraines, nausea/vomiting, excessive sweating, agitation and tremor, which were all reported by more than 20 percent of users.

Agitation

Agitation was the most common side effect reported in clinical trials of Wellbutrin, a medication containing bupropion prescribed to treat depression and seasonal affective disorder. According to data from the FDA, 31.9 percent of people reported agitation while using bupropion.

Other side effects associated with agitation include insomnia, which affected about 18 percent of bupropion users in clinical trials.

If you feel agitated after using bupropion and don’t notice this side effect improving in the first few weeks of treatment, talk to your healthcare provider. They may adjust your bupropion dosage or recommend other changes to manage this side effect.

Try to exercise regularly. Other techniques that may help include deep-breathing exercises and yoga. If you continue to feel agitated while using bupropion, you may also want to talk to your healthcare provider about using medication to help you relax or switching to a different antidepressant.

If you find it difficult to sleep after taking bupropion, avoid taking your medication close to your bedtime. Using bupropion earlier in the day will mean that a lower dose of the medication will be in your bloodstream at bedtime, which may make it easier for you to fall asleep. 

Dry Mouth

Bupropion and other antidepressants may cause xerostomia, or dry mouth. This side effect was reported by 27.6 percent of people who were prescribed bupropion in clinical trials, making it the second-most common side effect after agitation.

Dry mouth is a common side effect of many antidepressants, not only bupropion. It may be due to changes in your salivary glands caused by the medication. This side effect is generally more common with older antidepressants, such as tricyclic antidepressants (TCAs).

If you get dry mouth while using bupropion that doesn’t improve over the course of a few weeks, it’s best to talk to your healthcare provider. You can also try chewing sugarless or CPP-ACP gum to stimulate saliva production, which may help to loosen mucus and keep your mouth moist.

Headache/Migraine

Headaches and migraines are a fairly common side effect of bupropion, affecting 25.7 percent of people in clinical trials (versus 22.2 percent of people given a non-therapeutic placebo).

Like dry mouth, headaches are a common side effect of antidepressants. Interestingly, a 2012 study found that headaches were less common in bupropion users than in people prescribed SSRIs and other antidepressants.

As with other side effects of bupropion, your headaches may become less severe or go away completely as your body gets used to the medication. If you get persistent headaches, it’s best to talk to your healthcare provider.

Nausea/Vomiting

Nausea and vomiting are common side effects of bupropion, reported by 22.9 percent of people in clinical trials. 

As with many other side effects of bupropion, nausea and vomiting are common side effects of many antidepressants. Nausea caused by bupropion may get better or disappear completely over time as you become more used to the effects of the medication.

If you often feel nauseous after using bupropion, try to take your medication with food, eat small and frequent meals and make sure that you stay hydrated. You can also try an over-the-counter antacid such as Pepto-Bismol® to provide temporary relief.

If you have persistent nausea or vomiting that doesn’t get better over time or with treatment, it’s best to talk to your healthcare provider. 

Constipation

According to clinical trial data, 26 percent of people who use bupropion experience constipation as a side effect.

Like many other side effects of bupropion, constipation is a common side effect of medications used to treat depression. It’s particularly common with older antidepressants such as tricyclic antidepressants, as these medications can affect digestive function.

If you feel constipated after using bupropion, try increasing your intake of fibre-rich foods or use an over-the-counter fiber supplement. Other techniques that may help include drinking plenty of water and exercising regularly.

If you have severe, persistent or painful constipation after you start using bupropion, talk to your healthcare provider. They may recommend a non-prescription stool softener such as docusate sodium to ease your symptoms and make going to the toilet easier. 

Dizziness

Dizziness is a relatively common side effect of bupropion, reported by 22.3 percent of people in clinical trials. 

In addition to bupropion, several other antidepressants can cause dizziness. You may feel dizzy when you first start taking bupropion, or notice occasional dizziness when you stand up from a seated position or make other sudden movements.

To avoid dizziness, try avoiding caffeine, tobacco and alcohol while you use bupropion or other antidepressants. It can also help to avoid driving or operating machinery and practice standing up slowly when you need to get up. If necessary, you can use other items for support.

If you feel dizzy during the daytime, you can also talk to your healthcare provider about using bupropion at night, which may help to reduce the severity of this side effect.

Excessive Sweating

Another relatively common side effect of bupropion users, 22.3 percent of people in clinical trials experienced excessive sweating — a significantly larger percentage than those given a non-therapeutic placebo.

Sweating is a common side effect of antidepressants. It’s referred to as antidepressant-induced excessive sweating, or ADIES, and is estimated to affect between four and 22 percent of people who use antidepressants overall.

Excessive sweating from antidepressants usually affects the scalp, face, neck and chest areas, with symptoms often developing in bursts. 

If you notice yourself sweating excessively or uncomfortably after you start using bupropion, it’s best to talk to your healthcare provider. They may prescribe medication to treat the sweating or switch you to new antidepressant or different dosage of bupropion. 

Tremors

Tremors — involuntary muscle contractions that usually affect your hands, limbs, head, face or eyes — is a common side effect of bupropion, affecting 21.1 percent of people in clinical trials.

Like other bupropion side effects, tremor is a common side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants. It’s referred to as drug or medication-induced tremor (MIT) and can also occur with other medications.

If you get tremors after you start using bupropion, talk to your healthcare provider. Medication-induced tremors as usually treated by ending treatment with the medication that causes the tremors. They may also recommend adjusting your dosage or using a different type of antidepressant. 

Bupropion and Sexual Side Effects

Antidepressants are often associated with sexual side effects, such as decreased sexual desire, erection problems, reduced sexual excitement and difficulty ejaculating. 

These side effects are a particularly common occurrence in people who use selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). 

In a 2000 article, researchers found that 30 to 40 percent of patients prescribed antidepressants developed some degree of sexual dysfunction. Other research has found that between 25 and 73 percent of SSRI and SNRI users reported sexual side effects.

Interestingly, although some bupropion users report experiencing a decrease in sexual function, research tends to show that bupropion is less likely to cause sexual side effects than other antidepressants, and may even help to reverse antidepressant-related sexual issues.

In a 2008 review, researchers noted there’s robust evidence that bupropion tends to cause less sexual dysfunction than SSRIs. 

A separate study from 2004 also found that a sustained-release version of bupropion increased sexual desire and frequency of sexual activity in people with SSRI-induced sexual dysfunction.

In other words, bupropion may not cause the same sexual side effects as other antidepressants, or at least not cause them as often or severely. Still, if you notice any changes in your interest in sex or sexual performance after starting bupropion, it’s best to talk to your healthcare provider. 

Bupropion and Changes in Weight

Antidepressants are commonly associated with weight gain. This association is so strong that many people who are prescribed antidepressants stop using them either due to weight gain or concerns about weight gain during treatment.

Although there’s some evidence that you may gain weight after you start using antidepressants, the link isn’t as strong as many people think. 

According to a study published in JAMA Psychiatry, most people who use antidepressants only gain a small amount of weight over 12 months — for most medications, an increase of less than one percent of their original, pre-treatment body mass index (BMI).

Unlike other antidepressants, bupropion typically doesn’t cause weight gain. For example, in the study above, the researchers found that people who used bupropion experienced fluctuations of less than 0.25 percent of their original BMI over the course of 12 months of treatment.

Clinical trials of bupropion have also found that it typically doesn’t cause weight loss. In trials for Wellbutrin, a popular brand of bupropion, only 9.4 percent of people gained weight compared to 35 percent of people who received tricyclic antidepressants. Additionally, 28 percent of bupropion users actually lost more than five pounds.

Other studies have also found that bupropion causes mild weight loss when used over the long term.

In short, bupropion doesn’t appear to cause weight gain, at least not to the same extent as other common antidepressants. Most studies show the opposite — that bupropion either produces little change in weight or a small amount of weight loss. 

Serious Side Effects of Bupropion

Although uncommon, bupropion may cause a range of more serious side effects, including side effects that may require medical attention. We’ve listed these below and provided information on each potential side effect, as well as what you can do if you’re affected.

Suicidal Thoughts and Behaviors

Like other antidepressants, bupropion carries a “black box” warning from the FDA stating that it, as well as other medications in this category, may produce an increased risk of suicidal thoughts and behavior in children, adolescents and young adults.

Clinical trials of antidepressants do not show this risk in people over the age of twenty-four. Despite this, the FDA recommends monitoring for signs of suicidal thoughts or behavior in anyone prescribed an antidepressant. 

This warning is common to antidepressants and also appears on the packaging of most SSRIs, SNRIs and other medications prescribed to treat depression. A less severe warning is used on the packaging of Zyban, a form of bupropion prescribed for smoking cessation.

If you experience suicidal thoughts, worsened depression or other abnormal thoughts after you start using bupropion,contact your healthcare provider as soon as you can. Call 911 if you think you are having a medical emergency. 

Seizures

Bupropion may cause seizures. Use of bupropion is associated with seizures in approximately 0.4 percent of people at typical dosages of 450mg or less per day, making this a rare side effect. Seizures are significantly more common at dosages higher than 450mg per day.

The risk of seizures in people using bupropion is dose-related and is typically higher in people with conditions such as bulimia or anorexia, people who have quit using certain drugs or alcohol recently and people affected by seizure disorders.

Other conditions, such as metabolic disorders, head injury, prescription drug use or illegal drug use, may also increase your risk of seizures while using bupropion.

Hypertension (High Blood Pressure)

Bupropion may contribute to an increase in blood pressure and hypertension (overly high blood pressure). Your healthcare provider may ask that you monitor your blood pressure periodically while using bupropion to stay aware of any increases or changes.

If you currently have hypertension, or have a history of cardiovascular health issues, your healthcare provider may adjust your dosage of bupropion, recommend careful monitoring of your blood pressure or prescribe a different medication.

Activation of Mania/Hypomania

Treatment with antidepressants such as bupropion is associated with an increased risk of manic and hypomanic episodes, particularly in people who have risk factors for bipolar disorder or who have been diagnosed with bipolar disorder. 

Bupropion is currently not approved by the FDA for treating bipolar depression. If you have bipolar disorder or display risk factors for bipolar disorder, your healthcare provider may recommend using another type of medication to treat your symptoms. 

Psychosis and Other Neuropsychiatric Symptoms

There have been several reported cases of psychosis and other neuropsychiatric symptoms in patients treated with bupropion for depression. Several of these involved people who had previously used illicit drugs, while others involved patients diagnosed with bipolar disorder.

If you or a loved one experience any delusions, hallucinations, psychosis, paranoia, confusion or concentration disturbance while using bupropion, contact your healthcare provider.

Hypersensitivity Reactions

Although rare, bupropion may cause anaphylactoid/anaphylactic reactions. If you develop any symptoms of an allergic reaction, such as hives, skin rash, shortness of breath, edema, pruritus (itchy skin) or chest pain, contact your healthcare provider.

Bupropion Withdrawal

As with other antidepressants, bupropion may cause withdrawal symptoms if you abruptly stop taking it as prescribed. This is known as antidepressant discontinuation syndrome, and is a common issue for people who suddenly end their usage of antidepressants.

Bupropion may be less likely to cause severe withdrawal symptoms than other antidepressants, such as SSRIs and SNRIs. However, if you’re prescribed bupropion and want to stop taking it, it’s still important to talk to your healthcare provider first.

To reduce your risk of experiencing withdrawal symptoms, your healthcare provider may recommend tapering your dosage gradually over time. We’ve explained this in more detail in our guide to bupropion withdrawal. 

Learn More About Bupropion

Bupropion can help to treat depression and make it easier for you to deal with nicotine cravings while quitting smoking. Our full guide to bupropion goes into more detail on how this medication works, common dosages, frequently asked questions and more. 

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.