Side Effects of Bupropion

Bupropion (Wellbutrin) is an antidepressant medication that belongs to the aminoketone class of drugs. Bupropion is available as an immediate-release, sustained-release, or extended-release tablet that is taken orally. 

Bupropion is approved by the U.S. Food and Drug Administration (FDA) to treat conditions such as major depressive disorder (MDD) and seasonal affective disorder (SAD). It’s also used off-label for the treatment of conditions such as ADHD, bipolar disorder, anxiety, and obesity. Additionally, Zyban, which is another brand of bupropion, is utilized to help people quit smoking. 

What sets bupropion apart from all other antidepressants is that it does not affect an individual’s libido and sexual functions. In fact, it’s often prescribed along with other antidepressants to help counteract the sexual side effects associated with its use.

Bupropion is considered a safe and effective medication when used as prescribed. And to date, there are no known complications associated with the long-term use of bupropion. However, similar to any other medication, bupropion can cause side effects in certain people. If you experience any of these side effects, seek medical attention.

The Most Common Bupropion Side Effects

Bupropion can cause side effects during a certain period of its use as the body grows accustomed to the medication’s chemical effects. These side effects generally dissipate within a few weeks. The most common side effects of bupropion include:

• Anxiety
• Dry mouth
• Hyperventilation
• Irregular heartbeats
• Irritability
• Restlessness
• Trouble sleeping
• Headache
• Weight loss
• Nausea
• Dizziness
• Constipation

If these side effects persist or worsen, seek advice from your doctor.

Less Common Bupropion Side Effects

While side effects range from mild to severe, there are some side effects that are less common than others. Less than 10% of patients will experience bupropion side effects such as:

• Skin rash
• Profuse sweating
• Ringing in the ears
• Shakiness or twitching
• Stomach pain
• Muscle pain
• Thought disturbances
• Angle-closure glaucoma
• Migraines
• Fever
• Trouble swallowing
• Urinary tract infections
• Myalgia
• Hot flashes

The risk of seizures due to bupropion is relatively low. However, this risk is significantly increased if the patient consumes large doses of bupropion or has any of the following conditions.

• History of seizures 
• Head injury or brain tumor 
• Severe liver disease
• Eating disorder
• Alcohol or drug dependence

Although bupropion possesses a low risk of cardiovascular complications, the risk is  increased if the patient has: 

• Heart disease 
• High blood pressure 
• Previous heart attack 
• Irregular heartbeat
• When used in conjunction with transdermal nicotine replacement products

Severe Bupropion Side Effects

Bupropion can cause severe side effects that have the potential to be life-threatening. If you experience any of the following side effects, seek medical attention immediately.

The more severe side effects of bupropion include:

• Allergic Reaction

• Aggressiveness
• Agitation
• Changes in the menstrual cycle
• Changes in sexual desire or function
• Changes in vision
• Chest pain
• Confusion
• Dark urine
• Delusions or hallucinations
• Difficulty breathing
• Exaggerated feelings of well-being
• Fainting
• Fever, chills, or a sore throat
• Hearing problems
• Hostility
• Impulsiveness
• Inability to sit still
• Pale-colored stools
• Panic attacks
• Rapid or irregular heartbeat
• Seizures
• Severe headache
• Severe or lingering joint or muscle pain
• Severe or lingering nausea, vomiting, or stomach pain
• Severe or lingering nervousness, restlessness, or insomnia
• Swollen, blistered, or peeling skin
• Trouble concentrating
• Unusual swelling
• Worsening depression and/or suicidal thoughts
• Yellow skin or eyes

Bupropion includes a black box warning, which is the highest level of warning by the FDA. According to the U.S. Food and Drug Administration (FDA), bupropion may cause changes in behavior in certain people. These behavioral changes include: 

• Hostility
• Agitation
• Depressed moods 
• Suicidal thoughts 

The risk of suicidal thoughts and behavior is higher for children, adolescents, and young adults who consume this medication.

Allergic Reactions to Bupropion

Bupropion can cause a severe allergic reaction known as anaphylaxis in certain individuals. Anaphylaxis requires immediate medical attention as it can be life-threatening. Symptoms of bupropion allergic reaction include:

• Rashes
• Swelling of the lips or tongue
• Itchiness
• Hives
• Fever
• Swollen lymph glands
• Painful sores in the mouth or around the eyes
• Trouble breathing

Drug Interactions that Increase the Risk of Side Effects

Taking bupropion with certain medications can increase the risk of certain side effects associated with this medication. These medications include:

• Antidepressants (venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, or sertraline) – Increases the risk of seizures 
• Antipsychotics (haloperidol, risperidone, or thioridazine) – Increases the risk of seizures. 
• Beta-blockers (metoprolol) – Increases the risk of low blood pressure.
• Anti-arrhythmics (propafenone or flecainide)  – Increases the risk of fainting and irregular heartbeat.
• Theophylline – increases the risk of seizures.
• Corticosteroids (prednisone or methylprednisolone) – Increases the risk of seizures. 
• Levodopa and amantadine – Increased risk of restlessness, agitation, shakiness, loss of body movements, dizziness, loss of coordination, and trouble walking.
• Blood thinners (ticlopidine or clopidogrel) –  Increases the effects of bupropion to dangerous levels.

Bupropion is considered by medical experts as a safe and effective antidepressant with a favorable side effect profile. While the possibility of side effects is present, its risks are no greater than any other medication. Being aware of the possible side effects can help individuals seek medical attention when necessary or help individuals decide if the medication is right for them.

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