Wellbutrin Side Effects (bupropion), Let’s Have Some Clarity !

Last Updated on September 19, 2026 by Chris Weatherall

Alternative to Meds Editorial Team
Medically Reviewed by ATMC Clinical Review Team

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Wellbutrin Side Effects Summary

Some Wellbutrin side effects may be so mild as to almost go unnoticed, or be slightly annoying. However, some may persist longer than others, and some may be so intense as to require swift medical attention and so one should be aware of these too. The most common side effects are listed on the drug’s insert and on the FDA-approved label and a number of public safety warnings.^1-4

Please note that bupropion is marketed under the trade names Wellbutrin, and Zyban.

Common and relatively mild side effects can include:

• Elevated heart rate, arrhythmias, palpitations
• State of confusion
• Muscle tremors
• Mood changes including anger, hostility, agitation
• Depression
• Trouble sleeping
• Vision, auditory, and/or other sensory disturbances
• Nausea with or without vomiting
• Hydrosis (excessive sweat production)
• Dryness of the mouth
• Unusual rashes
• Headaches or migraines
• Difficulty passing stools, constipation
• Myalgias, arthralgia (aches in muscles, stiffness or aches in joints)
• urticaria, pruritus (itchiness in skin)
• Dyspnea (shortness of breath)
• Angioedema (swelling under the skin)
• Erythema glaucoma (target- or bulls-eye-shaped rash or raised welt in a non-mucous membrane area of the body)

Other side effects which are more severe and may require immediate medical attention include:

• Seizures
• Suicidality, ideation, attempted or completed suicide
• Homicidal ideation, aggression
• Anaphylactic shock (life-threatening allergic reactions, chest pain, swelling, shortness of breath, hives, rashes)
• Steven’s-Johnson syndrome (life threatening fever with rashes, skin eruptions, unconsciousness, coma)
• Mania
• Akathisia
• Psychosis
• Hallucinations
• Delusions
• Paranoia
• Unusual changes in behavior
• Worsened depression state
• Anxiety and panic
• Hypertension, high blood pressure
• Closed-angle glaucoma

These may not be all the side effects that may emerge. The drug’s label indicates that where severe side effects emerge, the person is advised to seek immediate medical attention. For the advent of seizures, the physician is advised to reduce the dosage. For other severe side effects such as those in the list just above, the physician is advised to discontinue the drug. Always seek professional medical care for serious Wellbutrin side effects.

You are encouraged to report the Wellbutrin, Zyban, or bupropion side effects you may experience by contacting the FAERS portal online, or by calling the FDA at 1-800-FDA 1088.

You can also make a FOIA request from the FDA to find out about the above and other side effects, that may not be listed above.⁵

What is Wellbutrin Approved to Treat?

Drug licensing can be complicated. Wellbutrin is approved to treat MDD, or major depressive disorder, but not approved to treat depression in bipolar patients. It is not approved for quitting smoking. Its sister drug “Zyban” is bupropion that has been approved for smoking cessation, but not for treating depression. Wellbutrin comes in immediate release and slow-release versions. (Wellbutrin XR, extended release, and Wellbutrin SR, or sustained release)

Generic bupropion is approved for quitting smoking, and seasonal affective disorder, but is not approved for treating MDD. Nonetheless, it is possible any of these versions could be prescribed for MDD, seasonal affective disorder, or smoking cessation. The FDA label has been modified to include various uses, noting that the side effects for either version of the drug could, of course, be identical.

Off-label uses also occur when a prescriber chooses Wellbutrin or generic bupropion, or a drug combination such as naltrexone-bupropion (XR) to treat obesity. Other conditions that are not FDA-approved include OCD, ADHD, antidepressant-induced sexual dysfunction, and even though the label expressly states it is not approved for treating depressive episodes of bipolar disorder, this sometimes has occurred off-label. The American Society of Addiction Medicine has recommended prescribing bupropion to assist with quitting cocaine or other stimulant drugs.

There are likely other off label uses that are not well documented.

Anyone taking any prescription drug deserves to be closely monitored for adverse effects so they can be handled before they become disabling.^2-4

How is Wellbutrin/bupropion Classified?

Bupropion marketed as Wellbutrin or Zyban is a unique antidepressant. It is classed as an atypical antidepressant and though its mechanisms are not completely understood, animal studies suggest it inhibits the normal reuptake of 2 neurotransmitters, norepinephrine and dopamine. Just as an SSRI (selective serotonin reuptake inhibitor) is thought to inhibit the reuptake of the neurotransmitter serotonin, Wellbutrin inhibits the reuptake of both norepinephrine (a precursor to adrenaline) and dopamine, another excitatory neurotransmitter. The higher the dose the more norepinephrine and dopamine are potentially made available.

Wellbutrin does not act on serotonin transmission like an SSRI does. Wellbutrin differs from SSRIs in that it does not cause weight gain, does not cause sedation, and does not cause sexual side effects associated with SSRI medications.

Bupropion’s unique neurochemical mechanisms of action also are thought to be what give it its unique side effect profile.⁶

Drug Interactions to Know About

If certain other drugs are taken concurrently with bupropion side effects may arise from the chemical interaction that occurs. Some drug interactions reduce the effectiveness of a drug, while other combinations may increase a drug’s effects. Below is a list compiled from the drug’s label and other sources where noted of drug combinations that should be avoided for safety reasons.^1,4

Drug interactions with safety concerns include:

• Wellbutrin/bupropion taken with other dopaminergic drugs (opioids, levodopa, amantadine) can lead to CNS toxicity
• MAOIs & Wellbutrin should not be taken together. A 14 day washout period is required to switch from MAOIs to bupropion, or from bupropion to an MAOI.
• Intravenous methylene blue and bupropion should not be taken concurrently
• Zyvox (an antibacterial drug) should not be taken at the same time as Wellbutrin, Zyban, or bupropion
• Bupropion products should not be taken concurrently with any other class of antidepressants, anticonvulsants, or antipsychotics as concentrations of the active ingredients can occur (venlafaxine, sertraline, paroxetine, antipsychotics, beta blockers, and others)
• Bupropion drugs should not be taken concurrently with cessation of alcohol, benzodiazepines, barbiturates, or cessation of antiepileptic drugs.
• Avoid taking bupropion at the same time as other CNS stimulants.
• FDA advises alcohol should be avoided while taking bupropion products.

These may not be all the drug interactions relating to Wellbutrin and bupropion products. Polypharmacy is becoming more common which means one must take care to always let your prescriber know all the drugs you are or have been recently taking to avoid drug interaction safety issues.

Paradoxical Bupropion Side Effects

Although bupropion has a structure similar to amphetamines, and acts more like a stimulant than a sedative, clinical reports of a side effect called somnambulism have been reported. Somnambulism is sleep-walking, with amnesia. The episodes are not remembered upon waking.^7-9
Impaired decision making and reduced awareness of one’s environment are associated with somnambulism, as are daytime fatigue and problem-solving skills. These are side effects that may be overlooked due to the associated decrease in awareness, but should be known for anyone taking bupropion or for their loved one’s safety.

How to Avoid Side Effects and Still Get Symptom Relief?

Holistic, drug-free methods can be extremely effective for treating the symptoms that a drug like bupropion is prescribed for. ATMC specializes in implementing strategies and protocols that are specifically designed to address unwanted symptoms without the liability of adverse reactions to drugs, like the Wellbutrin side-effects listed above.

The origin of symptoms can seem quite mysterious, can come on gradually or suddenly, and can be perplexing to understand why they present. So, prior to starting a prescription to a drug like Wellbutrin, lab testing can be used to help isolate causative factors and their primary and secondary effects that may have been overlooked completely.

A body’s burden of toxicity can lead to unwanted symptoms including depression, anxiety, insomnia and many others.¹⁰ The best approach is to remove the neurotoxic load from the body, allowing the CNS to function as it was intended. In the modern world, we are living in a soup of chemicals that we are exposed to on a near daily basis, in the air, in our water supply, in our work environments, and even in our commercial food industry.

Orthomolecular medicine approaches nutrition in therapeutic ways, that include choosing clean, organic food that is unprocessed as much as possible. Daily consumptions of probiotics such as sauerkraut, kimchi, pickled foods, yogurt can support a healthy gut microbiome. This is vital, as it is the gut microbiome that produces and distributes the bulk of neurochemicals throughout the body.¹¹

Nutritional deficiencies are another area that can be overlooked entirely, but can be easily determined through lab testing. These problems can be transformative once corrected. This is another benefit of orthomolecular approaches to both mental and physical health concerns.

Safe Drug Tapering is Possible Without Harsh Side Effects, and Without Returning Symptoms

Alternative to Meds Center uses a safe, proven set of protocols to enable safe tapering for the relief of untenable Wellbutrin side effects. And just as importantly, there is really no point in coming off a drug if the original symptoms are just going to return. So we do the investigative work to isolate the factors that are contributing to unwanted symptoms. And, using our vast array of treatment methods, make sure these are no longer present, and no longer problematic.

Our clients’ success shows how effective our approach is for regaining natural mental health without suffering the liabilities and side effects of harsh or intrusive drugs. Please feel free to contact us directly for more information and find out how we could be the missing link in your recovery or that of your loved one. We can also refer you to other resources if coming to an inpatient facility is not possible for you at this time. In any case, call today. We are here to help.

for Holistic Help with Wellbutrin (bupropion) Side Effects

Sources:

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1. FDA Drug Label Wellbutrin (bupropion hydrochloride) tablets for oral use, approval 1985 [cited 2025 July 16]

2. Huecker MR, Smiley A, Saadabadi A. Bupropion. [Updated 2024 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470212/ [cited July 18 2025]

3. FDA Public Health Advisory – The FDA Requires New Box Warnings … bupropion published 2009, archived with no changes to the present. [cited July 18 2025]

4. Popli AP, Tanquary J, Lamparella V, Masand PS. Bupropion and anticonvulsant drug interactions. Ann Clin Psychiatry. 1995 Jun;7(2):99-101. doi: 10.3109/10401239509149035. PMID: 8556101.[cited 2025 July 18]

5. FAERS Adverse Event Reporting System Database published online c.2017 [cited 2025 July 16]

6. Stahl SM, Pradko JF, Haight BR, Modell JG, Rockett CB, Learned-Coughlin S. A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. Prim Care Companion J Clin Psychiatry. 2004;6(4):159-166. doi: 10.4088/pcc.v06n0403. PMID: 15361919; PMCID: PMC514842. [cited 2025 July 16]

7. Khazaal Y, Krenz S, Zullino DF. Bupropion-induced somnambulism. Addict Biol. 2003 Sep;8(3):359-62. doi: 10.1080/13556210310001602284. PMID: 13129839. [cited 2025 July 18]

8. Zhu Y, Kolawole T, Jimenez XF. Atypical Findings in Massive Bupropion Overdose: A Case Report and Discussion of Psychopharmacologic Issues. J Psychiatr Pract. 2016 Sep;22(5):405-9. doi: 10.1097/PRA.0000000000000179. PMID: 27648505. [cited 2025 July 18]

9. Zergham AS, Chauhan Z. Somnambulism. [Updated 2023 Jan 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559001/ [cited 2025 July 18]

10. Genuis SJ. Toxic causes of mental illness are overlooked. Neurotoxicology. 2008 Nov;29(6):1147-9. doi: 10.1016/j.neuro.2008.06.005. Epub 2008 Jun 24. PMID: 18621076. [cited 2025 July 18]

11. Xiong RG, Li J, Cheng J, Zhou DD, Wu SX, Huang SY, Saimaiti A, Yang ZJ, Gan RY, Li HB. The Role of Gut Microbiota in Anxiety, Depression, and Other Mental Disorders as Well as the Protective Effects of Dietary Components. Nutrients. 2023 Jul 23;15(14):3258. doi: 10.3390/nu15143258. PMID: 37513676; PMCID: PMC10384867. [cited 2025 July 18]

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Originally Published July __, 2025 by Diane Ridaeus