Wellbutrin & Pregnancy: Is it Safe?

What Is Wellbutrin (Bupropion) & How Does it Work?

Wellbutrin, with the active ingredient bupropion, is an antidepressant medication belonging to the aminoketone class. It is primarily prescribed for the treatment of depression, including major depressive disorder (MDD), and is also used to manage seasonal affective disorder (SAD).

Wellbutrin affects neurotransmitters in the brain, particularly norepinephrine and dopamine, which play a role in regulating mood. By increasing the availability of these neurotransmitters, Wellbutrin helps alleviate depressive symptoms and improve overall mood in individuals with depression and SAD.²

It’s important to note that Wellbutrin is no longer available, but it is available as Wellbutrin SR (sustained-release) and Wellbutrin XL (extended-release). A generic form of bupropion is also available as an immediate-release, SR and XL version. The mention of Wellbutrin in this article is referencing all of the generic and brand names of bupropion (Wellbutrin SR, Wellbutrin XL) that are still available.

Side Effects of Wellbutrin

Common side effects of Wellbutrin (bupropion hydrochloride) can occur due to the medication’s impact on neurotransmitters in the brain. These side effects are often manageable and may not require immediate medical attention.

Common Wellbutrin side effects include:²

• Dry mouth
• Insomnia
• Headache
• Nausea
• Weight loss
• Dizziness
• Sweating
• Increased heart rate
• Constipation
• Tremors
• Agitation
• Anxiety

Severe side effects of Wellbutrin that require immediate medical attention include:²

• Severe allergic reactions (difficulty breathing, rash, itching, swelling of the face, lips, tongue, or throat)
• Suicidal thoughts or behavior
• Seizures
• High blood pressure (severe headache, blurred vision, chest pain, shortness of breath, irregular heartbeat)
• Hallucinations or delusions
• Severe skin reactions (fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads and causes blistering and peeling)
• Severe restlessness or agitation
• Uncontrolled movements or shaking

When treating depression symptoms with medications like Wellbutrin, some side effects may have a higher prevalence or be more noticeable. This may be due to the individual’s underlying depression symptoms, such as anxiety, agitation, and insomnia, which are also known side effects of Wellbutrin. Patients with depression may be more attuned to changes in their emotional state, making these side effects more prominent. Individuals and healthcare providers need to be watchful of these symptoms during treatment.

*All medications, including Wellbutrin, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Is Wellbutrin Safe During Pregnancy?

Using Wellbutrin to treat depression during pregnancy involves careful consideration. While there is no conclusive evidence suggesting that it makes it harder to get pregnant or increases the risk of birth defects, some studies have hinted at a possible weak link between first-trimester use and heart defects.

Overall, the risk appears to be low. It is essential to consult with your healthcare provider before making any medication changes during pregnancy, as untreated perinatal depression can also impact pregnancy. Always prioritize professional guidance for the safest approach.¹

Can Wellbutrin Cause Birth Defects?

Based on available studies, Wellbutrin use during pregnancy is unlikely to significantly increase the chance of birth defects. While one study suggested a weak link between first-trimester use and certain heart defects, other research involving a larger sample size found no such association. However, consulting with your healthcare provider for individualized guidance is essential.¹

Can Wellbutrin Cause Withdrawal Symptoms in Your Baby?

The potential for withdrawal symptoms in newborns exposed to Wellbutrin late in pregnancy has not been thoroughly studied. Antidepressants, including Wellbutrin, can cause temporary symptoms in newborns shortly after birth, but specific data regarding Wellbutrin withdrawal in infants is limited. Babies exposed to any antidepressant during pregnancy should be monitored for signs of withdrawal after delivery. Consult your healthcare provider for personalized advice.

Can Taking Wellbutrin Cause Preterm Birth or Low Birth Weight?

Studies have not conclusively established a link between Wellbutrin use during pregnancy and an increased risk of preterm birth or low birth weight. In a small study involving pregnant individuals who used Wellbutrin to quit smoking, no significant differences in birth weight, length, head circumference, or Apgar score were observed.³ However, the risk of preterm birth and low birth weight should be discussed with your healthcare provider in your specific case.

What Wellbutrin Dosage Is Safe During Pregnancy?

The safety of Wellbutrin dosage during pregnancy can vary from person to person. When considering the use of Wellbutrin during pregnancy, healthcare providers aim to balance the potential benefits of treating depression or other conditions with the risks involved. Your healthcare provider may suggest adjusting the dosage or slowly tapering off the medication if necessary.

What If You Are Already Taking Wellbutrin When You Become Pregnant?

If you are already taking Wellbutrin and discover that you are pregnant, discuss your situation with your healthcare provider promptly. Your healthcare provider will work with you to assess your individual needs and may recommend adjusting your medication regimen by gradually reducing the dosage. The goal is to find the safest and most effective approach for managing your condition during pregnancy while minimizing potential risks to you and your baby.

Should You Stop Taking Wellbutrin If You Think You Might Be Pregnant?

If you suspect you might be pregnant while taking Wellbutrin, do not make any medication changes without consulting your healthcare provider. Stopping Wellbutrin suddenly can lead to antidepressant discontinuation symptoms or a relapse of your underlying condition.

Instead, contact your healthcare provider as soon as possible to discuss your situation. They will provide personalized guidance and may consider adjustments to your treatment plan to ensure the well-being of both you and your potential pregnancy.

Can You Breastfeed While on Wellbutrin?

Bupropion, which is an active ingredient in Wellbutrin, can pass into breast milk in small amounts. While it is generally not expected to cause any negative effects in most breastfed infants, there have been isolated case reports that raise concerns. Specifically, there have been two cases where 6-month-old babies who were exposed to bupropion through breast milk experienced seizures. These seizures stopped once the breastfeeding individual discontinued using bupropion.¹

It’s important to talk with your healthcare professional to decide if it is safe to take Wellbutrin while breastfeeding. If Wellbutrin is taken while breastfeeding, it’s essential for parents to closely monitor their infants for any side effects, such as increased sleepiness or feeding difficulties, and to consult with their healthcare provider for personalized advice. Additionally, it’s worth noting that bupropion may reduce the amount of milk produced by some individuals. If you notice a decrease in milk supply or any adverse symptoms in your baby, you should inform your healthcare provider immediately.

Wellbutrin Alternatives During Pregnancy

When considering Wellbutrin alternatives during pregnancy, other antidepressants may be suitable depression treatments due to their well-documented safety profiles in pregnancy. In addition to prescription medications, non-pharmacological strategies may be helpful.

Wellbutrin alternatives during pregnancy may include:⁴

Other Antidepressants

For those looking for alternatives to Wellbutrin during pregnancy, selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are commonly considered options. SSRIs, like sertraline (Zoloft) and escitalopram (Lexapro), and SNRIs, such as duloxetine (Cymbalta) and venlafaxine (Effexor), are preferred for their well-documented safety profiles in pregnancy.

They are believed to carry a relatively low risk to the developing fetus, with extensive data supporting their reproductive safety. The choice among these alternatives is typically based on the patient’s history of medication response, potential side effects, and the specific safety data available. For example, sertraline is often discussed as a reasonable choice for many women due to its effectiveness in treating depression and anxiety.

A healthcare professional can help to determine what antidepressant is the safest choice.

Non-prescription Alternatives to Wellbutrin

Beyond prescription medications, there are non-medication strategies that may be beneficial for managing depression during pregnancy. Cognitive behavioral therapy (CBT) is a well-regarded approach that can help individuals manage depression by changing negative thought patterns and behaviors.

Mindfulness and meditation are also valuable for reducing stress and improving mood, offering a safe complement to medical treatments during pregnancy. Additionally, certain supplements, such as omega-3 fatty acids, have been suggested to have a positive impact on mood, though consult a healthcare provider before starting any supplement, especially during pregnancy, is recommended.

Lifestyle Habits that Help Manage Depression Symptoms

Adopting healthy lifestyle habits can play a significant role in managing depression symptoms. Poor sleep often worsens depressive symptoms, so getting adequate sleep is essential for supporting mental health. Regular physical activity is also recommended, as exercise can potentially reduce symptoms of depression by releasing endorphins and improving overall well-being.

Other helpful habits include maintaining a balanced diet, staying connected with a supportive social network, and engaging in activities that promote relaxation and stress reduction. These lifestyle changes can complement medical treatments and non-prescription alternatives to support mental health during pregnancy.

Questions to Ask Your Healthcare Provider About Wellbutrin & Pregnancy

When considering the use of Wellbutrin during pregnancy, speak to your doctor, psychiatrist, or therapist about your options. This conversation is particularly important for those who are already managing depression or other mental health conditions and are either pregnant or planning to become pregnant.

The primary goal is to weigh the benefits of managing mental health symptoms against the potential risks to the fetus. Online psychiatry services can be a valuable resource for those who may need to consult with or change their prescriber, especially when access to in-person care is limited or if seeking a second opinion is desired.

Questions to ask your care team when considering using Wellbutrin while pregnant may include:

• Do my symptoms warrant antidepressant medication?
• I’m already on Wellbutrin; should I switch to another antidepressant?
• Which medication do you suggest, and how did you reach that conclusion?
• What doses are considered safe?
• Should I take this medication throughout my pregnancy or only for parts?
• Does this medication affect the baby? How?
• What happens if I decide to stop taking this medication?
• Can I continue this medication if I choose to breastfeed?
• Will this medication help with postpartum depression?
• How long do I need to take this medication, and will I need to taper off it gradually?
• Are there any interactions between this medication and other medications or supplements that I am taking?