Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.
Bupropion, sometimes referred to by its full chemical name bupropion hydrochloride or bupropion HCL for short, is a prescription antidepressant that’s one of the most commonly-prescribed drugs in the US.
Unlike most medications for depression, it's not a selective serotonin reuptake inhibitor (SSRI).
But is bupropion really proven to reduce or eliminate depression in clinical trials? Is it as effective as SSRI drugs? Does it cause side effects? And how do real patients rate and describe the effects of bupropion?
In this article we'll answer all of these questions and more, as we review clinical studies on bupropion to determine if it's effective and safe for treating depression.
We'll also explain whether the drug causes weight loss, investigate whether it reduces symptoms of anxiety and feature real patient reviews and ratings.
Key takeaways:
- Proven in research studies to decrease depressive symptoms
- May cause severe side effects in over 10% of patients
- Clinically shown to cause weight loss in overweight patients
Does Bupropion Eliminate Depression?
The brand-name version of bupropion is called Wellbutrin, and as we noted in our Wellbutrin reviews article, there have been hundreds of clinical studies investigating the efficacy this drug for treating depression.
A 2016 meta-study analyzed clinical trials on bupropion as an antidepressant.
The study authors found that the drug reduced depression scores in 24 of 27 trials.
Another medical review, published in the Primary Care Companion journal, found similarly positive results.
Bupropion was shown to cause a "full" or "partial" response in 65% of depressed patients, which means this percentage of patients experienced some symptom reduction or total elimination of their depression.
A 2012 clinical trial evaluated whether bupropion is an effective adjunctive treatment (a drug used concurrently with another drug) for patients with depression who aren’t responding well to SSRIs.
The researchers found that when bupropion was used as an add-on therapy in this manner, it reduced depression scores by more than the group taking SSRI alone.
60% of patients using bupropion and SSRI experienced a significant reduction in their depression symptoms, while only 24% of patients on SSRIs alone did.
Based on the available research, we will conclude that bupropion is effective for treating depression, which is unsurprising given that the drug is approved by the FDA for this indication.
Does Bupropion Cause Side Effects?
Bupropion does cause side effects in some patients, as do most prescription antidepressants.
A medical review documents that “many side effects occur” in over 10% of patients on the drug. Some of the most common side effects are reported to be tachycardia (rapid heart beat), headache, insomnia and constipation.
The more rare, but more concerning side effect in our opinion, is the risk of suicidal thoughts and actions.
Bupropion’s FDA label contains a “black box” warning indicating this side effect, which is the most severe category of warning issued by the FDA.
According to the drug's label, bupropion may increase the risk of suicidal behavior in children, adolescents and young adults.
The risk does not appear to affect patients over the age of 24.
This information suggests that young adults or parents caring for a child may want to speak with their doctor or pediatrician about an alternative medication for depression.
Not all antidepressants increase the risk of suicidality, and it seems logical to consider alternatives for this at-risk group.
Real People Try Bupropion
A YouTube creator named "MentallyHellthy" has a bupropion review with over 100,000 views.
The video has "Wellbutrin" in the title but that's the same active drug ingredient (just the brand-name version):
A YouTube creator and registered pharmacist with a channel called "Drug Talk" shared his experience after using bupropion for two months:
Does Bupropion Cause Weight Loss?
Patients are often curious about whether bupropion causes weight loss, and the drug actually has been studied to that effect, though it's only FDA-approved for adult depression, seasonal affective disorder, and smoking cessation.
A 2002 clinical trial found that the standard release (SR) form of bupropion caused weight loss in obese patients.
Trial participants using bupropion lost 4.6% of their baseline weight over 12 weeks. This is a significant amount of weight loss, and equates to weight loss of 11.5 pounds for someone who started the trial at 250 pounds.
A recent medical review on bupropion for weight loss analyzed data from three clinical trials on the topic, and documented that the medication caused weight loss in all three trials.
The researchers noted that although bupropion isn’t currently approved by the FDA for weight loss, “There might be a role for this drug as a second-line consideration for obesity.”
Bupropion is actually one of two active ingredients in a prescription medication that’s FDA-approved for weight loss called Contrave.
It appears based on early research that bupropion does cause weight loss in overweight and obese patients, though using it for weight loss alone would be an "off-label" use not currently approved by the FDA.
We consider weight loss to be a potential secondary benefit of the medication for overweight and obese patients who are prescribed bupropion for depression.
Does Bupropion Cause Sexual Side Effects?
Many prescription antidepressants cause sexual side effects, particularly in men, so patients are often curious about whether bupropion has this risk.
An extensive meta-study published in the Cureus journal examined the side effect profile of bupropion and has some interesting findings on sexual side effects.
Not only was bupropion found to be more favorable than SSRIs in regard to sexual side effects, the drug may actually improve sexual function.
The researchers noted that some medical research found bupropion to increase sexual desire and sexual frequency compared to placebo.
However, in a separate clinical trial, 6% more patients on bupropion than placebo experienced sexual dysfunction.
It's inconclusive to us whether or not bupropion causes sexual side effects based on the current state of the research.
Many prescription antidepressants conclusively cause sexual side effects, so bupropion appears to be superior in this regard.
Is The Brand-Name Version Better?
As we've mentioned previously, the brand name version of bupropion is called Wellbutrin.
Patients are often curious about whether one or the other is more effective.
We would recommend that patients speak with their doctor about bupropion rather than Wellbutrin.
An extensive medical review published in 2019 compared the effectiveness of branded and generic versions of drugs, and found them to be equally effective on average.
This suggests that bupropion should be equally effective to Wellbutrin, but may be cheaper.
The retail price of brand-name Wellbutrin is currently around $100, according to Drugs.com.
The retail price of generic bupropion is currently $6.80 at Cost Plus Drugs.
Does Bupropion Cause Withdrawals?
While there are some case reports in the medical literature (example 1, example 2) of bupropion causing withdrawal symptoms, we cannot locate a comprehensive study proving this drug causes withdrawal symptoms in the average patient.
A case report documents one single patient’s response to a drug, and while it can be valuable in spurring further research, it doesn’t necessarily prove that a drug causes withdrawal symptoms.
Bupropion is prescribed millions of times annually and anyone can have an allergic or otherwise unique reaction to a drug (or a supplement or a food product).
Bupropion’s FDA label does not mention withdrawal symptoms other than in regard to concurrent nicotine use. Patients who smoke should speak to their doctor about this risk prior to using bupropion.
Bupropion doesn’t appear to cause withdrawal symptoms in patients who don’t smoke.
Can Bupropion Treat Anxiety?
Bupropion has been studied in clinical trials for its efficacy in treating anxiety disorders.
A medical review compared data on bupropion and SSRI drugs for treating anxiety.
Bupropion was 6% less effective than SSRI drugs for treating anxiety, suggesting that bupropion may be effective for reducing anxiety symptoms, but is not as effective as SSRI drugs.
Bupropion is not currently FDA-approved to treat anxiety alone, but since the drug is clinically shown to reduce anxiety levels, it may be an option for patients with both anxiety and depression.
Does Bupropion Interact With Alcohol?
Bupropion may negatively interact with alcohol if the alcohol is consumed at high doses.
Bupropion’s FDA label mentions that patients who consume high amounts of alcohol should speak with their doctor prior to taking the medication, and that patients consuming high amounts of alcohol who abruptly stop while using bupropion may be at higher risk for severe side effects such as seizures.
The amount of drinks categorized as “high” is not described on the label.
It seems as though bupropion has no interactions with alcohol consumed in moderate amounts, but we would strongly suggest that patients who regularly consume alcohol speak with their doctor about what constitutes a “high” amount in the context of this potential interaction.
It may be logical for patients who regularly drink alcohol to choose an alternative antidepressant medication that does not have any interaction with alcohol to be safe.
Can Bupropion Treat ADHD?
Attention deficit hyperactivity disorder (ADHD) has been theorized to be related to dopamine dysfunction, so patients are often curious about whether bupropion can treat this condition, given that it modulates dopamine levels.
A 2017 medical review examined whether bupropion was an effective treatment for ADHD. The researchers analyzed a data set from six clinical trials, totalling 438 patients.
While bupropion was found to reduce symptoms of ADHD, the study authors described the evidence as “low-quality” due to methodological issues in some of the studies.
Use of bupropion to treat ADHD is not currently FDA-approved, and would therefore be an "off-label" use.
There are existing ADHD medications with much more research backing for treating the condition than bupropion, which patients can speak with their doctor about.
Is Bupropion an SSRI?
Patients are often curious about whether or not bupropion is an SSRI, because this class of drugs is typically prescribed for depression.
Bupropion is a not an SSRI, but rather is a member of a drug class called norepinephrine-dopamine reuptake inhibitors (NDRI).
When this type of drug is taken, the body’s natural processing and clearance of these important neurotransmitters is delayed, which causes artificially increased levels of them in the brain.
Dopamine directly affects mood, motivation, and reward-seeking behavior, and low levels of this neurotransmitter are thought to be associated with higher risk of depression.
Norepinephrine is critically involved with proper sympathetic nervous system function, which affects the response to various stimuli. Similar to dopamine, low levels of this compound have been associated with increased risk of depression.
By artificially increasing levels of dopamine and norepinephrine, bupropion theoretically normalizes their levels in the brain to resolve depression symptoms.
However, it has not been conclusively proven that patients with depression have naturally low levels of these neurotransmitters.
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Bupropion Dosage
Bupropion is prescribed at a wide range of doses, and in a wide variety of different formats.
The drug has an immediate release (IR) form, a sustained release (SR) form and an extended release (XR) form.
According to a 2023 medical review, the effective daily dose range for bupropion is between 75 milligrams (mg) and 522 mg.
The IR pills range between 75 and 100 mg, while the XR pills range between 100 and 450 mg.
Doctors may prescribe bupropion at a lower starting dose of around 75 or 100 mg, and increase the dose slowly over the course of weeks if the patient isn’t experiencing benefit.
Lower doses generally confer a reduced risk of side effects, so if a patient has success on a lower dose, it’s a good sign.
