What You Need to Know About Bupropion Side Effects

Bupropion is one of the most widely prescribed antidepressants in the United States — and for good reason. It's effective for depression, seasonal affective disorder, and smoking cessation, and it's less likely to cause weight gain or sexual side effects than many other antidepressants.

But like all medications, Bupropion comes with potential side effects. Most are mild and go away within a few weeks. Others are rare but serious enough to require immediate medical attention. This guide covers what to expect so you can feel confident about your treatment.

What Is Bupropion?

Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) available under brand names like Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, and Aplenzin. It's FDA-approved for major depressive disorder (MDD), seasonal affective disorder (SAD), and smoking cessation. To learn more about how it works, see our guide on Bupropion's mechanism of action.

Common Side Effects

These side effects occur in a significant percentage of people taking Bupropion. Most are mild to moderate and tend to improve as your body adjusts to the medication (usually within the first 1-2 weeks):

• Dry mouth — One of the most frequently reported side effects. Staying hydrated and chewing sugar-free gum can help.
• Headache — Usually mild and responds well to over-the-counter pain relievers like Acetaminophen.
• Insomnia — Difficulty falling or staying asleep is common, especially at higher doses. Taking your dose in the morning (and avoiding late-afternoon or evening doses) can reduce this.
• Nausea — Taking Bupropion with food may help reduce stomach upset.
• Dizziness — Usually mild. Avoid getting up too quickly from sitting or lying down.
• Constipation — Increase your fiber and water intake. A mild stool softener can help if needed.
• Agitation or restlessness — Some people feel jittery or on edge, especially in the first few days.
• Tremor — Mild shaking in the hands is possible, usually temporary.
• Excessive sweating — More common at higher doses.
• Weight loss — Unlike many antidepressants, Bupropion is more likely to cause modest weight loss than weight gain.
• Increased heart rate (tachycardia) — Usually mild but worth mentioning to your doctor.
• Sore throat — Less common but reported in clinical trials.

Most of these side effects are dose-dependent, meaning they're more likely at higher doses (300-450 mg/day) than at starting doses (150 mg/day).

Serious Side Effects

These are less common but require immediate attention. Contact your doctor or go to the emergency room if you experience any of the following:

Seizures

Seizures are the most well-known serious risk with Bupropion. The risk is dose-dependent — it increases significantly at doses above 450 mg/day. People with certain risk factors are more vulnerable:

• History of seizures or epilepsy
• History of eating disorders (bulimia or anorexia nervosa)
• Heavy alcohol use or sudden alcohol withdrawal
• Use of other drugs that lower the seizure threshold
• Head trauma

At recommended doses (up to 450 mg/day), the seizure risk is approximately 0.1-0.4%. Your doctor will consider these factors before prescribing Bupropion.

Suicidal Thoughts and Behaviors

Bupropion carries an FDA boxed warning about increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults (ages 18-24), particularly during the first few months of treatment or when doses are changed. If you or someone you know experiences new or worsening depression, anxiety, agitation, or thoughts of self-harm, seek immediate help by calling 988 (Suicide & Crisis Lifeline) or going to the nearest emergency room.

Severe Allergic Reactions

Rare but serious allergic reactions can include:

• Hives or rash that spreads
• Swelling of the face, lips, tongue, or throat (angioedema)
• Difficulty breathing
• Stevens-Johnson syndrome (extremely rare but life-threatening)

Seek emergency medical help immediately if you experience these symptoms.

Severe High Blood Pressure

Bupropion can cause hypertension, sometimes severe. Your doctor may monitor your blood pressure, especially if you already have high blood pressure or take other medications that affect it.

Psychosis and Mania

In rare cases, Bupropion can trigger psychosis (hallucinations, paranoia, delusions) or activate a manic episode in people with bipolar disorder. Tell your doctor if you have a history of bipolar disorder.

Angle-Closure Glaucoma

Bupropion can cause pupil dilation that may trigger angle-closure glaucoma in susceptible individuals. Symptoms include eye pain, vision changes, and seeing halos around lights. This is a medical emergency.

Side Effects in Specific Populations

Pregnancy and Breastfeeding

Bupropion is not recommended during pregnancy unless the benefits clearly outweigh the risks. It is present in breast milk, so discuss the risks and benefits with your doctor if you're breastfeeding.

Older Adults

Older adults may be more sensitive to Bupropion's side effects, particularly dizziness and confusion. Dose adjustments may be needed, especially if there is kidney or liver impairment.

People with Liver or Kidney Problems

If you have liver disease (especially severe), your doctor will reduce your dose significantly. For kidney impairment (GFR below 90 mL/min), dose adjustments are also recommended to prevent buildup of the drug.

How to Manage Side Effects

Most Bupropion side effects are manageable with simple strategies:

• For insomnia: Take your dose in the morning. Avoid caffeine in the afternoon. Practice good sleep hygiene.
• For dry mouth: Drink plenty of water. Chew sugar-free gum. Use a saliva substitute if needed.
• For nausea: Take Bupropion with food. Eat smaller, more frequent meals.
• For headache: Over-the-counter pain relievers usually help. Stay hydrated.
• For constipation: Increase fiber, drink more water, and consider a mild stool softener.
• For agitation: This often improves after the first week. Talk to your doctor if it persists — they may adjust your dose.

If a side effect is persistent or interfering with your daily life, don't stop taking Bupropion on your own. Talk to your doctor first. They may adjust your dose, switch your formulation (for example, from SR to XL), or recommend an alternative. For more on alternatives, read our guide on alternatives to Bupropion.

Final Thoughts

Bupropion is generally well-tolerated compared to many other antidepressants. Its unique mechanism — targeting norepinephrine and dopamine instead of serotonin — means it avoids some of the side effects that make other antidepressants difficult for people to stay on, like weight gain and sexual dysfunction.

That said, every medication has trade-offs. Knowing what to expect helps you spot problems early and work with your doctor to find the right balance. If you're curious about what Bupropion does in your body, read What Is Bupropion? for a full overview.

Already have a prescription? Medfinder can help you find Bupropion in stock at a pharmacy near you.