Wellbutrin Side Effects: What to Expect and When to Call Your Doctor

What to Know About Wellbutrin Side Effects

If you've just started taking Wellbutrin (Bupropion) — or you're considering it — it's normal to wonder about side effects. Every medication has them, and knowing what to watch for can help you feel more in control of your treatment.

This guide covers the common side effects most people experience, the serious ones that need medical attention, and practical tips for managing them. All information here comes from FDA-approved labeling and clinical data.

What Is Wellbutrin?

Wellbutrin is the brand name for Bupropion, a norepinephrine-dopamine reuptake inhibitor (NDRI). It's FDA-approved for major depressive disorder (MDD) and seasonal affective disorder (SAD). Unlike SSRIs and SNRIs, Wellbutrin works primarily on dopamine and norepinephrine — not serotonin. This gives it a different side effect profile than many other antidepressants. For a deeper look at the medication, see our guide on what Wellbutrin is and how it's used.

Common Side Effects

Most side effects of Wellbutrin are mild and often improve within the first few weeks of treatment. The most frequently reported include:

• Dry mouth — One of the most common effects. Sipping water throughout the day and using sugar-free gum can help.
• Insomnia or difficulty sleeping — Wellbutrin can be activating. Taking your dose in the morning (and avoiding evening doses) usually helps.
• Headache — Often occurs early in treatment and tends to ease as your body adjusts.
• Nausea — Taking Wellbutrin with food may reduce stomach upset.
• Dizziness — Usually mild. Stand up slowly and stay hydrated.
• Constipation — Increase fiber, water intake, and physical activity.
• Agitation or anxiety — Some people feel more restless or jittery, especially in the first week or two.
• Tremor — A slight shakiness in the hands, usually temporary.
• Excessive sweating — More common than with many other antidepressants.
• Weight loss or decreased appetite — Unlike many antidepressants, Wellbutrin is less likely to cause weight gain and may actually reduce appetite.
• Fast heart rate (tachycardia) — Mild increases in heart rate have been reported.
• Sore throat — Occasionally reported in clinical trials.

Most of these side effects are temporary. If any become bothersome or don't improve after 2-3 weeks, talk to your doctor — they may adjust your dose or timing.

Serious Side Effects

While uncommon, some side effects require immediate medical attention. Contact your doctor right away — or go to the ER — if you experience any of the following:

Seizures

This is the most well-known serious risk with Wellbutrin. The risk is dose-related — at the maximum dose of 450 mg per day, seizures occur in roughly 0.4% (4 in 1,000) of patients. Risk factors include:

• Taking more than the recommended dose
• History of seizure disorder (Wellbutrin is contraindicated)
• Eating disorders (bulimia or anorexia nervosa)
• Abrupt withdrawal from alcohol or sedatives
• Taking other medications that lower the seizure threshold

Suicidal Thoughts and Behaviors

Wellbutrin carries an FDA boxed warning about increased risk of suicidal thinking and behavior in children, adolescents, and young adults (ages 18-24), especially in the first few months of treatment or when doses change. If you or someone you know has thoughts of self-harm, call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room immediately.

Neuropsychiatric Symptoms

In rare cases, patients have reported agitation, hostility, paranoia, delusions, hallucinations, or psychosis. If you notice major changes in your mood, thinking, or behavior, contact your provider.

Severe Allergic Reactions

Signs include rash, hives, swelling of the face or throat, difficulty breathing, or fever with joint pain. Rarely, Stevens-Johnson syndrome has been reported. Seek emergency care immediately.

Other Serious Effects

• Severe high blood pressure — especially with concurrent nicotine replacement therapy
• Angle-closure glaucoma — sudden eye pain, vision changes, swelling
• Mania or hypomania — especially in patients with bipolar disorder

Side Effects in Specific Populations

Young Adults (Under 25)

The FDA boxed warning applies. Close monitoring is essential during the first few months and any dose adjustments.

Older Adults

Elderly patients don't typically need dose adjustments but may be more sensitive to side effects like dizziness, dry mouth, and constipation.

Pregnant or Breastfeeding Women

Wellbutrin is pregnancy category C — it should only be used if the potential benefit justifies the risk. Bupropion does pass into breast milk, so discuss the risks with your OB/GYN or psychiatrist.

Patients with Liver or Kidney Issues

Dose reductions are needed for patients with hepatic impairment. For severe liver disease, the maximum is 150 mg every other day for XL formulations. Kidney impairment may also require lower doses.

How to Manage Side Effects

Here are practical strategies that help many patients:

• Take it in the morning. This reduces insomnia — Wellbutrin's activating effects work better during the day.
• Don't skip the ramp-up. Your doctor will start you on a lower dose and increase gradually. This is specifically designed to reduce side effects and seizure risk.
• Stay hydrated. Helps with dry mouth, constipation, and dizziness.
• Avoid alcohol. Alcohol can increase seizure risk and worsen side effects. Learn more about Wellbutrin drug interactions.
• Give it time. Many side effects peak in the first 1-2 weeks and then improve. Don't stop taking Wellbutrin without talking to your doctor.
• Track what you notice. Keep a simple log of side effects, when they happen, and how severe they are. This information is invaluable at your follow-up appointment.

Final Thoughts

Wellbutrin is generally well-tolerated, and many people take it with minimal side effects. The most common issues — dry mouth, insomnia, and headache — typically improve within a few weeks. Serious side effects are rare but important to know about so you can act quickly if they occur.

If you're experiencing side effects that worry you, don't stop your medication on your own — call your doctor first. And if you're looking for more information about this medication, check out our guides on how Wellbutrin works and Wellbutrin uses and dosage.

Need help finding Wellbutrin at a pharmacy near you? Try Medfinder to check availability.