Alcohol & Wellbutrin®: What you need to know

Medical Review by Jennie Stanford, MD, FAAFP, DABOM

Summary

• Drinking alcohol while taking Wellbutrin® may increase your risk of seizures, especially if you are used to drinking heavily and suddenly cut back.
• Alcohol and Wellbutrin® can also cause overlapping side effects like nausea and vomiting, and may reduce your tolerance to alcohol in rare cases.
• Alcohol may interfere with Wellbutrin®’s ability to regulate norepinephrine and dopamine, which could reduce the medication’s antidepressant benefits.
• The safest option is to avoid alcohol while taking Wellbutrin®, but if you choose to drink, limit intake to no more than one drink per day for females and two for males.
• Always consult a healthcare provider before using Wellbutrin®, and follow their recommendations about alcohol if this medication is prescribed to you.

Learn how drinking could impact your experience with Wellbutrin®

Wellbutrin®, a branded form of the medication bupropion, is an antidepressant commonly prescribed for major depressive disorder (MDD) and seasonal affective disorder (SAD). It is also used as a smoking cessation aid under the brand name Zyban®.

If you take Wellbutrin® or are considering it as part of your depression treatment plan, you may wonder whether it is safe to consume alcohol while using this medication. Below, Lemonaid Health explores how alcohol and bupropion may interact, what risks this combination can carry, and how you can work with a healthcare provider to make informed choices about drinking if you take this medication.

The risks of combining alcohol & Wellbutrin®

The patient information for Wellbutrin® states that you should avoid or minimize alcohol consumption while taking this medication. This is because alcohol and Wellbutrin® affect you in different ways, and combining them can lead to unintended consequences. Here are the primary risks:

Increased risk of seizures

Taking too much bupropion can cause you to overdose, which comes with a risk of experiencing seizures. It is important to note that the risk of having a seizure due to treatment with bupropion is low—only around 0.1% when taking a daily dose below 300 mg. However, it climbs to 0.4% when taking 300-450 mg daily, and goes up from there.

Alcohol withdrawal can also trigger seizures. This suggests that people who drink heavily and suddenly reduce their alcohol consumption while taking Wellbutrin® may be at even greater risk. For this reason, Wellbutrin® and other forms of bupropion are not recommended for people going through alcohol withdrawal.

Heightened side effects

Some of the side effects of Wellbutrin® are also possible side effects of ethanol toxicity—otherwise known as alcohol poisoning. Some of the most common side effects that can occur from drinking alcohol or taking Wellbutrin® include nausea and vomiting.

Lowering the benefits of Wellbutrin®

Unlike antidepressants that fall under the category of selective serotonin reuptake inhibitors (SSRIs), Wellbutrin® works by increasing your brain’s levels of the neurotransmitters norepinephrine and dopamine. Norepinephrine plays a role in regulating arousal, attention, cognitive function, and stress, while dopamine affects your movement, your emotions, and your brain’s reward system.

But drinking alcohol also affects your dopamine levels. Specifically, drinking releases dopamine to activate your brain’s reward system—which can lead to alcohol addiction over time. And long-term use of alcohol or other drugs has been linked to a decrease in dopamine function.

Research suggests that alcohol also impacts the way your brain releases norepinephrine in a similar way. This means you might have less dopamine and norepinephrine in your system if you drink alcohol, and it might be more difficult for Wellbutrin® to work as intended.

Possible increased sensitivity to alcohol

Although they are rare, there have been some reports that people who drank alcohol during their treatment with Wellbutrin® had a lower alcohol tolerance. This could potentially increase some of the behavioral risks that come with drinking alcohol—including injuries, violence, sexually transmitted infections, and unplanned pregnancies.

Safe practices

Because the patient information for Wellbutrin® advises against alcohol consumption, avoiding alcohol entirely while taking this medication or minimizing your intake is the safest option. If you choose to drink and assume responsibility for the associated risks, here are some precautions to keep in mind:

Limit your alcohol intake

Drinking in moderation may help reduce the risks outlined above, although it does not eliminate them. Here’s what moderation looks like for typical females and males: women and men:

• Females: No more than one standard drink per day
• Males: No more than two standard drinks per day

A standard drink is defined as:

Be cautious if you are cutting back on alcohol

If you have been drinking regularly and plan to cut down, do so before you start taking Wellbutrin®. Wellbutrin® should not be taken by people who are abruptly reducing their alcohol consumption. Remember, abruptly stopping alcohol consumption can lead to withdrawal symptoms, including seizures—which are also a potential rare side effect of Wellbutrin®.

Consulting your healthcare provider

Different people can react to the same medication in different ways. People also have different reasons for drinking, which means the choices you make around alcohol are unlikely to be the same as everyone else’s.

That’s one of the reasons why it’s important to make any decisions about taking Wellbutrin® with the help of a qualified healthcare practitioner. They can consider your individual health factors and medication history to determine whether this medication is appropriate for you, and whether any amount of alcohol is safe for you to drink.

Potential alternatives to Wellbutrin®

If you are concerned about Wellbutrin®’s interactions with alcohol, your healthcare provider may suggest alternative medications for depression that have a different risk profile. Some options include:

• Escitalopram (Lexapro®)
• Fluoxetine (Prozac®)
• Sertraline (Zoloft®)

Learn more: Anti-depression meds: finding one that works for you

Learn more about Wellbutrin® & your lifestyle with Lemonaid Health

Drinking alcohol while taking Wellbutrin® may increase your risk of seizures, make certain side effects more severe, and make it harder for you to effectively improve your mental health. The safest approach is to avoid alcohol altogether while taking this medication, but if you choose to drink, make sure to follow safe consumption guidelines and check in regularly with your healthcare provider.

Lemonaid Health connects you with U.S.-based healthcare professionals who can answer your questions about Wellbutrin® and provide a personalized plan to help you treat depression, which may include appropriate medication in clinically indicated cases. Get started today and make informed choices about your health.

Wellbutrin® and Zyban® are registered trademarks of GlaxoSmithKline LLC. Lexapro® is a registered trademark of H. Lundbeck A/S. Zoloft® is a registered trademark of Viatris Specialty LLC, a Viatris Company. Prozac® is a registered trademark of Eli Lilly and Company.