Bupropion: Does It Have Sexual Side Effects?

In this article, we will closely examine Bupropion, a second-generation antidepressant acting on dopamine and norepinephrine. We will discuss its uses, side effects, and particularly its lower risk of causing sexual side effects compared to other antidepressants.
Klara Hatinova

Klara Hatinova

Klara is postgraduate researcher in experimental psychology at the
University of Oxford.

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Bupropion, unlike other antidepressants, is less likely to cause sexual side effects. It is often chosen for treatment because it has a lower risk of causing such issues. However, like any medication, individual reactions can vary.

What is Bupropion?

Bupropion, brand name Wellbutrin, is a type of antidepressant which is primarily used to treat major depression, but also seasonal affective depression and as an aid in smoking cessation [1].

In contrast to selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, Lexapro or Zoloft, bupropion is a norepinephrine-dopamine disinhibitor (NDDI) and a second-generation antidepressant.

This means it improves mood by increasing the activity of dopamine and norepinephrine in the brain [1, 2]. This is somewhat similar to how Adderall works, although Adderall has a stronger stimulatory effect.

Since bupropion does not act on serotonin, it is commonly prescribed together with other SSRIs, as there isn’t a risk of serotonin syndrome.

Bupropion is available under various brand names and extended-release formulations, such as Wellbutrin SR, Wellbutrin XL, Aplenzin, and Forfivo XL. Still, it is also available as a generic drug, which costs less than the brand-name version [1].

Side Effects of Bupropion

Does Bupropion Have Sexual Side Effects?

Bupropion is generally associated with fewer sexual side effects compared to other antidepressants. There are several studies to support this:

  1. 1. In a study involving 13 healthy men, no differences were found in self-reported sexual function, number of erections, total erection time, or penile rigidity in subjects taking bupropion compared with those taking a placebo [3].
  2. 2. In a comparison study, 86% of patients treated with bupropion reported no adverse sexual effects. Quite the opposite – 77% of bupropion-treated patients reported at least one aspect of improved sexual functioning [4].
  3. 3. Another study found that bupropion successfully reversed a variety of sexual dysfunctions caused by serotonin reuptake inhibitors being too high in 66% of patients [5].
  4. 4. A fourth study involving 40 male outpatients found that the adverse sexual effects of other antidepressants, such as fluoxetine, resolved in 24 of the 28 patients when they were transferred to bupropion. The 12 patients who had a negative history of sexual dysfunction continued to have normal sexual functioning during bupropion treatment [6].
  5. 5. Caution! Too much is too much! Some case studies indicated bupropion can worsen hypersexuality in prone individuals, particularly during a manic episode in individuals with bipolar disorder [7].

The studies above, therefore, agree that bupropion is unlikely to reduce sexual dysfunction but can improve sex-related performance.

Can Bupropion Cause Erectile Dysfunction?

Bupropion is also not likely to cause erectile dysfunction. It is often used to treat sexual dysfunction induced by other antidepressants, such as fluoxetine [8, 6]. Bupropion can also alleviate sexual dysfunction in men with diabetes or methadone-induced erectile dysfunction, demonstrating the cross-diagnostic benefits of bupropion on sexual health [9, 10].

Summary: Bupropion Improves Sexual Function

In conclusion, bupropion is not typically associated with sexual side effects or causing erectile dysfunction. Instead, it is often used to treat sexual dysfunction induced by other antidepressants. However, individual responses may vary and be dose-dependent. All concerns should be discussed with a healthcare provider, as they can give individualised advice.

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Klara Hatinova

Klara Hatinova

Klara is a postgraduate researcher in experimental psychology at the University of Oxford. She has worked across a spectrum of hot topics in neuroscience, including her current project measuring reinforcement learning strategies in Parkinson’s disease. Previously, she studied the efficacy of psilocybin as a therapy for critical mental health conditions and examined molecular circadian rhythms of migraine disorders. She completed her undergraduate degree in Neuroscience at the University of Glasgow and participated in a year abroad at the University of California, where she worked on a clinical trial for spinal cord injury.