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Antidepressants can change our lives for the better, but there are times in your life when a little change can be a bad thing, including when you’re expecting. If you’re a Wellbutrin user planning to start or grow a family, you may be concerned about using antidepressants while pregnant, and whether there are any risks associated with combining Wellbutrin and pregnancy.
While Wellbutrin does have a lot of side effects that could be dangerous to anyone, pregnant or not, the research into whether or not medications like Wellbutrin are dangerous for pregnant women to take is a little less clear.
We do know that taking antidepressants during pregnancy in general can lead to some increased risks of birth defects and other adverse effects. But that’s not necessarily a better option than suffering through depression during pregnancy while unmedicated, as untreated depression can cause its own problems.
So you may still be wondering where Wellbutrin fits into that risk. If you have immediate concerns about pregnancy and antidepressants, it’s best to communicate with your doctor — if you’re currently pregnant, you may need to make some decisions ASAP. But if you’re trying to plan your family’s future while taking care of your mental health, there are some things you should know about Wellbutrin and similar antidepressants and their risk for people who are pregnant or breastfeeding.
Let’s start with the most important information — the basics about Wellbutrin.
Wellbutrin and its generic bupropion are antidepressant medications, but they work a little bit differently than most of the other players in this space. Bupropion, which was approved by the FDA in 1985, is capable of treating major depression and other depressive disorders, but it can also be used to help people with smoking cessation, obesity, bipolar disorder and even ADHD.
What makes bupropion different? The mechanism of action. Instead of targeting serotonin like many modern antidepressant medications, bupropion actually affects dopamine and norepinephrine receptors, making it a norepinephrine and dopamine reuptake inhibitor, or NDRI.
NDRIs help your brain keep spare norepinephrine and dopamine supplies. These neurotransmitters are important in regulating your mood, so having excess supply helps prevent the lows brought on when your brain finds itself without them.
Wellbutrin may treat a number of conditions, but it can also cause a number of side effects, some of which might be intolerable for some people. What it does not, however, is pose an immediate danger to pregnant women.
The side effects of bupropion include weight loss, constipation, dry mouth, nausea, headache, sore throat, loss of appetite, stomach pain and vomiting, ringing in the ears, uncontrollable shaking in the extremities, frequent urination and a negative effect on your sense of taste.
In more serious cases, Wellbutrin can cause irrational fears, seizures, confusion, rapid heart beat, hallucinations and muscle and joint pain.
Contact a healthcare professional and get medical attention immediately if you have these symptoms, or if you have difficulty swallowing or experience blisters, swelling, fever, rash or hives as a result of taking this antidepressant medication.
We note these side effects because, well, those can be just as dangerous to a pregnant person as someone who is not pregnant.
And experts generally agree that breastfeeding mothers should avoid taking bupropion because the medication can be secreted into breast milk and potentially cause problems for an infant.
But from what we found, there doesn’t appear to be a heightened risk — at least not of birth defects — with this medication during pregnancy.
While there is not an immediate, emergency warning against taking Wellbutrin while pregnant, you should definitely bring it to your doctor’s attention if you become pregnant or plan to become pregnant soon.
So should you trash these meds if you have a positive pregnancy test? Should you reduce your dose of bupropion? Not necessarily.
There are a couple of issues here. The first is that while study data about birth defects or congenital malformations seem to be inconclusive (we didn’t find a strong link between bupropion use and increased rate of birth defects or low birth weight), experts do generally agree that bupropion can increase the potential risk of spontaneous abortions if the fetus is exposed to the medication during the first trimester of pregnancy.
Still, recent clinical studies have gone so far as to call bupropion a reasonable treatment for depressed pregnant women. That’s a pretty substantial claim to make if there are lingering doubts about the dangers to fetal exposure.
But while antidepressants have been linked to fetal malformations, preterm delivery, spontaneous abortion and other negative birth outcomes, bupropion does not seem to carry many of these risks, perhaps because of its different formulation from other antidepressants like selective serotonin reuptake inhibitors and tricyclic antidepressants.
More important, arguably, is your own mental health during pregnancy. Suddenly ceasing a treatment for depression can cause some unwelcome withdrawal symptoms, and while those may be tolerable, it’s still best to go through them with a healthcare professional’s support. So talk to healthcare providers and let them help you make the right decision for your needs, whether it’s going off the medication or cutting back to the lowest dose.
If you’re currently expecting and worried about staying on Wellbutrin through your pregnancy, you may want to consider talking to a healthcare provider about your worries.
While experts don’t seem to believe there’s an immediate risk to the baby growing inside you, the risks do grow if you start breastfeeding.
If you plan to breastfeed your baby, it may make sense to make a plan with your healthcare provider for how to safely and effectively transition off of your medication before you’re due, as there are some concerns for the health of infants exposed to bupropion.
That’s a choice you should make with the support of a mental health professional, because your circumstances may be unique.
A word of advice: mental health is an important and often neglected part of our wellbeing, and as an expectant mother, you’ll benefit both your child and yourself in the long run if you feel supported and at your mental best.
To get to your best, you may want to consider including other depression and mental health treatment options, like therapy. Therapy is an effective, scientifically proven technique for dealing with mental health issues and psychiatric disorders. To learn more, consider reading about the types of therapy on our blog, where you can also check out our mental health resources.
If you have immediate questions about your mental health (regardless of your pregnancy status) we can help with that too: reach out for an online psychiatry evaluation today.
Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education.
Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families.
She is also an active member of the American Academy of Nurse Practitioners.
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