Is Wellbutrin Safe During Pregnancy?
Wellbutrin (bupropion) works differently from SSRI antidepressants, and it is also used to help people quit smoking (as Zyban). According to MotherToBaby, it is considered unlikely that bupropion increases the chance of birth defects above the background risk.
It is not one of the first-line antidepressants named by the American College of Obstetricians and Gynecologists (ACOG), which recommends SSRIs first. But ACOG also says a medication that has already worked for you should generally be the choice, from any class. For the full comparison, see antidepressants during pregnancy.
Wellbutrin and Birth Defects
About 3 in 100 babies have a birth defect regardless of medication.
- The current FDA label says studies of pregnant women exposed to bupropion in the first trimester have not identified an increased risk of birth defects overall.
- In a U.S. study of nearly 950,000 pregnancies, heart defects occurred in about 86 per 10,000 bupropion-exposed babies and 72 per 10,000 unexposed babies, and after adjustment there was no increased risk.
- Two smaller case-control studies each reported a possible link with a heart defect, but they pointed to different types of defects, and MotherToBaby notes both had limitations. These signals have not been confirmed.
Other Pregnancy Risks
- Miscarriage: studies have not found a higher chance of miscarriage with bupropion.
- Newborn adaptation symptoms: one study suggests the chance of these temporary symptoms may be lower with bupropion than with some other antidepressants.
- ADHD: a single insurance-claims study reported a link between bupropion in pregnancy and later ADHD. It has not been replicated, parental psychiatric conditions strongly influenced the results, and ADHD has many causes.
- Anxiety: ACOG notes that activating antidepressants, including bupropion, may make anxiety worse, which matters if anxiety is part of your symptoms.
Wellbutrin for Quitting Smoking in Pregnancy
Smoking during pregnancy carries serious, well-established risks. ACOG says bupropion has limited pregnancy data but no known risk of birth defects or adverse pregnancy effects, and lists it among options that may help pregnant people quit. A review summarized by ACOG found no increased risk of birth defects, low birth weight or preterm birth. In a small pilot trial, more pregnant women stopped smoking during treatment with bupropion than with placebo, with no differences in birth weight, length or Apgar scores.
Is Wellbutrin Category B or C?
Wellbutrin was labeled “Pregnancy Category C” on its FDA label. Claims online that it was Category B are not supported by FDA labeling. In 2015, the FDA removed all pregnancy letter categories because they were confusing and overly simplistic, and the current label uses a written risk summary. Zoloft, Lexapro and Prozac were also Category C.
Should You Keep Taking Wellbutrin If You Get Pregnant?
- ACOG recommends against stopping mental health medication because of pregnancy alone.
- If bupropion is what has kept you well, that history matters in the decision.
- Do not stop suddenly; talk with your prescriber about whether to continue, adjust or switch.
Wellbutrin and Breastfeeding
According to the NIH’s LactMed database, bupropion is not a reason to stop breastfeeding, but another drug may be preferred, especially while nursing a newborn or preterm baby.
- Doses up to 300 mg a day produce low levels in breast milk. One study estimated the baby receives about 2% of the mother’s weight-adjusted dose including its breakdown products; another estimated about 5%.
- There is little reported use in breastfed newborns.
- Two case reports describe possible seizures in partially breastfed 6-month-old babies. In one, the link was rated only possible; in the other, the mother was also taking escitalopram. This is not an established effect, but it is why LactMed suggests caution.
- Babies exposed to bupropion together with an SSRI should be watched closely for vomiting, diarrhea, jitteriness or sleepiness.
Combination Products
- Auvelity (bupropion with dextromethorphan): the manufacturer recommends avoiding breastfeeding during treatment and for 5 days after the last dose.
- Contrave (bupropion with naltrexone): LactMed says it can be used during breastfeeding.
Talk to Your Prescriber
Find a perinatal mental health therapist
If you have thoughts of harming yourself, call or text 988, or call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262).
Frequently Asked Questions
Can you take Wellbutrin while pregnant?
Many people do. Birth defect risk has not been shown to increase overall, though ACOG recommends SSRIs as the first-line option and bupropion has less data. A medication that already works for you is usually a good reason to continue.
Does Wellbutrin cause birth defects?
The largest study found no increased risk of heart defects after adjustment. Two smaller studies reported different possible heart defect links that have not been confirmed.
What pregnancy category is Wellbutrin?
It was formerly Category C, not B. The FDA removed letter categories in 2015.
Is Wellbutrin safe for quitting smoking during pregnancy?
ACOG lists bupropion as a possible aid, noting limited data but no known risk of birth defects or adverse pregnancy effects.
Can you take Wellbutrin while breastfeeding?
LactMed says it is not a reason to stop breastfeeding, but another antidepressant may be preferred, especially for newborns and preterm babies, because of rare seizure case reports.
