Does Bupropion Cause Sexual Side Effects?

It’s normal to experience difficulty with orgasm or low libido (sex drive) when you’re feeling depressed. But several medications can also cause or contribute to unwanted sexual side effects.

Ironically, these medications include antidepressants. But not all antidepressants carry the same risks of sexual side effects. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are the most likely to cause sexual problems.

Bupropion (Wellbutrin XL, Wellbutrin SR) is another widely used antidepressant, like SSRIs and SNRIs. But bupropion works slightly differently from these other medications, and its risk of sexual side effects is lower than you might think.

Let’s explore possible bupropion side effects, sexually speaking, and what you should know if you experience them.

Does bupropion cause sexual side effects?

Bupropion is an atypical antidepressant that’s mainly used to treat depression. It can also treat seasonal affective disorder and help people stop smoking. Many people report that bupropion helps with their depression symptoms.

Yet a bupropion prescription sometimes comes with side effects — including sexual side effects. Here’s a breakdown by gender.

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Sexual side effects of bupropion for men

Men generally have fewer sexual side effects with bupropion than with other antidepressants. But here’s what you might experience: 

• Decreased libido: Some men report feeling less sexual desire after starting bupropion. But this can also be a symptom of depression itself.

• Erectile dysfunction (ED): Rarely, men find it more difficult to get or maintain an erection while taking bupropion.

• Changing in ejaculation timing: It’s possible to experience a delay or inability to orgasm, which can be frustrating. However, some men report the opposite problem; there are one-off instances of premature ejaculation.

Remember that everyone’s experience is unique. You may not have any of these side effects. Or, if you do, they might be mild and manageable.

Sexual side effects of bupropion for women

Bupropion’s sexual side effects look a little different for women. If you happen to experience sexual side effects with bupropion, you might notice:

• Decreased libido: A lower sex drive is possible with bupropion. But it’s less common in women than in men.

• Difficulty achieving orgasm: Some women find it harder to reach orgasm with bupropion. This can impact sexual satisfaction.

For many women, bupropion’s sexual side effects are mild. They’re typically less bothersome than those caused by other antidepressants. Some studies even suggest that bupropion can help treat symptoms of sexual dysfunction due to the unique way that it works.

Good to know: Bupropion works differently than SSRIs and SNRIs. It’s thought to slow the reuptake of norepinephrine and dopamine in the brain. These are brain chemicals that play a role in mood, among other aspects of your health.

How common are sexual side effects with bupropion?

Sexual side effects with bupropion are relatively uncommon. Exactly how uncommon is still up for debate. But most studies suggest that bupropion causes fewer sexual side effects than SSRIs, SNRIs, and many other antidepressants.

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This lower risk makes bupropion a good alternative for people who experience sexual side effects with other antidepressants. Bupropion is also sometimes used in combination with other antidepressants to reduce their sexual side effects.

Do sexual side effects from bupropion go away?

In many cases, yes. Sexual side effects from bupropion often gradually ease as your body adjusts to the medication. 

But sexual problems from bupropion may not always resolve on their own. It’s important to talk to your prescriber if this happens. Voice your concerns and symptoms with them before stopping the medication. Discontinuing the medication on your own can lead to the return of depression symptoms.

How can you manage sexual side effects from bupropion?

First, it’s important not to stop taking bupropion without talking with your prescriber first. They may want you to wait a few more weeks to see if the side effects improve. Or, they might recommend a couple of management tips, such as:

• Changing your dose: A lower dose can help reduce the risk of sexual side effects.

• Switching to a different medication: Some other antidepressants and antipsychotics have a low risk of sexual side effects. Examples include mirtazapine (Remeron) and aripiprazole (Abilify).

• Taking another medication to counteract your side effects: For instance, your psychiatrist might prescribe a medication to help you maintain an erection, such as sildenafil (Viagra). Libido-enhancing medications for women are also available.

• Making minor lifestyle changes: Exercising more often, eating a nutritious diet, and lowering your alcohol intake can make a difference.

When to seek emergency care for sexual side effects

Most sexual side effects from bupropion are manageable. They may be annoying, but they’re generally not life-threatening.

But this isn’t always the case. Although very rare, there are situations when you should seek medical help right away.

• Priapism: This is a painful erection that lasts more than 4 hours. If not treated promptly, it can cause permanent damage to the penis.

• Severe allergic reactions: Symptoms such as severe dizziness and skin rashes could be serious. Swelling — especially in your face, tongue, or throat — are also clear warning signs.

Don’t wait if you notice these potentially serious side effects. Seeking urgent medical treatment can help you avoid complications. Call 911 or go to the nearest ER.

Is bupropion less likely to cause sexual side effects than other antidepressants?

Yes. Most research suggests that bupropion is less likely to cause sexual side effects than other commonly prescribed antidepressants — most notably SSRIs and SNRIs. While many believe this is because of bupropion’s effect on dopamine levels, experts don’t know for sure.

Other factors can also cause sexual dysfunction. Health conditions such as depression and anxiety can contribute to sexual difficulties in both men and women. Stress, other illnesses, and medications other than antidepressants are also potential causes.

Why trust our experts?

Written by:

Taylor K. Clarke, PharmD

Taylor K. Clarke, PharmD, has 8 years of pharmacy experience working in community practice, hospital pharmacy, and ambulatory care pharmacy. Taylor's commitment to patient education motivated her to pursue health communications as a pharmacist.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Renad Abu-Sawwa, PharmD, BCPPS

Renad Abu-Sawwa, PharmD, BCPPS, is an associate professor and associate discipline director of clinical pharmacology at Rush Medical College with a practice site as a clinical pharmacy specialist practitioner at RUSH Children's Hospital in the Pediatric Epilepsy Clinic.

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