Wellbutrin interactions: Alcohol, medications, and other factors

When to avoid Wellbutrin

In some cases, factors or conditions could prevent your doctor from prescribing Wellbutrin due to the risk of harm. These are known as contraindications. The contraindications of Wellbutrin include the following:

Note:Before you start treatment with Wellbutrin, it’s important to tell your doctor whether any of these contraindications apply to you. They can determine whether to prescribe Wellbutrin based on this information.

Having a seizure disorder

Doctors typically will not prescribe Wellbutrin if you have a seizure disorder. Taking Wellbutrin can increase the risk of seizures. And if you already have a seizure disorder, taking this drug could make your seizures more frequent or severe.

Having a current or past diagnosis of bulimia or anorexia

Doctors typically will not prescribe Wellbutrin if you have been diagnosed with a certain eating disorder, such as bulimia or anorexia. Seizures are more likely to occur in people who have or have had these conditions. And taking Wellbutrin can increase the risk of seizures. So if you have received a diagnosis for an eating disorder and take the medication, your seizure risk could increase further.

Having suddenly stopped drinking alcohol or taking certain drugs recently

Doctors typically will not prescribe Wellbutrin if you have suddenly stopped drinking alcohol recently. They also typically will not prescribe the drug if you have abruptly stopped taking certain medications recently. These drugs include:

• benzodiazepines, such as alprazolam (Xanax)
• barbiturates, such as phenobarbital
• antiepileptic drugs, such as cenobamate (Xcopri) or felbamate (Felbatol)

Suddenly stopping consuming alcohol or taking certain drugs could cause withdrawal symptoms* such as seizures. One of Wellbutrin’s side effects is seizures. So taking the drug in this situation could increase your risk of seizures further.

* Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.

Taking a monoamine oxidase inhibitor (MAOI)

Doctors typically will not prescribe Wellbutrin if you’re taking a type of drug called a monoamine oxidase inhibitor (MAOI). This is because the combination may cause extremely high blood pressure.

Additionally, doctors typically won’t prescribe Wellbutrin if you have taken an MAOI within the last 14 days. If you need to take an MAOI, they’ll have you wait to start treatment until it’s been at least 14 days since your last dose of Wellbutrin.

Examples of MAOIs include:

• isocarboxazid (Marplan)
• linezolid (Zyvox)
• methylene blue (ProvayBlue)
• phenelzine (Nardil)
• selegiline (Emsam)
• tranylcypromine (Parnate)

Having had an allergic reaction to Wellbutrin or any of its ingredients

If you have had an allergic reaction to Wellbutrin or any of its ingredients, your doctor will likely not prescribe Wellbutrin. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Wellbutrin interaction with alcohol

Wellbutrin can interact with alcohol.

Heavy drinking can lead to seizures in some people, and seizures are a possible side effect of Wellbutrin. So if you drink a lot of alcohol and take Wellbutrin, your risk of seizures can increase.

In some reports, the combination of Wellbutrin and alcohol has been linked to decreased alcohol tolerance. This means that lesser amounts of alcohol may cause you to become more intoxicated than you expect. There have also been reports of people experiencing mental health issues after combining Wellbutrin and alcohol.

In addition, doctors typically will not prescribe Wellbutrin to people who have suddenly stopped drinking alcohol recently. (For more information, see the “When to avoid Wellbutrin” section.)

Because of these risks, doctors typically recommend limiting how much you drink or not consuming alcohol during Wellbutrin treatment. If you have questions about alcohol and this medication, talk with your doctor.

Wellbutrin interactions with other medications

Before you start treatment with Wellbutrin, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

To learn whether Wellbutrin interacts with supplements, herbs, or vitamins, see the “Wellbutrin and other interactions” section.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Wellbutrin. Keep in mind that this table doesn’t include all drugs that may interact with Wellbutrin. Some of these interactions are described in detail in “Drug interactions in depth.”

Drug interactions in depth

Here’s a closer look at certain drug interactions of Wellbutrin.

Other antidepressant drugs

Antidepressants are drugs typically used to treat depression. Wellbutrin is a type of antidepressant. In some cases, your doctor may prescribe more than one type of antidepressant to treat mental health conditions.

Interaction result. Taking Wellbutrin in combination with another antidepressant can increase the risk of side effects of Wellbutrin, especially seizures.

In addition, Wellbutrin may interact with certain antidepressants in a way that increases the risk of side effects from the other antidepressant.

Interaction explained. Wellbutrin may cause seizures. Other antidepressants can also increase your seizure risk. So taking Wellbutrin with another antidepressant may make seizures more likely to occur.

Certain antidepressants also interact with Wellbutrin in a second way. Some antidepressants are metabolized (broken down) by an enzyme in the body called CYP2D6. (CYP stands for cytochrome P450.) Wellbutrin can reduce the activity of CYP2D6.

If the CYP2D6 enzyme is less active than usual, tyour body may not break down the antidepressant correctly. This can increase the level of the antidepressant in your system. With more of the antidepressant in your body than usual, side effects of the drug may be more frequent or severe.

Examples of other antidepressant drugs. Here are some antidepressants that may interact with Wellbutrin:

• escitalopram (Lexapro), a selective serotonin reuptake inhibitor (SSRI)
• duloxetine (Cymbalta), a serotonin-norepinephrine reuptake inhibitor (SNRI)
• vortioxetine (Trintellix), an SSRI/serotonin receptor modulator
• certain SNRIs, such as venlafaxine (Effexor XR)
• certain tricyclic antidepressants, such as:
  • nortriptyline (Pamelor)
  • imipramine (Tofranil)
  • desipramine (Norpramin)
• certain SSRIs, such as:
  • paroxetine (Paxil)
  • fluoxetine (Prozac)
  • sertraline (Zoloft)

Steps you or your doctor may take. If your doctor prescribes Wellbutrin with another antidepressant, they may have you take a low dose of the other antidepressant drug. Your doctor may also monitor you closely throughout your treatment for side effects from either drug.

Antipsychotics

Antipsychotics are drugs used to treat mental health conditions such as schizophrenia and bipolar disorder. In some cases, your doctor may prescribe an antipsychotic medication to treat certain mental health conditions.

Interaction result. Taking Wellbutrin in combination with an antipsychotic drug can increase the risk of side effects of Wellbutrin, especially seizures.

In addition, Wellbutrin may interact with certain antipsychotics in a way that increases the risk of side effects from the antipsychotic drug.

Interaction explained. Wellbutrin may cause seizures. Antipsychotic drugs can also increase your seizure risk. So taking Wellbutrin with an antipsychotic drug may make seizures more likely to occur.

Additionally, certain antipsychotic drugs can interact with Wellbutrin in a second way. Certain antipsychotic drugs are metabolized (broken down) by an enzyme in the body called CYP2D6. (CYP stands for cytochrome P450.) Wellbutrin can reduce the activity of CYP2D6.

If the CYP2D6 enzyme is less active than usual, your body may not break down the antipsychotic correctly. This can increase the level of the antipsychotic in your system. With more of the antipsychotic in your body than usual, side effects of the drug may be more frequent or severe.

Examples of antipsychotic drugs. Here are some antipsychotic drugs that may interact with Wellbutrin:

• aripiprazole (Abilify)
• brexpiprazole (Rexulti)
• clozapine (Clozaril)
• haloperidol (Haldol)
• risperidone (Risperdal)
• thioridazine

Steps you or your doctor may take. If your doctor prescribes Wellbutrin with an antipsychotic drug, they may prescribe a low dose of the antipsychotic drug. Your doctor may also monitor you closely throughout your treatment for side effects from either drug.

Strattera

Atomoxetine (Strattera) is a drug that’s used to treat attention deficit hyperactivity disorder (ADHD).

Interaction result. Taking Wellbutrin with Strattera can increase the risk of side effects of Strattera.

Interaction explained. Strattera is metabolized (broken down) by an enzyme in the body called CYP2D6. (CYP stands for cytochrome P450.) Wellbutrin can reduce the activity of CYP2D6.

If the CYP2D6 enzyme is less active than usual, your body may not break down Strattera correctly. This can increase the level of Strattera in your system. With more Strattera in your body than usual, side effects of the drug may be more frequent or severe.

Steps you or your doctor may take. If your doctor prescribes Strattera while you’re taking Wellbutrin, they’ll likely prescribe a low dose of Strattera. Your doctor will also monitor you closely throughout your treatment for side effects from Strattera.

Stimulants

Stimulants, also known as central nervous system (CNS) stimulants, are drugs typically used to treat attention deficit hyperactivity disorder (ADHD). The CNS is made up of your brain and spinal cord.

Interaction result. Taking Wellbutrin in combination with a stimulant can increase the risk of side effects of Wellbutrin, especially seizures.

Interaction explained. Wellbutrin may cause seizures. Stimulant drugs can also increase your risk of seizures. So taking Wellbutrin with a stimulant can make seizures more likely to occur.

Examples of stimulant drugs. Here are some stimulants that may interact with Wellbutrin:

• amphetamine/dextroamphetamine (Adderall)
• lisdexamfetamine (Vyvanse)
• caffeine, which may be found in certain foods, drinks, supplements, and over-the-counter drugs such as Vivarin and some Excedrin products (For more details, see “Wellbutrin and other interactions.”)

Steps you or your doctor may take. If you’re taking Wellbutrin, your doctor may not prescribe a stimulant drug. They may also recommend limiting the use of products that contain caffeine.

If your doctor does prescribe Wellbutrin and a stimulant, they may monitor you more often than usual throughout your treatment.

Wellbutrin and other interactions

Wellbutrin may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Wellbutrin.

Wellbutrin interactions with supplements

Before you start treatment with Wellbutrin, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Wellbutrin interactions with herbs

Some herbal products contain caffeine. Examples of these products include green tea supplements and energy supplements.

Wellbutrin may interact with caffeine. Consuming too much caffeine while taking Wellbutrin may increase the risk of seizures. Your doctor may recommend limiting your caffeine intake during your Wellbutrin treatment.

It’s important to check with your doctor or pharmacist before taking any herbal products that contain caffeine. They can advise you on whether or not to take them during Wellbutrin treatment.

Wellbutrin and vitamins

There are no specific reports of vitamins interacting with Wellbutrin. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Wellbutrin.

Wellbutrin interactions with food

Wellbutrin may interact with caffeine. Consuming too much caffeine while taking Wellbutrin can increase the risk of seizures. Examples of foods and beverages that contain caffeine include:

• coffee
• tea
• chocolate
• energy drinks

Because of this interaction, your doctor may recommend limiting how much caffeine you consume during Wellbutrin treatment.

If you’d like to learn more about eating certain foods during treatment with Wellbutrin, talk with your doctor.

Wellbutrin and vaccines

Wellbutrin is not known to interact with any vaccines. If you have questions about receiving vaccines during treatment, talk with your doctor or pharmacist.

Wellbutrin interactions with lab tests

Wellbutrin may interfere with the results of certain lab tests. Taking the medication may cause a false-positive result on a urine drug screening test that checks for the presence of amphetamines. This means the test could show that you have amphetamines in your urine even if you do not. Such urine tests may be required by an employer or for other reasons.

Because of this, it’s important to tell the person giving you the test that you’re taking Wellbutrin.

For additional information, talk with your doctor or pharmacist.

Wellbutrin interactions with cannabis or CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Wellbutrin. Taking these drugs together may make Wellbutrin less effective or could increase the risk of side effects of Wellbutrin.

Before you start treatment with Wellbutrin, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Wellbutrin and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Wellbutrin. Before you take this drug, be sure to talk with your doctor about your health history. Wellbutrin may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Wellbutrin include:

• Risk of suicidal thoughts and behaviors: Wellbutrin has a boxed warning about the risk of suicidal thoughts and behaviors. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.
• Seizure disorder: If you have a seizure disorder, taking Wellbutrin could make your seizures more frequent or severe.
• Eating disorder: Doctors typically will not prescribe Wellbutrin if you have been diagnosed with a certain eating disorder, such as bulimia or anorexia.
• Having stopped drinking alcohol or taking certain drugs: Doctors typically will not prescribe Wellbutrin if you have recently suddenly stopped drinking alcohol or taking certain substances.
• MAOI: Doctors typically will not prescribe Wellbutrin if you’re taking or recently took a type of drug called a monoamine oxidase inhibitor (MAOI).
• Allergic reaction: If you’ve had an allergic reaction to Wellbutrin or any of its ingredients, your doctor will likely not prescribe Wellbutrin.
• Mental health conditions: Wellbutrin may cause certain mental health side effects, such as anxiety. You may have an increased risk of these side effects if you have a mental health condition, such as bipolar disorder. Before you start Wellbutrin treatment, tell your doctor if you have a mental health condition. They can help determine whether the drug is right for you.
• Glaucoma or narrow eye angles: Wellbutrin may cause dilated pupils, which can cause glaucoma in people with narrow eye angles. Glaucoma can be severe and lead to vision loss. Before you take Wellbutrin, your doctor may suggest that you have an eye exam to check for narrow angles. If you have them, your doctor can advise you on whether or not you should take Wellbutrin.
• Pregnancy: It is unknown whether Wellbutrin is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor about whether the drug is a safe option for you.
• Breastfeeding: It is unknown whether Wellbutrin is safe to take while breastfeeding. If you’re breastfeeding or plan to breastfeed, talk with your doctor. They can help determine the right treatment plan for you and ways to feed your child.

For details about some of these conditions and Wellbutrin, see the “When to avoid Wellbutrin” section.

Preventing interactions

You can take certain steps to help prevent interactions with Wellbutrin. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Wellbutrin label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Wellbutrin doesn’t come with paperwork, you can ask your pharmacist to print a copy.)

If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Wellbutrin by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.