From the Guidelines
Bupropion typically does not prevent orgasms and is actually often prescribed to counteract the sexual side effects of other antidepressants. Unlike many antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), bupropion works primarily on dopamine and norepinephrine systems rather than serotonin, which is why it generally has fewer sexual side effects 1. In fact, bupropion (commonly sold under brand names like Wellbutrin, Zyban, or Aplenzin) is sometimes added to a treatment regimen specifically to help restore sexual function in patients experiencing sexual dysfunction from other medications.
Some key points to consider:
- Bupropion is associated with a lower rate of sexual adverse events than fluoxetine and sertraline, whereas paroxetine has higher rates of sexual dysfunction than fluoxetine, fluvoxamine, nefazodone, and sertraline 1.
- Typical dosages of bupropion range from 150-450 mg daily, usually divided into multiple doses.
- The medication's dopaminergic effects may even slightly enhance sexual function in some individuals.
- However, individual responses to medications vary significantly, and a small percentage of people might still experience sexual side effects while taking bupropion.
- If you're experiencing sexual dysfunction while on any medication, it's essential to discuss this with your healthcare provider, as adjustments to dosage or medication type may help resolve these issues.
From the Research
Bupropion and Orgasm
- Bupropion is not typically associated with preventing orgasms, but rather with improving orgasmic function in some cases 2, 3.
- In fact, bupropion has been shown to have a prosexual effect, which is unusual among antidepressants 4.
- Studies have found that bupropion can improve orgasmic dysfunction in nondepressed subjects, with significant improvements in overall sexual satisfaction, ability to achieve orgasm, and delay in reaching orgasm/ejaculation 2.
- Additionally, some subjects have reported an improvement in SSRI-associated sexual dysfunction, including orgasmic function, while taking bupropion 3.
Comparison to Other Antidepressants
- Most antidepressants, with the exception of bupropion and nefazodone, have been associated with drug-induced anorgasmia 4.
- Bupropion, mirtazapine, nefazodone, and vilazodone have been associated with less sexual dysfunction compared to SSRIs and SNRIs 5.
- Bupropion's unique mechanism of action may contribute to its prosexual effects, which are not fully understood 4.
Clinical Implications
- Bupropion may be a useful agent for treating orgasmic delay and inhibition, and possibly disorders of sexual arousal 2.
- The use of bupropion in patients with sexual dysfunction, including those with SSRI-associated sexual dysfunction, may be beneficial 3, 5.
- However, more research is needed to fully understand the effects of bupropion on orgasmic function and sexual dysfunction 2, 4, 3, 5.