From the Guidelines
Wellbutrin (bupropion) can potentially cause or worsen tinnitus as a side effect in some patients, and if you're experiencing tinnitus while taking Wellbutrin, you should discuss this with your healthcare provider rather than stopping the medication abruptly. The relationship between Wellbutrin and tinnitus appears to be dose-dependent, with higher doses (300-450mg daily) more likely to trigger this side effect than lower doses (150mg daily) 1. Tinnitus typically develops within the first few weeks of treatment but may occur at any time. The mechanism likely involves Wellbutrin's effects on dopamine and norepinephrine neurotransmission in the auditory pathways.
Some key points to consider when managing tinnitus associated with Wellbutrin include:
- The dose-dependent nature of the side effect, with higher doses being more likely to cause tinnitus 1
- The potential for tinnitus to resolve after discontinuation of the medication, though this is not guaranteed 1
- The importance of maintaining good overall hearing health by avoiding loud noises and using hearing protection when appropriate 1
- The possibility of switching to a different antidepressant or adding treatments specifically for tinnitus management if the side effect becomes bothersome 1
It's also important to note that tinnitus can have a significant impact on quality of life, and patients who experience tinnitus accompanied by severe anxiety or depression require prompt identification and intervention 1. Overall, the management of tinnitus associated with Wellbutrin should prioritize the individual patient's needs and circumstances, and involve a collaborative approach between the patient and their healthcare provider.
From the FDA Drug Label
Special Senses Tinnitus 2% 6% 6% 300 mg/day of bupropion HCl sustained-release: ... tinnitus, 400 mg/day of bupropion HCl sustained-release: ... tinnitus, Ear and Labyrinth Disorders Tinnitus <1% 3%
Tinnitus is a reported adverse reaction in patients taking bupropion. The incidence of tinnitus varies across different studies, with rates ranging from 2% to 6% in some trials 2. In other studies, the incidence of tinnitus was reported as <1% to 3% 2. Tinnitus is also listed as one of the adverse reactions that occurred in at least 5% of patients treated with bupropion HCl sustained-release (300 mg and 400 mg per day) and at a rate at least twice the placebo rate 2 2.
From the Research
Wellbutrin and Tinnitus
- There is limited direct evidence on the relationship between Wellbutrin and tinnitus in the provided studies.
- However, some studies suggest that antidepressants, including those with similar mechanisms to Wellbutrin, may be used to treat tinnitus, especially in patients with co-morbid depression 3.
- A study on SSRI use by tinnitus patients found that these medications can improve tinnitus symptoms in patients with depression 4.
- Another study reviewed the literature on antidepressant therapy in tinnitus and found that some antidepressants, including bupropion (the active ingredient in Wellbutrin), have been reported to have an effect on tinnitus, although more research is needed 3.
- A systematic review of the prevalence of depression among patients with tinnitus found that a substantial proportion of patients with tinnitus have depression, and recommends screening and treating depression in these patients 5.
- Overall, while there is no direct evidence on the use of Wellbutrin for tinnitus, the available evidence suggests that antidepressants may be beneficial in treating tinnitus, especially in patients with co-morbid depression 4, 3.