From the Research
Bupropion can decrease prolactin levels in some individuals, as evidenced by its dopaminergic effects which naturally inhibit prolactin secretion. This antidepressant, also known by brand names like Wellbutrin, works differently from other antidepressants by primarily affecting dopamine and norepinephrine rather than serotonin. The study by 1 found that bupropion significantly decreased prolactin concentrations in rats, accompanied by increased dopamine and norepinephrine levels. Although the evidence is mostly based on animal studies, the mechanism of action of bupropion suggests that it may have a prolactin-lowering effect in humans as well.
Some key points to consider:
- Bupropion's effect on prolactin levels is generally modest and may not be clinically significant for most patients.
- The prolactin-lowering effect of bupropion might be beneficial for individuals experiencing hyperprolactinemia from other medications or conditions, though bupropion is not specifically prescribed for this purpose.
- Typical dosages of bupropion range from 150-450 mg daily, depending on the formulation (immediate, sustained, or extended-release).
- Patients taking bupropion who have concerns about hormone levels should discuss this with their healthcare provider, as individual responses can vary and regular monitoring may be appropriate in some cases.
- It is essential to note that other studies, such as 2, found no significant effect of bupropion on prolactin levels, highlighting the need for further research to fully understand the relationship between bupropion and prolactin.
In terms of management, if a patient taking bupropion presents with symptoms potentially related to hyperprolactinemia, such as galactorrhoea, their plasma prolactin level should be measured, and their antidepressant changed if an increased prolactin level is confirmed, as suggested by 3. However, routine monitoring of prolactin levels is not necessary for most patients taking bupropion.