From the Guidelines
Wellbutrin (Bupropion) is generally considered safe during pregnancy, particularly when the benefits of treatment outweigh the risks.
Safety Considerations
- The available safety data for bupropion in the perinatal period suggests that it can be a viable option for individuals requiring treatment for co-occurring depression or other conditions 1.
- While there are limited studies on the use of bupropion during pregnancy, the available evidence does not indicate a significant increase in adverse outcomes 1.
- In fact, some studies suggest that bupropion may be safer than other medications, such as methadone, in terms of fetal exposure and neonatal outcomes 1.
Clinical Guidelines
- The American Journal of Obstetrics and Gynecology recommends considering bupropion as a treatment option for individuals with ADHD or depression during pregnancy, particularly when stimulants are not effective or suitable 1.
- However, it is essential to weigh the risks and benefits of treatment and to carefully monitor patients during pregnancy.
Important Notes
- Bupropion is not as efficacious as stimulants for the treatment of ADHD, and its use should be considered on a case-by-case basis 1.
- More research is needed to fully understand the safety and efficacy of bupropion during pregnancy, particularly in terms of long-term outcomes 1.
From the FDA Drug Label
Talk to your healthcare provider about the risk to your unborn baby if you take bupropion hydrochloride extended-release tablets (XL) during pregnancy. o If you become pregnant during treatment with bupropion hydrochloride extended-release tablets (XL), talk to your healthcare provider about registering with the National Pregnancy Registry for Antidepressants.
The FDA drug label does not provide a clear answer to whether Wellbutrin (Bupropion) is safe during pregnancy, but it does recommend discussing the risks with a healthcare provider. It is advised to consult a healthcare provider to determine the best course of action. 2
From the Research
Safety of Wellbutrin (Bupropion) During Pregnancy
- The safety of Wellbutrin (Bupropion) during pregnancy has been studied in several research papers 3, 4, 5, 6, 7.
- A prospective comparative study found that bupropion does not increase the rates of major malformation above baseline, but there were significantly more spontaneous abortions in the bupropion group 3.
- Another study suggested a higher-than-expected frequency of neonatal cardiac malformations, which led to a caution against using bupropion during pregnancy 4.
- A systematic review found that bupropion's use in the first trimester has been linked with a small elevation in the risk of cardiovascular defects, although the absolute risk was low 5.
- A study using data from UnitedHealthcare found that the prevalence of congenital malformations associated with bupropion exposure in the first trimester was not increased relative to the comparison groups 6.
- A systematic review and meta-analysis found no strong evidence that bupropion exposure in pregnancy is associated with major positive or negative outcomes, including congenital abnormalities, birthweight, or premature birth 7.
Key Findings
- Bupropion may not increase the risk of major malformations above baseline 3, 6.
- There may be a small elevation in the risk of cardiovascular defects with bupropion use in the first trimester 5.
- The risk of miscarriage following prenatal bupropion exposure may be higher than that of a control group of women, but remains within the general population rate 3, 5.
- Available evidence on the safety of bupropion in pregnancy is of variable quality and sometimes conflicting 4, 7.