Does taking Wellbutrin (bupropion) cause weight gain?

Does Wellbutrin (Bupropion) Cause Weight Gain?

No, Wellbutrin (bupropion) does not cause weight gain; it is actually the only antidepressant that has been consistently shown to promote weight loss. 1

Effects of Bupropion on Weight

• Bupropion is a norepinephrine and dopamine reuptake inhibitor that has been shown to consistently promote weight loss rather than weight gain 1
• Clinical trials have demonstrated that bupropion decreases body weight by suppressing appetite and reducing food cravings 1
• Bupropion is the only antidepressant with a consistent weight loss profile, in contrast to many other antidepressants that commonly cause weight gain 1
• In fact, bupropion is included as an active ingredient in the FDA-approved weight management medication Contrave (naltrexone/bupropion) 1

Clinical Evidence Supporting Weight Loss Effects

• In a 24-week study, subjects taking bupropion SR 300 mg/day experienced an average weight loss of 7.2% of initial body weight, while those taking 400 mg/day lost 10.1% 2
• In an 8-week randomized controlled trial, overweight and obese women taking bupropion achieved a mean weight loss of 4.9% compared to only 1.3% in the placebo group 3
• Bupropion has been successfully used to counteract weight gain associated with other medications, such as olanzapine (an antipsychotic known for causing significant weight gain) 4

Comparison with Other Antidepressants

• Many antidepressants, particularly SSRIs like paroxetine and tricyclic antidepressants like amitriptyline, are associated with significant weight gain 1
• Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline may cause initial short-term weight loss but are generally weight-neutral with long-term use 1
• Lithium, mirtazapine, and monoamine oxidase inhibitors are closely associated with weight gain 1
• Bupropion stands out as the only antidepressant consistently shown to promote weight loss 1

Mechanism of Weight Effects

• Bupropion's weight loss effects are attributed to its action as a dopamine and norepinephrine reuptake inhibitor 1
• This mechanism suppresses appetite and reduces food cravings, leading to decreased caloric intake 1
• The weight loss properties of bupropion are significant enough that it was combined with naltrexone to create an FDA-approved weight management medication (Contrave) 1

Potential Side Effects of Bupropion

• Common side effects of bupropion include constipation, nausea, headache, dry mouth, insomnia, and elevated heart rate and blood pressure 1, 5
• Bupropion carries a black box warning regarding the risk of suicidal thoughts/behaviors in young adults younger than 24 years old who have depression 1
• Bupropion is contraindicated in patients with seizure disorders, eating disorders, or during abrupt discontinuation of alcohol or sedatives 1
• It should not be used in combination with monoamine oxidase inhibitors (MAOIs) 5

Clinical Applications

• Bupropion may be particularly beneficial for patients with depression who are concerned about weight gain 1
• It can be a good choice for patients who describe food cravings or addictive behaviors related to food 1
• Bupropion may also benefit patients who are trying to quit smoking or reduce alcohol intake 1
• The typical dosing for depression is 150-300 mg daily of the SR formulation or 150-450 mg daily of the XL formulation 6

In conclusion, unlike many other antidepressants, Wellbutrin (bupropion) does not cause weight gain but rather tends to promote modest weight loss in most patients.