Can bupropion (Wellbutrin) increase libido in females?

From the Guidelines

Bupropion can increase libido in females, although the evidence is limited and based on off-label use.

Evidence for Bupropion

• The NCCN guidelines suggest that bupropion may be considered as an option for survivors with hypoactive sexual desire disorder (HSDD) 1, 2.
• Both studies mention that bupropion has been studied in a few trials involving noncancer populations, but despite limited safety and efficacy data, it may be an option for survivors with HSDD.
• It is worth noting that bupropion is not FDA-approved for this indication, and more research is needed to fully understand its effectiveness and safety in this context.

Comparison to Other Options

• Other options for HSDD in females include flibanserin, bremelanotide, and ospemifene, which have more established safety and efficacy data 1, 2.
• However, bupropion may still be considered as an option, particularly in cases where other treatments are not effective or tolerated.

Clinical Considerations

• When considering bupropion for HSDD, clinicians should weigh the potential benefits against the limited evidence and potential risks, and discuss the options with patients to determine the best course of treatment.

From the Research

Bupropion and Libido in Females

• Bupropion has been studied as a potential treatment for hypoactive sexual desire disorder (HSDD) in females, with some studies suggesting it may be effective in increasing libido 3, 4, 5, 6.
• A systematic review and meta-analysis found that bupropion was almost three-fold more favorable in improving problems with sexual desire in women with HSDD, with lower dosages (150 mg) showing better improvement than higher dosages (300 mg) 3.
• Clinical trials have shown that bupropion sustained release (SR) can improve sexual desire and functioning in premenopausal women with HSDD, with response rates ranging from 29% to 65.3% 4, 5, 6.
• Studies have used various measures to assess sexual function, including the Brief Index of Sexual Functioning for Women (BISF-W), the Personal Distress Scale (PDS), and the Changes in Sexual Functioning Questionnaire, with bupropion showing significant effects on increasing measures of sexual arousal, orgasm completion, and sexual satisfaction 5, 6.
• While some studies have found no significant difference in sexual function between bupropion and placebo in women, others have suggested that bupropion may be an effective treatment option for HSDD in ovulating women 4, 5, 7.