Can I use Wellbutrin (bupropion) to keep someone awake all night?

No, Wellbutrin (Bupropion) Should Not Be Used to Keep Someone Awake All Night

Using bupropion to intentionally keep someone awake all night is medically inappropriate and potentially dangerous, as this medication is an activating antidepressant approved only for depression and seasonal affective disorder—not as a wakefulness agent—and combining it with sleep deprivation significantly increases seizure risk. 1, 2

Why This Is Dangerous

Seizure Risk with Sleep Deprivation

• A documented case report describes a generalized tonic-clonic seizure in a patient taking sustained-release bupropion who stayed up nearly all night, with sleep deprivation identified as an additive risk factor for bupropion-associated seizures 2
• The FDA label lists seizures as a serious adverse reaction, and intentional sleep deprivation would compound this risk 1

Bupropion's Mechanism Is Not for Wakefulness Promotion

• Bupropion works through dopamine and norepinephrine reuptake inhibition, making it an "activating" antidepressant that can cause insomnia as a side effect—not a medication designed or approved for promoting wakefulness 3, 1
• The FDA-approved indications are major depressive disorder and seasonal affective disorder only 1, 4

Insomnia as an Adverse Effect (Not Therapeutic Use)

High Incidence of Sleep Disruption

• In clinical trials, insomnia occurred in 11-20% of patients on bupropion sustained-release (300-400 mg/day) compared to 6% on placebo 1
• Nervousness and insomnia are among the most common side effects reported 5

Clinical Management to Minimize Insomnia

• Guidelines explicitly recommend administering the second daily dose before 3 p.m. to reduce insomnia risk 3
• If insomnia develops despite proper timing, dose adjustment or medication change is recommended—not exploitation of this side effect 3

Appropriate Use Context

When Bupropion's Activating Properties Are Therapeutic

• One small case series (4 patients) explored bedtime long-acting bupropion for severe morning sleep inertia in patients with idiopathic hypersomnia—a specific medical condition where the goal was improving morning awakening, not preventing sleep entirely 6
• This represents treatment of a pathological condition under medical supervision, not recreational or non-medical use for staying awake 6

Critical Safety Concerns

Contraindications and Warnings

• The FDA label includes a black box warning about suicidal behavior/ideation risk in patients younger than 24 years with depression 7
• Bupropion is contraindicated in patients with seizure disorders 7, 1
• Intentional sleep deprivation while on bupropion creates an unsafe combination that increases seizure risk beyond baseline 2

Other Adverse Effects

• Central nervous system stimulation, agitation, anxiety, tremor, and irritability occur at rates of 1-9% depending on dose 1
• These effects are considered adverse reactions requiring management, not therapeutic benefits to be exploited 1

The appropriate approach is to address the underlying reason someone believes they need to stay awake all night through proper medical evaluation and evidence-based interventions, not misuse of an antidepressant medication. 7, 3