Can Wellbutrin Cause Constipation?
Yes, Wellbutrin (bupropion) commonly causes constipation as a recognized gastrointestinal side effect across all formulations.
Evidence from Guidelines and FDA Labeling
Constipation is consistently identified as one of the most common adverse effects of bupropion across multiple authoritative sources. The American College of Physicians guidelines explicitly list constipation among the most commonly reported adverse events with second-generation antidepressants, including bupropion 1. The American Diabetes Association specifically identifies constipation as a common side effect when bupropion is used in combination therapy 2.
The FDA drug label for bupropion documents constipation occurring in clinical trials, though specific incidence rates vary by formulation and indication 3. Multiple medical societies acknowledge that bupropion commonly causes gastrointestinal effects including constipation, along with dry mouth, nausea, and vomiting 2.
Clinical Significance and Frequency
Constipation occurs frequently enough to warrant routine counseling when prescribing bupropion. The side effect is listed among primary common adverse effects across multiple authoritative sources 2. In comparative studies, sertraline had a higher rate of diarrhea than bupropion, suggesting bupropion's gastrointestinal profile may lean more toward constipation than diarrhea 1.
Research literature confirms these findings, with comprehensive reviews identifying constipation as one of the most common adverse events alongside headache, dry mouth, nausea, insomnia, and dizziness 4, 5.
Severe Cases and Clinical Management
While typically mild, constipation from bupropion can occasionally become severe enough to require intervention or discontinuation. A documented case report describes a 38-year-old man who developed severe constipation with inflamed hemorrhoids requiring hemorrhoidectomy surgery after starting extended-release bupropion 150 mg daily 6. The constipation completely resolved after discontinuation of bupropion, establishing a clear causal relationship 6.
Important Clinical Considerations
- Monitor patients for constipation development, particularly in the first few weeks of therapy when gastrointestinal side effects are most prominent 6
- Recommend preventive measures including increased fluid intake, dietary fiber supplementation, and regular exercise when initiating bupropion 6
- Consider stool softeners (such as docusate sodium) if constipation develops 6
- Evaluate for discontinuation if constipation becomes severe or unresponsive to conservative management, as the side effect is dose-related and reversible 6
The constipation risk should be weighed against bupropion's favorable profile in other areas, particularly its lower incidence of sexual dysfunction and weight gain compared to SSRIs 4.