Genitourinary Effects of Wellbutrin (Bupropion)
Bupropion has minimal direct genitourinary effects and is notably associated with significantly lower rates of sexual dysfunction compared to SSRIs, making it a preferred choice for patients concerned about GU/sexual side effects. 1
Sexual Function Benefits
Bupropion demonstrates a favorable GU profile specifically regarding sexual function:
- Bupropion has the lowest incidence of sexual dysfunction among newer antidepressants, with decreased risk compared to SSRIs like escitalopram and paroxetine 1, 2
- Sexual dysfunction rates are significantly lower with bupropion versus serotonergic antidepressants, representing a key clinical advantage 1
- Bupropion may actually counteract SSRI-induced sexual dysfunction when used as augmentation therapy 1
Limited Evidence for Other GU Effects
The available evidence does not identify significant genitourinary adverse effects beyond sexual function:
- Common side effects include dry mouth, headache, insomnia, nausea, and constipation—but urinary or other GU symptoms are not prominently reported 3, 4, 2
- Bupropion's mechanism involves dopamine and norepinephrine reuptake inhibition without significant serotonergic effects, which explains the lower sexual dysfunction profile 4
Specific GU Consideration: Delayed Ejaculation
One small study examined bupropion for treating primary lifelong delayed ejaculation:
- Bupropion-SR 150 mg daily showed limited benefit for lifelong delayed ejaculation, with only 21% of patients rating ejaculatory control as "fair to good" after 2 months 5
- This represents an off-label use with modest efficacy at best 5
Clinical Implications
For patients with depression or those attempting smoking cessation who are concerned about sexual side effects, bupropion represents an optimal first-line choice due to its minimal impact on sexual function. 1, 2