Common Side Effects of Wellbutrin (Bupropion) 150 mg XR
The most common side effects of Wellbutrin XR 150 mg include insomnia, dry mouth, headache, nausea, constipation, dizziness, and anxiety. 1
Most Frequently Reported Side Effects
According to the FDA drug label, patients taking bupropion extended-release most commonly experience: 1
- Insomnia (trouble sleeping) – This is the most prominent side effect and occurs frequently enough that the FDA recommends not taking the medication too close to bedtime 1
- Dry mouth – Reported as one of the most common adverse events across all formulations 2, 3
- Headache – Frequently reported in clinical trials 2, 4
- Nausea – Common gastrointestinal effect, though slightly less frequent than with SSRIs 2, 5
- Constipation – A recognized gastrointestinal side effect 2, 1
- Dizziness – Common neurological effect 2, 1
- Anxiety/feeling anxious – May overlap with nicotine withdrawal symptoms in smoking cessation trials 1, 4
Additional Common Effects
- Stuffy nose – Listed in the FDA label as a common side effect 1
- Joint aches – Noted in the official prescribing information 1
- Tremor – A neurological effect reported in clinical experience 2
Cardiovascular Effects
- Tachycardia (rapid heart rate) and palpitations occur in approximately 12% of patients with therapeutic errors, though serious dysrhythmias are rare 2, 6
- Blood pressure and heart rate should be monitored periodically, especially during the first 12 weeks of treatment 7, 2
Important Clinical Context
Most common side effects are generally mild and transient, often resolving within the first few weeks without intervention. 4 In clinical trials, only 6–12% of patients discontinued bupropion due to adverse events, indicating good overall tolerability. 4
Key Management Points
- For insomnia: Take the dose in the morning and avoid late-day dosing 7, 1
- For dry mouth and constipation: These effects are typically manageable and may diminish over time 3, 4
- Dose reduction can address bothersome side effects if they persist 4
Serious but Rare Side Effects to Monitor
While not "common," patients should be aware of: 2, 1
- Seizures – Occur in approximately 0.1% (1 in 1,000) at the 300 mg/day dose when patients are properly screened 7, 4
- Allergic reactions (urticaria, angioedema) – Approximately 0.1% incidence 7
- Suicidal thoughts – Particularly in patients under 24 years, highest risk in first 1–2 months 7, 2
Advantages Over Other Antidepressants
Bupropion has significantly lower rates of sexual dysfunction and weight gain compared to SSRIs, making it advantageous for patients concerned about these effects. 7, 8, 3 In fact, bupropion may cause minimal weight gain or even modest weight loss. 7