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After delivery, a few mothers may slip into depression due to the additional responsibilities with an infant. As a result, doctors may prescribe an antidepressant, Bupropion, marketed under Wellbutrin. If you wonder if this drug is safe, this post on “Wellbutrin while breastfeeding” answers your query. A small amount of Wellbutrin may reach the baby through the breastmilk, and this could concern a few mothers, making them stop their intake. Thus, taking expert recommendations and learning more about the drug and its side effects can help you decide better. Here’s all you need to know about it when nursing and a few tips for safe intake to ensure your overall well-being.
Key Pointers
- Wellbutrin is an antidepressant drug that heightens mood and reduces the symptoms of seasonal affective disorders or depression.
- Wellbutrin is safe to consume while breastfeeding as it enters the breast milk in small portions.
- However, mothers must observe their baby for side effects such as sedation, mood changes, feeding problems, and weight changes.
- It is best to consult a doctor for proper guidance on dosages and adverse effects of the medication.
What is Wellbutrin?
Wellbutrin, the drug name being bupropion, is a medication indicated for the treatment of seasonal affective disorder and depression.
Bupropion is also available under the trade names Zyban, Forfivo XL, Buproban, Budeprion and Aplenzin.
The medication is available as Wellbutrin, Wellbutrin XL and Wellbutrin SR, and the generic bupropion. They vary in the way the chemical enters the body. For instance, Wellbutrin, Zyban and generic bupropion are classified under “immediate release” bupropion, Wellbutrin SR as “intermediate release” and Wellbutrin XL as “extended release”.
What do these various ‘releases’ mean? Immediate release means that the formulation of the drug is released into the bloodstream immediately, for a short span. The SR formulation mixes in the blood gradually in 12 hours while XL takes 24 hours.
Wellbutrin belongs to the antidepressant class of drugs called norepinephrine-dopamineiA chemical made in the brain that acts as a messenger for various body functions and is involved in mood regulation. reuptake inhibitors (NDRI). These help in balancing the levels of dopamine and norepinephrineiA compound acting as a hormone and a chemical messenger to regulate body functions and emotional responses. , the neurotransmittersiChemical messengers in the brain that send signals throughout the body to carry out different functions. neurotransmittersi in the brain that enhance your mood and mental health (1).
Keep reading to learn if a breastfeeding mother can have it as an anti-depressant.
Is Wellbutrin Safe While Breastfeeding?
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Yes, in most cases, Bupropion may not harm neonatal health, as the drug enters the breast milk in small amounts. A nursing mother need not stop breastfeeding her baby while taking the drug. However, make sure to check for any reactions in your baby. If you notice symptoms such as vomiting, sedation, diarrhea, and jitteriness, take your baby to the doctor for assessment. Measuring serum levels may rule out toxicity concerns.
According to Dr. Hale of Hale’s Medications & Mothers’ Milk, Wellbutrin is considered an L3 – Limited Data-Probably Compatible. Hale uses a system from L1 through L5, with L1 being the safest to take when breastfeeding and L5 being the least safe. Since Wellbutrin is considered an L3, one should observe the baby for any signs of sedation, irritability, seizures, not waking up to feed/ poor feeding and weight gain.
Sarah, a mother who experienced extreme emotional turmoil and rage postpartum, shares, “First, we increased my dosage of Wellbutrin. The next thing was entirely my choice. I decided to end my nursing journey and continue breastfeeding by exclusively pumping for my daughter. I had not realized how badly my inability to get her to latch and nurse was affecting me. I felt like such a failure because I was not having a beautiful, magical breastfeeding experience like so many women told me I would. My mental health was more important than Lydia getting breastmilk by nursing. Once I began exclusively bottle feeding and pumping, I noticed a huge improvement in my mood. By the time I adjusted to the increase in my Wellbutrin, my uncontrollable anger was much more manageable. I was finally calm and less quick to snap over silly little things. I stopped wanting to hurt myself. It was like the fog was lifted, and I could see clearly again (i).”
What Does Research Say?
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Research reveals that an average of 0.2% of the maternal weight-adjusted dosage of bupropion and 2% of the maternal weight-adjusted dosage of bupropion plus metabolites is received by an infant on exclusive breastfeeding (2).
In an uncontrolled online survey conducted on 930 nursing mothers on the antidepressant, nearly 10% infants displayed infant drug discontinuation symptoms such as uncontrollable crying, low body temperature, irritability, eating and sleeping disorders. The discontinuation symptoms were less noticed in babies whose mothers used antidepressants only while nursing, compared to those who had them even during pregnancy (3).
One report showed that a baby exposed to bupropion had seizures (4). As the mother stopped the drug, the seizures too stopped.
While research shows the impact on the baby, the mother too has the risk of facing side effects.
Quick factSide Effects Of Taking Wellbutrin While Breastfeeding
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According to Dr. Hale, some of the common side effects are headache, restlessness, agitation, sleep disturbances, seizures, blurred vision, dry mouth, tachycardiaiA medical term for fast heart rates due to stress, smoking, excess caffeine, or heart problems. , nausea, and constipation or diarrhea. Use is contraindicated in patients with seizure disorders. Seek immediate medical advice if you have any side effects after taking medicine.
Quick factIs there a way you can reduce the effect of the drug on yourself and your baby?
Care To Be Taken While Taking Bupropion
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Follow these simple measures to mitigate side effects for you and your baby.
- Inform the doctor about any other health issues such as hypertension, bipolar disorderiThe psychological condition that makes the person experience severe mood swings and behavioral changes. , heart disease, seizures, spinal cord or brain tumors or liver disease, before starting Wellbutrin. Also, tell him if you have taken a Monoamine oxidase inhibitors (MAOI) within the last two weeks, as Wellbutrin is not compatible with MAOIs.
- A sudden withdrawal of bupropion may lead to withdrawal symptoms like dizziness, anxiety, nervousness, and stomach upset. Thus, experts suggest gradual withdrawal of the drug after discussing it with the doctor.
- Due to the pharmacokinetics of this drug, it may reduce the quantity of milk in some nursing mothers. If you notice such a thing, talk to your doctor immediately. Also, if you have any concerns about its effects on your infant, discuss them with your doctor and look for alternative treatments. They may recommend alternative drugs such as nortriptyline, paroxetine, and sertraline.
Note:
Any drug should be continued or discontinued only with the doctor’s approval.
Frequently Asked Questions
1. Is Wellbutrin pregnancy category B or C medication?
According to the American Academy of Family Physicians (AAFP), Wellbutrin belongs to the B category of medication (5). The United States Food and Drug Administration (FDA) classifies the safety of the drugs into categories such as A, B, C, D, and X. Category B medicines are those drugs that have shown no risk to the fetus in animal studies and have no well-controlled studies in pregnant women (6).
2. Is Wellbutrin a stimulant?
Wellbutrin is an antidepressant that increases a certain type of brain activity, treats conditions such as adult or postpartum depression and seasonal affective disorder, and helps in the cessation of smoking (7). It is also prescribed “off-label” for conditions such as ADHD and bipolar disorder (8).
3. How long does it take for Wellbutrin to get out of my system?
The half-life of a drug is the time a drug stays in the system after reaching its half effectiveness (9). Wellburtin has a half-life of three to four hours. However, when used regularly, its half-life increases to 21 hours (10). Therefore, depending on how many doses of Wellbutrin you consume, it will take a few days to weeks to completely get out of your system.
4. How will I know if Wellbutrin is working or not?
After starting Wellbutrin, you may notice an improvement in sleep, energy, or appetite in about one to two weeks. These could be early signs that your medication is working. However, it may take up to six to eight weeks to see an improvement in mood and interest in activities (12).
5. Are there any long-term effects of consuming Wellbutrin?
Currently, the available medical research deos not indicate any long-term ill-effects of consuming Wellbutrin.
Wellbutrin is an antidepressant used to treat depressive or mood disorders. Consuming Wellbutrin during lactation or breastfeeding under medical guidance is safe in most cases. However, some studies indicate that the drug may cause side effects, such as uncontrolled crying and irritability in babies. These studies also highlight that Wellbutrin use may increase the risk of seizures in nursing babies. Hence, breastfeeding mothers should only take the drug after consulting their healthcare provider. The doctor will evaluate infant and maternal health and prescribe an appropriate drug dose.
Infographic: Side Effects Of Wellbutrin While Breastfeeding
Wellbutrin is a commonly prescribed medication for treating depression, anxiety, and other conditions. If you have been prescribed the drug while breastfeeding, it is important to be aware of its potential side effects so that it may not affect your baby’s care and nursing schedule. Illustration: Momjunction Design Team
Learn about bupropion nursing considerations, side effects, and mechanism of action pharmacology for nurses. This video has a few facts to help you.
Personal Experience: Source
MomJunction articles include first-hand experiences to provide you with better insights through real-life narratives. Here are the sources of personal accounts referenced in this article.
i. Rage: the PPD symptom no one talks about.https://granitestatemama.wordpress.com/2020/08/03/rage-the-ppd-symptom-no-one-talks-about/
References
- Bupropion (Wellbutrin®).
https://mothertobaby.org/fact-sheets/bupropion-wellbutrin-pregnancy/ - J S Haas et al. (2004); Bupropion in breast milk: an exposure assessment for potential treatment to prevent post-partum tobacco use.
https://pubmed.ncbi.nlm.nih.gov/14985597/ - Thomas W Hale et al. (2010); Discontinuation syndrome in newborns whose mothers took antidepressants while pregnant or breastfeeding.
https://pubmed.ncbi.nlm.nih.gov/20807106/ - Gal Neuman et al. (2014); Bupropion and Escitalopram During Lactation.
https://pubmed.ncbi.nlm.nih.gov/24732787/ - ACOG Guidelines on Psychiatric Medication Use During Pregnancy and Lactation.
https://www.aafp.org/pubs/afp/issues/2008/0915/p772.html - FDA Pregnancy Categories.
https://chemm.hhs.gov/pregnancycategories.htm - Bupropion: Important Patient Information.
https://www.urmc.rochester.edu/medialibraries/urmcmedia/medicine/general-medicine/patientcare/documents/Buproprion_Brochure_Depression.pdf - Bupropion (Wellbutrin).
https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Bupropion-(Wellbutrin) - Jericho Hallare and Valerie Gerriets; (2022); Half Life.
https://www.ncbi.nlm.nih.gov/books/NBK554498/ - Martin R. Huecker et al.; (2022); Bupropion.
https://www.ncbi.nlm.nih.gov/books/NBK470212/ - Bupropion
https://www.ncbi.nlm.nih.gov/books/NBK501184/ - Bupropion (Wellbutrin)
https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Bupropion-(Wellbutrin)#:~:text=Sleep%2C%20energy%2C%20or%20appetite%20may,8%20weeks%20to%20fully%20improve.
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