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Sleepy on wellbutrin


Can Wellbutrin Trigger or Worsen Insomnia?

Written by
Dr. R. Y. Langham

Medically Reviewed by
Dr Katherine Hall

Fact Checked

Yes, it is possible that Wellbutrin may trigger or worsen your insomnia.

Nineteen percent of people taking Wellbutrin, 6% of people taking Wellbutrin SR (sustained-release), and 7% of those taking Wellbutrin XL (extended-release) grapple with insomnia.

When sleep eludes you almost every night, you eventually become desperate for relief. Sometimes, this “sleeplessness” stems from a health condition or injury and other times, it stems from stress, medication side-effects, insomnia or a circadian rhythm disorder, pregnancy, anxiety, or depression. Yet, sometimes, there is no “official” reason why you can’t sleep at night.

Regardless of the origin, when you’ve been struggling with an inability to get sound sleep, any sign of respite can feel like a blessing. But what happens when you take a medication, like Wellbutrin, for your mental health and it prevents you from sleeping at night? What if this lack of sleep causes your mental health to decline even further? Struggling with mental health concerns, while suffering from insomnia can make combating mental illness challenging.

If you have concerns about being able to sleep, while taking a form of Wellbutrin (brand or generic), you have come to the right place. This article will provide you with all of the information you need to make an informed decision about your health and well-being.

Content

What is Wellbutrin?

Do I Need a Prescription for Wellbutrin?

How Much of Wellbutrin Should I Take?

How Does Wellbutrin Work?

Is There Anything I Should Consider Before Taking Wellbutrin?

Does Wellbutrin Have Side-Effects?

How is Wellbutrin Different from Other Non-Bupropion Antidepressants?

What is the Relationship between Wellbutrin and Insomnia?

How Long Does the Insomnia Side-Effect of Wellbutrin Last?

How Can I Get Some ZZZ While on Wellbutrin?

Summary

What is Wellbutrin?

Bupropion, also referred to by the brand name, Wellbutrin, is an atypical antidepressant used to treat major depressive disorder, bipolar disorder, attention-deficit hyperactivity disorder (ADHD), binge-eating disorder, and seasonal affective disorder (SAD). It is also used to help smokers quit the habit.

Bupropion is also marketed under the following labels: Wellbutrin SR, Wellbutrin XL, Zyban, Aplenzin, Budeprion SR, Budeprion XL, Buproban, Forfivo XL, and bupropion hydrochloride. Although, Wellbutrin can effectively treat conditions that involve mental health by itself, it is often combined with other psychotropic medications when a person has not experienced success with other first-line antidepressants, like SSRIs (selective-serotonin reuptake inhibitors).

Do I Need a Prescription for Wellbutrin?

Yes, you will need a prescription from your doctor for Wellbutrin.

How Much of Wellbutrin Should I Take?

The dosage varies from person-to-person, depending on the purpose. Thus, it is imperative that you follow your doctor’s instructions when taking this medication. Listed below are the typical dosages for Wellbutrin for specific uses. Ultimately, your doctor will determine the correct dosage for your condition.

Wellbutrin (tablets)

Depression

Doctors may initially prescribe 100mg twice-a-day for adults, struggling with depression. This dosage can be tweaked, as needed. However, the dosage should not exceed 150mg, 3x per day. The doses should be taken 6 hours apart. The dosage for children will vary and should be determined by your child’s pediatrician.

Wellbutrin XL (extended-release tablets)

Depression

Doctors may initially prescribe 150mg once-a-day each morning for adults, struggling with depression. This dosage can be tweaked, as needed. However, the dosage should not exceed 450mg, per day. The dosage for children will vary and should be determined by your child’s pediatrician.

Seasonal Affective Disorder (SAD)

Doctors may initially prescribe 150mg once-a-day each morning for adults, struggling with SAD. This dosage can be tweaked, as needed. However, the dose should not exceed 300mg, per day. The dosage for children will vary and should be determined by your child’s pediatrician.

Wellbutrin SR (sustained-release tablets)

Depression

Doctors may initially prescribe 150mg once-a-day each morning for adults, struggling with depression. This dosage can be tweaked, as needed. However, the dose should not exceed 200mg, per day. This dosage should be taken 8 hours apart. The dosage for children will vary and should be determined by your child’s pediatrician.

Smoking Cessation

Doctors may initially prescribe 150mg once-a-day each morning (for 3 days) for adults, wanting to stop smoking. This dosage can be tweaked, as needed. However, the dose should not exceed 300mg, per day. The dosage should be taken 8 hours apart. The dosage for teens will vary and should be determined by his or her pediatrician.

How Does Wellbutrin Work?

Experts aren’t exactly sure how Wellbutrin works.

Wellbutrin is an antidepressant that is typically prescribed to treat some form of clinical depression (major depressive disorder, bipolar disorder, and season-affective disorder). However, researchers are stumped as to how it works in the body. Still, the general consensus is that it prevents your brain from tapping into your body’s norepinephrine and dopamine reserves. Norepinephrine and dopamine are neurotransmitters/hormones responsible for stimulating your brain. This medication stops your racing and disturbing thoughts, causing your mind to become “quieter.”

Is There Anything I Should Consider Before Taking Wellbutrin?

Yes, there are a few things you should consider before taking Wellbutrin.

  • First, the benefits of taking this medication should outweigh any side-effects. This decision should be made with loved ones and your doctor. It is also important that your doctor regularly monitor you to ensure that it is working properly and not negatively affecting your health overall.
  • Also, alert your doctor of any allergies or allergic reactions to Wellbutrin or other medications, foods, dyes, preservatives, or even animals.
  • Keep in mind that the relationship between Wellbutrin (bupropion) has not been fully defined in young children and teens. However, studies suggest that children are more vulnerable to antidepressant side-effects than adults.

    Thus, most experts warn against using Wellbutrin with these populations. Still, some pediatricians prescribe Wellbutrin to children and teens, suffering from depression under strict monitoring. Studies on the safety, guidelines, and effectiveness of using Wellbutrin to help teens stop smoking have been limited and inconclusive.

  • There are currently no studies on using Wellbutrin in the elderly population for age-related depression. Thus, older adults should avoid this medication unless deemed absolutely necessary.

    It is important to understand that elderly patients are more likely to have age-related health conditions (i.e. kidney disease or liver problems) that may worsen with this medication. This population may also have an increased vulnerability to Wellbutrin side-effects. For these reasons, if the medication is prescribed to the geriatric population, they must be closely monitored for side-effects and health complications.

  • Studies on treating postpartum depression in breastfeeding women are limited and inconclusive. Thus, it is unknown if this medication is transferred to the baby through the mother’s breastmilk. As a result, the benefits and risks should be thoroughly weighed before giving this medication to nursing mothers.
  • Combining Wellbutrin with other antidepressants and psychotropic medications may increase your risk of side-effects, like insomnia. Thereby, do not take Wellbutrin with monoamine oxidase (MAO) inhibitors like: isocarboxazid or Marplan, linezolid or Zyvox, phenelzine or Nardil, selegiline or Eldepryl, or tranylcypromine or Parnate. So, wait two weeks after you stop a MAO inhibitor to start taking Wellbutrin.

    If you combine Wellbutrin with a MAO inhibitor, you may experience mental confusion, anger and agitation, restlessness, gastrointestinal distress (vomiting, nausea, upset stomach, etc. ), fevers, severe hypertension (high blood pressure) and/or convulsions.

  • Do not take this medication with alcohol, drugs, or any other medication that affects your central nervous system (CNS). Alcohol, drugs and certain medications can intensify the effects of Wellbutrin, leading to confusion, lightheadedness, inattention, daytime grogginess, strange dreams and/or nightmares, and insomnia.

    Examples of medications that affect your CNS include: antihistamines, allergy or colds meds, sedatives, tranquilizers, or sleeping pills, antidepressants, anti-anxiety meds, prescription pain pills or narcotics, ADHD medications, like Ritalin, seizures medications, barbiturates, muscle relaxants, and dental anesthetics (numbing agents).

  • You have an increased risk of becoming anxious, while taking Wellbutrin. You also have a heightened risk of exhibiting uncharacteristic behaviors during this time. It may also cause some people to become extremely depressed and suicidal. Thus, this medication has a “Black Box” label.

    So, alert your doctor if you suddenly have a hard time falling and staying asleep at night, become easily angered or irritated, experience a sudden and abnormal boost in energy, exhibit violent tendencies, or begin to behave impulsively after taking this medication. Also, alert your doctor if you begin to experience suicidal thoughts after starting Wellbutrin.

  • Your blood pressure may rise while you are taking this medication. An elevated blood pressure may lead to headaches, confusion, lightheadedness, and/or blurred vision. Therefore, it is important that you check your blood pressure at least twice a day and call your doctor immediately if it becomes dangerously high.
  • Wellbutrin may trigger anaphylaxis, a life-threatening allergic reaction. So, call your doctor immediately if you experience shortness of breath, chest pain, dizziness, a rash, muscle rigidity, itching of the face or throat, or tongue-swelling.
  • Wellbutrin can also cause skin reactions. So, call your doctor immediately if you experience peeling or blistering skin, red skin sores, rashes, ulcers, or lesions, a severe acne breakout, chills, or a high fever.
  • Wellbutrin may cause daytime drowsiness, inattention, or mental confusion. So, avoid or use caution when driving or operating machinery.
  • Do not stop this medication without consulting your doctor first. You will most likely need to be gradually weaned-off Wellbutrin. Stopping the medication too quickly can lead to vertigo, anxiety and agitation, mood swings, headaches, excessive perspiration, nausea, vomiting, diarrhea, or upset stomach, tremors or shakiness, insomnia, mobility problems, and/or extreme fatigue.
  • Call your doctor immediately if you have stomach pain or tenderness, pale stools, dark or abnormally-colored urine, poor appetite, nausea or vomiting, extreme tiredness, muscle weakness, and/or jaundice (yellow eyes or skin). Wellbutrin can affect your liver.
  • Wellbutrin may cause you to suddenly lose weight. So, monitor your weight loss and alert your doctor if you lose a lot of weight with little-to-no effort.
  • Do not take Wellbutrin with other medications (i.e., prescription, OTC, or supplements) without discussing it with your doctor first. Combining medications may reduce their effectiveness.

Does Wellbutrin Have Side-Effects?

Yes, Wellbutrin is linked to a variety of side-effects, such as:

  • Dry “cotton” mouth
  • Gastrointestinal distress (i.e. nausea, vomiting, upset stomach, constipation, or diarrhea)
  • Poor appetite
  • Chronic insomnia
  • Anxiety and irritability
  • Excessive perspiration (sweating)
  • Hyperventilation
  • Irregular heartbeats
  • Mood swings
  • Restlessness
  • Tremors or shakiness

The following rare, but serious side-effects can also occur:

  • Seizures
  • Liver toxicity or damage
  • Psychosis
  • Overdose or death
  • Congenital heart defects when used during pregnancy
  • Mental confusion
  • Sudden change in behavior
  • Anger and aggressiveness
  • Loss of consciousness
  • Distrust and paranoia
  • Hallucinations and delusions
  • Inattention
  • Buzzing or ringing in the ears
  • Severe headaches or migraines
  • Rashes, hives, and/or severe itching
  • Suicidal ideation (suicidal thoughts or attempts)

Note: According to an FDA report, children, teens, and young adults have an increased risk of suicidal ideation when taking Wellbutrin. Researchers also suggest that older individuals (65+), who take Wellbutrin for age-related depression, have an increased risk of suicidal ideation. Thus, it is important that you call your doctor if you experience suicidal thoughts and behaviors. It is also important that you tell your friends, caregivers, and loved ones that you are taking the medication so they can alert your doctor if they notice a change in your behavior.

How is Wellbutrin Different from Other Non-Bupropion Antidepressants?

Wellbutrin has the lowest risk of sexual dysfunction (i.e., erectile dysfunction, poor libido, premature ejaculation, orgasm dysfunction, vaginal hemorrhage, hormonal fluctuations, or impotence), compared to non-bupropion antidepressants. There is also less of a risk of sleepiness or weight gain with Wellbutrin, and it appears to be more effective at improving hypersomnia and severe fatigue than non-bupropion antidepressants.

What is the Relationship between Wellbutrin and Insomnia?

Wellbutrin was originally developed for people, who have some form of depression. It is now also used for other “off-label” purposes, such as ADHD, eating disorders, and even smoking cessation. This antidepressant “activates” your brain’s neurotransmitters (chemical messengers), so they can more effectively send messages to various parts of your body. Active neurotransmitters can lead to racing thoughts, increased physical activity, chronic insomnia (due to an inability to quiet your thoughts) and poor sleep quality, especially when this medication is taken shortly before bed.

It is important to note that insomnia is a common side-effect of depression and that Wellbutrin may worsen your inability to fall and stay asleep all night. It may also lead to tossing-and-turning and frequent wake-ups throughout the night. So, it is important that you contact your doctor if the insomnia lasts more than a few days, frequently reoccurs, or is worsening. Depending on the severity of your insomnia, your doctor may lower your dose, prescribe a sleep aid to take at night, or change your medication altogether.

Fortunately, many people, who take Wellbutrin, experience an improvement in sleep once their bodies become acclimate to the medication. And, in the case of depression, typically once the depression improves, the insomnia also improves. Thus, determining if the “sleeplessness” is stemming from Wellbutrin or depression can be challenging. As a result, many doctors treat the insomnia as it occurs.

How Long Does the Insomnia Side-Effect of Wellbutrin Last?

If they insomnia is due to Wellbutrin it could, theoretically, last up to 4 weeks (once you have developed a sound sleep routine). However, if they insomnia is due to depression or psychological distress, the insomnia will likely last until your emotional distress (depression or anxiety) improves. In this case, your doctor may try to counteract the insomnia by prescribing sleeping pills or suggesting natural sleep aids (i.e. an online sleep program, reading, establishing a bedtime routine, etc.).

It is important that you refrain from taking Wellbutrin too close to bedtime because there is a strong chance it may affect your ability to fall and stay asleep all night long. However, you may be able to avoid insomnia by taking your medication in the mornings and/or afternoons (if you are prescribed it 2x a day). Your doctor may also prescribe a sleep aid or another antidepressant, like Ambien or Trazodone, to combat the “sleeplessness.”

How Can I Get Some ZZZ While on Wellbutrin?

The truth is insomnia can be an unpleasant problem when you’re taking Wellbutrin or antidepressants, in general. As a result, many doctors prescribe the lowest dose possible. Studies suggest that 150mg of Wellbutrin reduces your risk of side-effects (like insomnia) better than 300mg, Researchers also suggest that Wellbutrin XL produces fewer side-effects (like insomnia), than other forms of Wellbutrin. Still, some people may experience insomnia, regardless of the form of Wellbutrin.

Thankfully, if you experience insomnia after taking Wellbutrin, there are steps that you can take to get the sleep you crave.

These steps are listed below:

  • Establish a consistent bedtime routine – A consistent routine, such as taking a warm bath, turning-off your devices (including the television), reading a book for an hour before bed, and/or turning on soft music or a sound machine before turning off the lights and closing your eyes can send a message to your mind and body that it is time to go to sleep.
  • Read – Reading a slow-paced or mundane book may trigger sleepiness after a while.
  • Complete a jigsaw puzzle – A puzzle (even an online one) may relax you and “tire you out” so you become sleepy.
  • Play Solitaire – The “quietness” and “stillness” of Solitaire can “calm” your mind, so your become relaxed and sleepy.
  • Exercise – Exercising during the day can help you sleep better at night. Exercise can “tire you out,” so you are ready to go to sleep when bedtime rolls around. However, avoid exercising too close to your bedtime because doing so may stimulate you and prevent you from falling asleep.
  • Eat a reasonable time – The worst thing you can do is eat too much too late, especially if you suffer from insomnia. So, try not to eat past 6:30pm or at the very latest, 7:00pm each night. This gives your stomach time to digest your food, so you don’t feel bloated and uncomfortable. You can’t sleep if you are uncomfortable. This time is based on a 10:00pm bedtime. However, you may need to adjust your last meal based on your bedtime. Allow 2-3 hours between your last meal and your bedtime.
  • Turn-off your devices and lights – Turn-off your devices and the lights if you have trouble sleeping. If you have trouble sleeping in total darkness, leave a small nightlight on. Leave your television, smartphone, computer, and/or tablet off because the blue light from these screens can stimulate your mind and prevent you from falling asleep.
  • Say NO to caffeine – Caffeine is a stimulant, as is chocolate, so cut it off a few hours before bed.
  • Engage in an online sleep program – Online sleep programs, like Somnus Therapy, can alter how you view your bedroom, bed, and sleep, in general, so you can get some much-needed zzz. Somnus Therapy uses a variety of techniques, like cognitive-behavioral therapy for insomnia (CBT-I), guided meditation, and visualization to help you relax so you can peacefully drift-off to sleep. The best part about an online sleep program is you can do it in the comfort of your home!
  • Repeat a mantra – Saying a word or phrase over and over again will eventually make you sleepy. The key to success with this tip is to stay focused on the word or phrase.

Summary

Wellbutrin appears to be effective for depression and other “off label” conditions; however, it may not help your sleep quality, if you also suffer from insomnia. In fact, researchers suggest that it could actually trigger insomnia, so it is important to alert your doctor if you experience chronic “sleeplessness.”

References

  • eHealthMe. (2021). Wellbutrin SR and insomnia – A phase IV clinical study of FDA data. Retrieved from https://www.ehealthme.com/ds/wellbutrin-sr/insomnia/
  • eHealthMe. (2021). Wellbutrin XL and insomnia – A phase IV clinical study of FDA data. Retrieved from https://www.ehealthme.com/ds/wellbutrin-xl/insomnia/FDA
  • FDA. (2017). Wellbutrin clinical study. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018644s052lbl.pdf
  • Wiese, B. S. (2011). Geriatric depression: The use of antidepressants in the elderly. BCMJ, 53(7). Retrieved from https://bcmj.org/sites/default/files/public/BCMJ_53_Vol7_depression.pdf
  • Yasin, W., Ahmed, S. I., & Gouthro, R. V. (2019). Does bupropion impact more than mood? A case report and review of the literature. Cureus, 11(3), e4277. Retrieved from https://doi.org/10.7759/cureus.4277
  • Patel, K., Allen, S., Haque, M. N., Angelescu, I., Baumeister, D., & Tracy, D. K. (2016). Bupropion: A systematic review and meta-analysis of effectiveness as an antidepressant. Therapeutic Advances in Psychopharmacology, 6(2), 99–144. Retrieved from https://doi.org/10.1177/2045125316629071

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