In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. This sheet talks about whether exposure to bupropion may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider.
What is bupropion?
Bupropion is a medication used to treat depression and seasonal affective disorder. It is marketed under the trade name Wellbutrin®. Bupropion is also sold under the trade name Zyban® as an aid to quit smoking. Bupropion belongs to the class of antidepressants known as norepinephrine-dopamine reuptake inhibitors (NDRI), which help balance the levels of norepinephrine and dopamine in the brain.
I am taking bupropion, but I would like to stop taking it before becoming pregnant. How long does bupropion stay in my body?
While it can vary from person to person, buproprion is generally gone from the body three days after the last dose. Pregnant women who suddenly stop taking their antidepressants are at risk for physical and psychological symptoms. Symptoms may include: dizziness, stomach upset, and nervousness or anxiety. If a woman plans to stop taking her bupropion, it is recommended that this be done slowly over time. If you are considering coming off your treatment with bupropion, please talk with your health care provider to decide if the benefits of not taking this medication during pregnancy outweigh the chance of your symptoms returning.
Can bupropion make it more difficult for me to become pregnant?
Infertility was not seen in rat studies. There are no studies that look specifically at fertility in women taking bupropion. Two cases have been reported of irregular menstrual cycles linked to bupropion use. However, these case reports did not mention fertility problems.
Does bupropion use increase the risk for miscarriage?
One study reported miscarriages occur more often in pregnant women taking bupropion as compared to women not taking this medication. However, the rate of miscarriage in women taking bupropion was not above what is considered to be the background rate for miscarriage in the general population.
Can taking bupropion during my pregnancy cause birth defects?
One study has suggested a weak association between first trimester exposure and heart defects. The design of this study does not allow a conclusion to be drawn. In contrast, the manufacturer’s pregnancy registry reported there was not an increased chance for major birth defects among over 1,000 pregnancies with first trimester exposure to bupropion. Other studies involving over 1,300 pregnancies exposed to bupropion in the first trimester also showed no increase in the rates of birth defects when bupropion was taken during pregnancy. Therefore, it is unlikely that using bupropion during pregnancy would increase the chance for birth defects over a background risk.
Should I stop taking bupropion when I find out I am pregnant? What about weaning off bupropion before the third trimester?
In pregnant women who have untreated depression, there are reports of a greater chance for miscarriage and preterm delivery, as well as babies born with complications or low birth weight. Untreated depression in pregnancy can continue after delivery as postpartum depression, which is a serious condition that should be treated.
Your health care provider should be involved in your decision of whether or not to stop antidepressant therapy. If you choose to stop your medication, your health care provider can help you wean off it in a slow and controlled manner.
I need to take bupropion throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby?
There are no reports of third trimester exposure to bupropion and withdrawal symptoms in babies. Some infants whose mothers took other antidepressants near the end of pregnancy have had withdrawal symptoms like irritability, jitteriness, sleep disturbances, or eating difficulties. These symptoms usually go away within a few days to two weeks. It is important to decide with your health care provider whether the treatment of depression with bupropion offsets the chance of potential symptoms in the newborn.
Will taking bupropion have any long-term effect on my baby’s behavior and development?
There is very little known about long term effects on children exposed to bupropion during pregnancy. One study has suggested an association between prenatal exposure to bupropion and attention deficit hyperactivity disorder (ADHD). There are many factors that contribute to ADHD and further study is needed before a conclusion can be made. Presently, we do not know if taking bupropion during pregnancy would have any long term effects on learning and behavior.
Can I take bupropion while breastfeeding?
Please talk to your health care provider if you need to take bupropion while breastfeeding. Bupropion is found in breast milk. A mother taking the recommended dosage of bupropion passes only a small amount of the drug to an infant. Breastfeeding while taking bupropion should not be harmful for most babies.
Bupropion can bring on seizures in individuals prone to them. There is a report of one baby exposed to bupropion through breast milk who then had seizures. The seizures stopped when the mother stopped taking bupropion. The small amount of bupropion passed through breast milk may have more impact on premature infants or babies with other complications. More studies are needed to better focus on this area.
In some women, bupropion can reduce the amount of milk their bodies make. If you notice this, please tell your health care provider. Be sure to talk to your health care provider about all your choices for breastfeeding.
What if the father of the baby takes bupropion?
There are no studies looking at possible risks to a pregnancy when the father takes bupropion. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at: http://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
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