“To be pregnant is to be vitally alive, thoroughly woman, and distressingly inhabited. Soul and spirit are stretched – along with body – making pregnancy a time of transition, growth, and profound beginnings.” – Anne Christian Buchanan
Pregnancy is one of the most beautiful experiences a woman ever has in her life. It is also one of the most intense, tedious and daunting time of your life. There is the constant worry about what to eat and what not, whether the medicines I take are going to benefit my baby or harm him/her, and the list just goes on. Here, let’s know about wellbutrin, a medical drug.
Read More: Can I Take Antidepressants During Pregnancy?
A Guide for Wellbutrin while Breastfeeding
What is wellbutrin?
Buproprion is a medication sold under the brand name of wellbutrin and other drugs. Wellbutrin is used as an anti-depressant medication and smoking cessation aid. It acts as an anti-depressant by balancing the role of neurotransmitters in your brain.
What are its side effects?
- Wellbutrin does have quite side effects but your doctor would prescribe you this drug only after analyzing that the benefits outweigh the risks.
- Wellbutrin rarely causes seizures. Immediately consult a doctor if you have a seizure and if the seizure is due to wellbutrin then do not take it again.
- It may cause elevation in blood pressure leading to hypertension.
- Nausea, vomiting, dry mouth, headache, constipation, increased sweating, joint aches, sore throat, blurred vision, strange taste in the mouth, diarrhoea, or dizziness may occur.
- Though uncommon, depression can lead to thoughts or attempts of suicide. Consult your doctor if you are having any suicidal thoughts.
- Mania and psychosis may happen rarely.
- Hypersensitivity reactions can occur.
Is Wellbutrin Safe During Pregnancy?
During pregnancy wellbutrin should be used only when prescribed. Wellbutrin is usually not the first choice of anti-depressant of pharmacists and physicians during pregnancy but it’s prescribed for women who haven’t responded to other anti-depressant medications.
Taking anti-depressants such as wellbutrin during the first and second trimesters of pregnancy are not known to have any profound effect on the baby.
During the third trimester, if the drug is continued the baby may experience drug withdrawal symptoms such as jitters, irritability, etc. The baby may require feeding tube and also face respiratory distress for a month after which it may come back to normal.
Pregnancy outcome of women exposed to bupropion during pregnancy: a prospective comparative study by Chun-Fai-Chan B1, Koren G, Fayez I, Kalra S, Voyer-Lavigne S, Boshier A, Shakir S, Einarson A. The primary objective of this study was to determine whether bupropion increased the risks for major malformations above baseline. The secondary objective was to examine the rates of live births, stillbirths, spontaneous and therapeutic abortions, mean birth weight, and gestational age at birth.
The results suggested that Buproprion did not increase the rates of major malformation above baseline. The higher rates of spontaneous abortions are similar to other studies examining the safety of antidepressants during pregnancy.
Thus, wellbutrin similar to other anti-depressants raised the risks for spontaneous abortions during pregnancy.
Is Wellbutrin safe during breastfeeding?
Buproprion can pass into the breast milk and while nursing it can pass to the baby. In some cases at least two metabolites of Buproprion get accumulated in the plasma of the infant while in one such case neither of the two metabolites were detected in the infant’s plasma.
Breastfeeding while taking bupropion is generally not harmful for most babies. The small amount of bupropion that is passed through breast milk may have a profound impact on premature infants or babies with other complications.
In some women, bupropion can reduce the amount of milk their bodies make.
It is not generally expected to cause adverse effects in breastfed infants; however, there are case reports of possible seizure in infants prone to seizures. Seizures were stopped once the mother stopped taking Buproprion. In such a case, either of the two options has to be considered –
- Buproprion has to be replaced by another anti-depressant such as nortriptyline, paroxetine, and sertraline.
- Nursing has to be discontinued if the mother does not respond to any other anti-depressant medication.
In any case you notice a slight deviation from normal whether in your body or your baby’s, consult your physician or pharmacist immediately.
Precautions to be considered while taking wellbutrin
- Taking drugs containing monoamine oxidase inhibitors (MAO) along with wellbutrin leads to serious drug interactions and can prove to be fatal. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication.
Thus, it is important to notify your doctor of all the drugs you take before taking a prescription for a new drug.
- Sudden increase in the dosage of wellbutrin (i.e. when dosage is increased to 300 mg per day in the first three days of consumption) can lead to seizures and other neuropsychiatric symptoms.
Dosage of wellbutrin to be considered
The recommended starting dose is 200 mg per day, given as 100 mg twice daily.
After 3 days of dosing, the dose may be increased to 300 mg per day, given as 100 mg 3 times daily, with at least 6 hours between successive doses.
Wellbutrin is thus used as an anti-depressant and smoking cessation aid. Although, not the first line of treatment for depression, it is used in cases when other medications fail to show any prognosis. During pregnancy, there aren’t enough studies to show any profound side effects in the baby. During breastfeeding, wellbutrin can cause seizures in infants prone to seizures. In such cases, either a substitute to wellbutrin has to be prescribed or nursing has to be stopped.