Is Wellbutrin (Bupropion) Safe During Pregnancy?

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Wellbutrin is a brand name for the generic antidepressant drug Bupropion. This drug may also be prescribed for smoking cessation (under the brand name Zyban). Wellbutrin modulates the function of certain natural substances in the brain (neurotransmittersⁱXChemical messengers in the brain that send signals throughout the body to carry out its vital functions) to help people with major depressive disorder (MDD) (1).

So can you take Wellbutrin while pregnant? This post explains the safety aspects of Wellbutrin (Bupropion) During Pregnancy, possible side effects, and the precautions to follow before taking this medicine.

Is Wellbutrin Safe During Pregnancy?

The US Food and Drug Administration (FDA) lists Wellbutrin under pregnancy category C (fetal toxicityⁱXPossible adverse effects of a substance or a factor on the developing fetus during pregnancywas shown in animal reproduction studies, whereas there are no adequate and well-controlled studies in pregnant women). FDA advises,“Wellbutrin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus”(2).

How Does Wellbutrin Work?

The mechanism of antidepressant action of Bupropion is not clearly known. The drug may increase the availability of neurotransmittersdopamineⁱXA chemical that transport messages among nerve cells and also acts as a hormone that induces happiness and motivationand, to a lesser extent,noradrenaline (norepinephrine)ⁱXA chemical messenger that also acts as a hormone and regulates blood pressure, mental abilities, and physiological response during stressin the brain. A liver enzyme, CYP2B6, converts Bupropion to hydroxy bupropion, which is also active and reinforces the action of the drug (3).

Does Taking Wellbutrin In The First Trimester Increase The Risk Of Birth Defects?

There is very little safety data about Wellbutrin and pregnancy. Some scientific studies show no association between Wellbutrin use during early pregnancy and increased risk ofcongenital malformationsⁱXStructural or functional abnormalities present since birthor disabilities, while others show potential risks (4).

• In 2006, first-trimester exposure to Bupropion was seen to causecongenitalcardiac anomalies(congenital defects of the heart). However, a 2007 study did not support the observations.
• In 2010, mothers exposed to Bupropion during the first trimester were found to be at a higher risk of giving birth to infants withcongenital left ventricular outflow tract obstruction (LVOTO)ⁱXA defect in the heart that limits the flow of blood out of the left ventricle (a main chamber of the heart).
• Another study in 2010 showed an association between Bupropion exposure, especially in thesecond trimester, and an increased risk ofattention-deficit hyperactivity disorder (ADHD)ⁱXA chronic condition of childhood characterized by inattentiveness, hyperactivity, and impulsive behaviorsin the offspring (5).
• In 2012, a study from the Slone Epidemiology Center at Boston University suggested an increasedrisk forventricular septal defect (VSD)ⁱXA heart condition in which there is an opening in the wall of the lower heart chambers (ventricles)in newborns whose mothers took Bupropion in early pregnancy.

All the studies showed low absolute risk and had certain limitations, making them inconclusive. Current evidence suggests that Bupropion may be a reasonable treatment option for depressed pregnant women who require therapy and those who wish to reduce nicotine consumption (smoking) during pregnancy (6).

Does Taking Wellbutrin Increase The Risk Of Spontaneous Abortion (Miscarriage)?

Adequate human studies are not available to confirm whether or not Wellbutrin increases the risk of miscarriages.A study on 136 women exposed to Bupropion during the first trimester of pregnancy showed a higher risk of spontaneous abortion. However, prenatal depression is itself a risk factor formanbetx3.0安卓下载 . Hence, you should talk to your doctor regarding the risks and benefits (6) (7).

What Are The Side Effects Of Wellbutrin?

The drug’s action on neurotransmitters may cause side effects in more than 10% of its users. The side effects may include the following (3).

• Tachycardia(increased heart rate)
• Rhinitis (irritation in the nasal passage)

• Pharyngitis (inflammation of the pharynx)
• Headache
• Sleep problems
• Agitation
• Diaphoresis (excessive sweating)
• Weight loss
• Dry mouth
• Constipation
• Nausea
• Tremor
• Blurred vision

More serious adverse reactions, which you should immediately inform your doctor are (1):

• SeizuresⁱXSudden and abnormal surges of electrical activity in the brain characterized by jerking body movements and loss of consciousness
• Worsening of suicidal thoughts
• An allergic reaction such as hives, itching, difficulty breathing, swelling of face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

Sudden stoppage of the medication may produce withdrawal symptoms, including (4):

• Agitation and abnormalities in mental status
• Nausea and vomiting
• Seizure
• Headache
• Sleep disturbances
• Rash

These events may also occur at doses exceeding the recommended daily dose. Therefore it is necessary to exercise caution while taking this medication.

有哪些预防措施之前,While Taking Wellbutrin?

Pregnancy causes changes in the body’s hormonal, metabolic, and psychological status, requiring dosage adjustment of drugs. Talk to your physician if you are or plan to be pregnant while already on Wellbutrin. Other precautions that you may take include the following (8).

• Make sure you inform your doctor about all medications, dietary supplements, or herbal products that you are taking tominimize drug interactions.
• Take the Wellbutrin (Bupropion) dose exactly as directed by your doctor. Feel free to discuss anyside effectsto avoid any adverse outcome.
• The FDA has warned that antidepressants may cause worseningsuicidal ideation. Inform your mental health provider about any family history of suicide or bipolar disorder (2).
• The drug may increase yourrisk of having seizures. Inform your healthcare provider if you have had seizures before.
• Do not abruptly stop taking the medication without consulting your doctor. It may causewithdrawal symptoms.
• Some patients may experience restlessness, agitation, anxiety, and insomnia during the initial treatment. It is advised that the caretakers and family members be aware of the risks associated with the treatment

• Discusscombination therapywith counseling and behavioral therapy with your healthcare provider to minimize the dose of medication.

• Cessation of smoking is necessary for the well-being of the mother and baby. There are many support groups available for cessation of smoking, which could be tried as an alternative to medicines like Wellbutrin. Talk to your doctor to know your options.

Treating depression is necessary during pregnancy because, if untreated, it may contribute to adverse outcomes such as preterm labor, low birth weight, fetal growth restriction, and postnatal complications (12). Wellbutrin or Bupropion acts differently from other commonly prescribed antidepressant medications as it does not affect the functioning of the neurotransmitterserotoninⁱXA molecule secreted in the brain that transports messages from nerve cells and helps regulate mood, sleep, and appetite. It may be of theoretical importance in pregnancy as altered serotonin systems in fetal brains are often linked to adverse developmental effects (6). However, it is essential to discuss with your doctor the risks and benefits of the drug, including whether you can take Wellbutrin while pregnant for a safe and healthy pregnancy.

Pregnant and feeling down? Learn about the safest antidepressant to take during pregnancy in this informative video!

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