Does Wellbutrin Raise Blood Pressure?
Yes, Wellbutrin (bupropion) can increase blood pressure, particularly at higher doses or in people with preexisting hypertension. Clinical trials show dose-related elevations: systolic blood pressure rose by an average of 1.3 mmHg at 300 mg/day and 2.5 mmHg at 450 mg/day, with diastolic increases of 0.6 mmHg and 1.9 mmHg, respectively.[1][2] This effect stems from bupropion's action as a norepinephrine-dopamine reuptake inhibitor, which boosts sympathetic nervous system activity and can elevate blood pressure.[3]
How Common Is This Side Effect?
Hypertension occurs in about 4-6% of patients on Wellbutrin, compared to 2-3% on placebo, based on post-marketing data. It's more frequent with the extended-release form (Wellbutrin XL) and in those over 50 or with risk factors like obesity or smoking.[1][4] Seizure risk, another concern, also rises with dose and can indirectly affect blood pressure through stress responses.[2]
Who Should Monitor Blood Pressure Closely?
Patients with hypertension, heart disease, or on blood pressure meds face higher risks—up to 11% incidence in some studies. The FDA label advises baseline and periodic checks, especially during the first weeks or dose increases.[1][5] Avoid combining with MAOIs or stimulants, as this amplifies pressor effects.[3]
What If You Already Have High Blood Pressure?
Wellbutrin is not contraindicated but requires caution. Studies in hypertensive patients show manageable increases (e.g., 3-5 mmHg systolic), often controlled by adjusting antihypertensives like ACE inhibitors.[6] Report readings over 140/90 mmHg to a doctor; discontinuation reverses changes within days.[2]
How Does It Compare to Other Antidepressants?
Unlike SSRIs (e.g., Prozac, which rarely affects blood pressure), Wellbutrin's noradrenergic effects make it more likely to raise it than SNRIs like Effexor (venlafaxine), which can cause similar but dose-dependent spikes.[3][7] Tricyclics like Elavil pose even greater cardiovascular risks.[4]
When Does the Effect Kick In and Fade?
Increases typically appear within 1-4 weeks and stabilize; they resolve 1-2 weeks after stopping.[1][2] Long-term use (over 6 months) shows persistent but mild elevations in 2-4% of cases.[5]
[1]: FDA Label for Wellbutrin XL
[2]: GlaxoSmithKline Wellbutrin Prescribing Information
[3]: PubMed: Bupropion and Cardiovascular Effects
[4]: Drugs.com Wellbutrin Side Effects
[5]: American Journal of Psychiatry: Bupropion Safety
[6]: Journal of Clinical Psychiatry: Use in Hypertensives
[7]: UpToDate: Antidepressant Cardiovascular Risks