Is Wellbutrin breastfeeding safe?

In this article:

• Wellbutrin while breastfeeding
• Side effects
• How to take it
• Wellbutrin and postpartum depression
• Which antidepressant is the safest?
• The bottom line

In this article

• Wellbutrin while breastfeeding
• Side effects
• How to take it
• Wellbutrin and postpartum depression
• Which antidepressant is the safest?
• The bottom line

Wellbutrin is the brand name for bupropion, an antidepressant that’s FDA approved to treat major depressive disorder. It’s also approved to prevent seasonal affective disorder and to help people stop smoking. Wellbutrin is classified as a norepinephrine-dopamine reuptake inhibitor (NDRI) and is available in both sustained-release and extended-release formulations.

One in eight women experiences postpartum depression in the first year after giving birth, according to the CDC—a time period when new moms are frequently breastfeeding. Plus, some women live with depression during pregnancy. In other words, it’s common to need treatment with an antidepressant while lactating. Is Wellbutrin safe for breastfeeding? While there aren’t extensive studies, it’s known that very little of the medication gets excreted into breast milk, and it’s not thought to be harmful to breastfeeding babies.

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Can you take Wellbutrin while breastfeeding?

“Yes, Wellbutrin (bupropion) is considered compatible with breastfeeding,” says Jennifer Bergman, IBCLC, program assistant and instructor at Aeroflow Breastpumps. It is often used to treat postpartum depression, and also to continue to treat depression when parents have a history of doing well with it. However, if you haven’t taken Wellbutrin prior to breastfeeding, your provider might try another medication first.

First-line treatments for depression while breastfeeding include selective serotonin reuptake inhibitors (SSRIs), such as:

• Sertraline
• Paroxetine

Wellbutrin is not a first-line treatment for depression during lactation, but it’s a valuable tool in the toolbox, Bergman says. It is often used when other antidepressants aren’t recommended for a particular patient. “Wellbutrin is a go-to when patients have experience with SSRIs not working for them, need smoking cessation support, and or have responded well to it previously,” explains Kelly Hobbs, PMHNP, a psychiatric nurse practitioner at Neuro Wellness Spa.

Contrary to popular belief, most prescription medications are safe to take while breastfeeding. This is the take-home message from both the CDC and the American Academy of Pediatrics (AAP). The reason for this is that, most of the time, the amount of medication passed into breast milk is minimal and has few side effects in breastfed infants.

While there aren’t large-scale clinical trials proving its safety, Wellbutrin is excreted into breast milk in insignificant amounts, meaning that it’s likely to be safe for breastfeeding babies and unlikely to cause harm. “Only 0.2% of the overall dose transfers via breast milk,” Hobbs says. “This low level is considered very safe.”

Side effects of Wellbutrin while breastfeeding

Since such low levels of Wellbutrin are found in breast milk, it’s not likely to cause negative side effects in babies. But there’s very little research about specific side effects in babies from Wellbutrin and the use of bupropion during breastfeeding. Most of the research we have is based on small studies or case reports.

According to the Infant Risk Center, two babies whose breastfeeding parents took Wellbutrin developed seizures. It’s not clear if these seizures were related to Wellbutrin. However, if your baby is at risk of seizures because of a family history or a medical condition, another medication may be preferable.

As noted by the Academy of Breastfeeding Medicine (ABM), Wellbutrin reaches its peak effect within three to four hours of taking it. It has a half-life of 21 hours, which means that’s how long it takes for half of the medication to leave your breast milk. Overall, the ABM considers Wellbutrin “compatible with breastfeeding.”

Perhaps most importantly, taking Wellbutrin can have positive side effects on breastfeeding parents who take it. Between 5% and 26% of parents experience postpartum depression, which can have significant and serious impacts on both mental health and a parent’s ability to care for their baby. For many of these parents, the use of antidepressants is crucial to their recovery.

“Untreated depression poses a significant risk to both the mother and baby, which is why medication shouldn’t automatically be avoided due to breastfeeding concerns,” Hobbs says. “If you are currently taking psychiatric medication that seems to be working well and you feel stable on it, consult your provider before making any changes.”

Bergman fully agrees with these sentiments, noting that treating mental health concerns during lactation is beneficial to everyone involved. “When a parent’s mental health improves, feeding outcomes, bonding, and overall confidence often improve too,” she says.

How to take Wellbutrin while breastfeeding

Most experts agree that there are no special precautions you need to take if you are breastfeeding while taking Wellbutrin. 

“There’s no need to ‘pump and dump’ or time feeds around doses when taking Wellbutrin,” Bergman says. “Most parents take the standard prescribed dose (typically 150–300 mg/day) and continue nursing as usual.”

If you are taking Wellbutrin for the first time, your provider will likely start with the lower 150 mg dose and gradually increase to 300 mg, if needed. “Be sure to talk to your provider about the recommended dosage since it fluctuates per person,” Hobbs recommends.

Is Wellbutrin effective for postpartum depression?

The research on Wellbutrin and postpartum depression is limited. One older, smaller study looked at eight parents with postpartum depression who took Wellbutrin for eight weeks. Six out of eight patients experienced a decrease in depression symptoms, and three patients experienced remission from postpartum depression. In all, these patients tolerated Wellbutrin well.

This is promising, but a very small study. In general, when choosing antidepressant medications for postpartum depression, Hobbs says that treatment plans are best when tailored to a patient’s individual history.

“Using medications with the most safety data is recommended, but if Wellbutrin is the route for you, it’s important for you to consider it with your healthcare professional,” she says. “While research on many psychiatric medications during pregnancy and breastfeeding is limited, your provider can discuss with you the risks and benefits to help determine what’s safest for you and your baby.”

What is the safest antidepressant for breastfeeding?

In general, SSRIs like Zoloft (sertraline) and Paxil (paroxetine) are considered most compatible with breastfeeding because they have the most research behind them and have very low levels in breast milk. “But ‘safest’ really means what’s most effective and manageable for the individual,” Bergman emphasizes.

According to Hobbs, after sertraline and paroxetine, Celexa (citalopram) and Lexapro (escitalopram) are second-line antidepressants for breastfeeding because they have only slightly higher infant exposure than sertraline and paroxetine.

Hobbs also emphasizes, though, that the safest antidepressant varies from one person to another. “If you are stable on medication during pregnancy, then continuing it postpartum can avoid destabilization,” she says. “Making sure to take your medication consistently is imperative for continued results.”

The bottom line

Most experts say that it’s safe to take Wellbutrin while breastfeeding. Only minimal amounts of it are detectable in breast milk. But there are few studies looking at the safety of Wellbutrin in breastfeeding babies.

Each breastfeeding parent and baby is different. That’s why it’s vital to seek medical advice from a healthcare provider or pharmacist when deciding whether or not to take a particular medicine while breastfeeding.