Wellbutrin / Bupropion
Wellbutrin (generic bupropion) is an antidepressant typically classified as an NDRI (norepinephrine–dopamine reuptake inhibitor) and also has nicotinic acetylcholine receptor–blocking activity. Unlike SSRIs/SNRIs, it is generally described as having minimal direct serotonergic activity. Clinically, it is often considered one of the antidepressants with lower rates of treatment-emergent sexual dysfunction compared with SSRIs, and it is sometimes chosen specifically for that reason.
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This page summarizes anecdotal reports and community observations, not medical evidence. Reports may be incomplete, biased or inaccurate and are not medical advice or recommendations. “Risk” here refers to how frequently severe or prolonged symptom worsening is reported, not to proven causation or population-wide probability. Individual responses vary widely, and absence of issues in some users does not rule out significant reactions in others.
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Within PFS/PSSD/PAS communities, bupropion is discussed in relation to its potential interactions with dopamine and norepinephrine signaling pathways. Bupropion acts as an NDRI (norepinephrine–dopamine reuptake inhibitor) and also has nicotinic acetylcholine receptor–blocking activity, which can significantly shift arousal and stress-related neurochemistry. Unlike SSRIs/SNRIs, it is generally described as having minimal direct serotonergic activity, but its effects on dopamine and norepinephrine systems may interact with pathways involving reward, motivation, and stress response that are often discussed in relation to PFS / PSSD / PAS. (pmc) (fda)
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Reports of Severe and Sometimes Lasting Worsening (for PFS/PSSD/PAS):
Among individuals with established PFS/PSSD/PAS, community reports describing experiences with bupropion are mixed but highly polarized. While some individuals report partial or temporary symptomatic relief—often described as a short-term “band-aid” effect on mood, energy, or motivation—there are also numerous accounts of acute worsening, including cases described as severe and sometimes lasting declines in baseline. Because reported benefits are often transient and unpredictable, whereas negative outcomes can be significant, many within the community consider bupropion to carry elevated risk for those with PFS/PSSD/PAS, even in the absence of controlled data.
For individuals without these conditions, bupropion is widely prescribed and beneficial for many, and it is often associated with fewer sexual side effects than SSRIs. However, there are still reports of significant activation and mood/anxiety side effects in a subset of users along with reports of users developing pssd like symptoms from cessation of the drug.
Evidence basis: Clinical/review literature on sexual side effects; FDA labeling and safety information; anecdotal reports (online forums, self-reports); no controlled studies examining PFS/PSSD/PAS-specific outcomes.
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Public comments reflect individual experiences and opinions. They are not medical advice and may not be accurate or representative.