Understanding What Are the Neurological Symptoms of Wellbutrin?

October 7, 2025 •

4 min read

According to prescribing information, common neurological effects of Wellbutrin (bupropion) include insomnia, headaches, dizziness, and tremor. Understanding these and other potential side effects is vital for anyone taking this medication. The drug's unique mechanism of action as a norepinephrine-dopamine reuptake inhibitor (NDRI) sets its side effect profile apart from many other antidepressants, making awareness of what are the neurological symptoms of Wellbutrin crucial for patient safety.

Quick Summary

Wellbutrin can cause various neurological side effects by altering dopamine and norepinephrine levels. Common symptoms include headaches, insomnia, dizziness, and tremors, while more serious but rare effects involve seizures and psychosis. Agitation and anxiety are also reported, particularly during initial treatment or dosage changes. Understanding these risks is crucial for effective management and patient safety.

Key Points

Common neurological symptoms: Include headaches, dizziness, insomnia, and tremors, which often lessen after the initial weeks of treatment.
Dose-dependent seizure risk: Wellbutrin is known to lower the seizure threshold, with the risk increasing significantly at higher doses or in patients with pre-existing risk factors like a history of seizures or eating disorders.
Increased agitation and anxiety: As an activating antidepressant, bupropion can cause agitation, irritability, and anxiety, particularly during the initial phase of treatment.
Rare but serious psychiatric effects: In vulnerable individuals, Wellbutrin can, in rare cases, induce or worsen psychosis, delusions, or hallucinations due to its dopaminergic activity.
Management strategies: Neurological side effects can often be managed through dose adjustments, proper timing of medication, and avoiding alcohol and stimulants.
Distinct side effect profile: Wellbutrin’s mechanism as an NDRI gives it a different side effect profile from common SSRIs, with lower rates of sexual dysfunction and weight gain but a specific risk for seizures and agitation.

Common Neurological Symptoms

Wellbutrin, known generically as bupropion, is an atypical antidepressant that works by inhibiting the reuptake of norepinephrine and dopamine. This mechanism can lead to a variety of neurological symptoms. While often mild and temporary, these effects should be monitored closely, especially during the first few weeks of treatment.

Headaches and Dizziness

Headaches are among the most commonly reported neurological side effects of Wellbutrin. Some patients may also experience migraines. Dizziness is another frequent complaint, and can sometimes be severe enough to affect daily activities like driving. These symptoms can often lessen as the body adjusts to the medication, but if they persist or worsen, it's important to consult a healthcare provider.

Insomnia and Sleep Disturbances

As an activating antidepressant, Wellbutrin can cause insomnia or other sleep problems, particularly if taken later in the day. Many doctors recommend taking the last daily dose before 3 p.m. to mitigate this side effect. Patients should discuss sleep hygiene strategies with their doctor and ensure proper dosing timing to improve sleep quality.

Tremors and Shakiness

Some individuals may experience tremors or shakiness, which are often described as an uncontrollable shaking of a part of the body. This is a documented side effect, often occurring early in treatment. In some cases, adjusting the dose can help manage or resolve this symptom.

Agitation and Anxiety

Wellbutrin's stimulating properties can increase dopamine and norepinephrine, leading to heightened agitation, irritability, and anxiety in some people. The FDA explicitly warns about monitoring for these effects, especially early in treatment or after dose changes. For those with a pre-existing anxiety disorder, these symptoms may be exacerbated.

Serious and Rare Neurological Symptoms

While less common, some neurological symptoms of Wellbutrin are serious and require immediate medical attention. Awareness of these is critical for patient safety.

Seizures

The most well-known and serious neurological risk of Wellbutrin is seizures, with the risk being dose-dependent. Patients with a history of seizures, eating disorders like bulimia or anorexia, or those undergoing abrupt withdrawal from alcohol or sedatives are at a higher risk. The risk is significantly higher with immediate-release formulations compared to extended-release formulations and at higher doses. Treatment should be discontinued immediately if a seizure occurs.

Psychosis and Hallucinations

Due to its dopaminergic effects, bupropion can, in rare cases, induce or worsen psychosis, delusions, or hallucinations, particularly in vulnerable individuals or at high doses. Some patients, especially those with underlying bipolar disorder, may be at increased risk of mood shifts towards mania or psychosis. Immediate reporting of new or worsening psychotic symptoms is essential.

Extrapyramidal Symptoms

Postmarketing reports have included rare cases of extrapyramidal symptoms, such as dyskinesia, dystonia, and parkinsonism. These involve issues with muscle control and coordination. While uncommon, they indicate significant central nervous system effects.

Managing Neurological Side Effects

Managing Wellbutrin's neurological side effects often involves a combination of medical supervision and lifestyle adjustments. It is crucial to work with a healthcare provider to find the right strategy.

Strategies for managing Wellbutrin neurological side effects

Dose Adjustment: Your doctor may reduce the dosage, especially if symptoms like agitation or anxiety are prominent.
Timing of Dosing: Taking the medication earlier in the day can help manage insomnia.
Lifestyle Changes: Practicing good sleep hygiene, reducing caffeine, and avoiding alcohol and recreational drugs can help manage side effects.
Supportive Care: In cases of overdose or severe toxicity, supportive care may be necessary, and benzodiazepines may be used to control seizures.
Alternative Medications: If side effects are persistent or severe, your doctor may consider switching to a different class of antidepressant.

Comparison of Wellbutrin vs. SSRI Side Effects


Feature	Wellbutrin (Bupropion)	SSRIs (e.g., Lexapro, Prozac)
Mechanism of Action	Norepinephrine-Dopamine Reuptake Inhibitor (NDRI)	Selective Serotonin Reuptake Inhibitor (SSRI)
Sexual Side Effects	Low incidence; can improve sexual dysfunction caused by other antidepressants	Common side effect; often linked to orgasmic and desire issues
Weight Changes	Associated with weight loss or no change	Often associated with weight gain
Sedation	Low incidence of sedation; more activating	Can cause sedation or somnolence
Seizure Risk	Rare but significant, especially at higher doses or in vulnerable populations	Rare, but generally comparable risk of seizures
Anxiety/Agitation	Can be activating, potentially causing anxiety and agitation in some individuals	Can cause anxiety, particularly initially, but often used for long-term anxiety management
Initial Side Effects	Dry mouth, insomnia, headache, nausea, agitation	Nausea, headache, insomnia, dizziness

Conclusion

Wellbutrin's unique mechanism of action as an NDRI gives it a distinct neurological side effect profile compared to other antidepressants. While common symptoms like headaches, dizziness, and insomnia are generally manageable and often diminish over time, patients must be aware of the more serious but rare risks, such as seizures and psychosis. Open communication with a healthcare provider is essential, especially regarding dosage adjustments and monitoring for potentially serious symptoms. For those sensitive to its stimulating effects, alternative medications or lifestyle adjustments can help provide relief. By understanding these potential neurological effects, patients can make informed decisions and work with their doctor to manage their treatment effectively and safely. For further information on bupropion side effects and drug interactions, consulting resources like the FDA's accessdata.fda.gov is recommended.

Frequently Asked Questions

Yes, headaches are one of the most commonly reported side effects of Wellbutrin. While often temporary, some individuals may also experience migraines. If headaches are persistent or severe, you should consult your healthcare provider.

Yes, some individuals may experience increased anxiety, agitation, and restlessness, especially when first starting Wellbutrin. This is due to its stimulating effects on norepinephrine and dopamine. For those with pre-existing anxiety disorders, this can exacerbate symptoms.

Wellbutrin carries a dose-dependent risk of seizures. This risk is higher at elevated doses and in individuals with a history of seizures, eating disorders, or those withdrawing from alcohol or sedatives. A doctor should be consulted immediately if a seizure occurs.

To manage Wellbutrin-induced insomnia, try taking your dose earlier in the day and practicing good sleep hygiene. Avoiding caffeine and other stimulants, especially in the afternoon and evening, can also help. Your doctor may also suggest a dosage adjustment.

Tremors or shakiness are a common neurological side effect of Wellbutrin, often seen in the initial weeks of treatment. This symptom is typically dose-related, and adjustments to your medication may help alleviate it.

In rare instances, Wellbutrin can induce or worsen psychotic symptoms like hallucinations, delusions, paranoia, and confusion. This risk is higher at elevated doses and in individuals with pre-existing psychotic disorders or bipolar disorder. Any such symptoms should be reported to a doctor immediately.

Yes. Unlike SSRIs which primarily affect serotonin, Wellbutrin is a norepinephrine-dopamine reuptake inhibitor. This results in a unique side effect profile, with a different risk for things like sexual dysfunction and weight gain, but a specific risk for seizures and agitation.