Can I Drink on Wellbutrin?

Bupropion is one of the most commonly prescribed drugs in the United States. It goes by a few different names based on how it is used. When used as an antidepressant, it’s sold under the name Wellbutrin; when used as a smoking cessation aid, it is sold under the name Zyban.

Bupropion and alcohol interact with our brain chemistry in different ways. Bupropion’s effects are intentionally used to correct a chemical imbalance. Alcohol intentionally creates a chemical imbalance to produce intoxicating effects.

So what happens when you mix bupropion with alcohol? Do these two play nice, or are they a bad mix? In this article, we’ll take a look at the science and find out what exactly happens when you mix Wellbutrin with alcohol, and whether there are any bupropion-alcohol interactions to be aware of. Let’s dive in!

What Is Bupropion (Wellbutrin / Zyban)?

Bupropion is most commonly used to treat depression. Sometimes it’s prescribed on its own, sometimes it’s used when typical antidepressants don’t work, and sometimes it’s used in addition to a typical antidepressant.

It’s considered an atypical antidepressant because it doesn’t work like most antidepressant medications. The first choice for medical treatment of depression is a type of drug called selective serotonin reuptake inhibitors (SSRIs). These medications prevent our brains from tossing out serotonin molecules. Serotonin helps us regulate our mood, and a lack of serotonin can cause clinical depression.

But not all depression is caused by low serotonin. This is where bupropion comes in. Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) — it does the same thing for dopamine and norepinephrine as SSRIs do for serotonin. Norepinephrine is a stimulating neurotransmitter (brain chemical) responsible for alertness, attention, memory, and the fight-or-flight response. Dopamine is involved in motivation, planning, and the rewards system.

Why Is Bupropion Used?

When depression doesn’t improve with typical antidepressants, Wellbutrin is often the first alternative choice. The stimulating effects of increased norepinephrine and dopamine make it especially useful for treating the fatigue associated with depression and Seasonal Affective Disorder (SAD).

Bupropion is also frequently prescribed when we experience depression in addition to attention deficit hyperactivity disorder (ADHD). Since ADHD involves a dysfunction of dopamine, bupropion’s dopamine-boosting properties give the brain more dopamine to work with. Bupropion works very mildly on dopamine, making it an easier treatment to tolerate than traditional stimulants, and its balanced properties make it an unlikely candidate for misuse.

Bupropion goes by the brand name Wellbutrin when used to treat depression. Since bupropion also inhibits nicotine receptors in the brain, it is also used under the brand name Zyban as an aid for quitting smoking cigarettes. Wellbutrin and Zyban are the same thing: they’re both bupropion, just in different doses.

In this article, we will focus on Wellbutrin; Zyban is typically only prescribed for a short period of time at a low dose (150 mg), whereas Wellbutrin is taken over longer periods at a higher dose (300 - 450 mg).

Bupropion Side Effects

Bupropion has some common side effects:

• Dry mouth
• Nausea
• Constipation
• Insomnia
• Anxiety
• Tremor
• Sweating
• Suicidal thoughts

Bupropion also lowers the seizure threshold, the minimum stimulation necessary to cause a seizure. Because of this, it is not usually prescribed to people with other conditions that lower their seizure threshold, like epilepsy, anorexia nervosa, bulimia nervosa, and alcohol use disorder (AUD), since alcohol withdrawal is associated with an increased risk of seizure.

Thinking Through Alcohol's Effects on the Brain

Much like Wellbutrin, alcohol is a drug that changes our brain chemistry. When we drink alcohol, our brain floods with dopamine and gamma-aminobutyric acid (GABA), a calming neurotransmitter, and reduces the effectiveness of glutamate, a stimulating neurotransmitter. This chemical cocktail makes us feel calm, warm, fuzzy, and inspired to keep drinking.

In the short term, this causes the feeling we recognize as “tipsy” or “drunk.” When we drink consistently, our brains get used to alcohol’s effects and adjust our baseline brain chemistry in anticipation of that next drink. Among other things, this includes lowering dopamine production, leading to a generally lower mood and cravings for dopamine-boosting activities (like drinking).

The Interaction Between Wellbutrin and Alcohol

Combining Wellbutrin and alcohol can present serious risks in chemical interactions and side effect amplification. Let’s take a closer look at both of these categories.

Chemical Interactions

Studies show that increased norepinephrine in the brain increases the effect of alcohol on our rewards system.

Imagine your brain as the center of a busy city, bustling with traffic. Wellbutrin and alcohol are like two very different kinds of drivers making their way along the roads. Wellbutrin is a responsible driver — it follows traffic signals, lets people in, stops for pedestrians, and uses its turn signal. As a result, traffic around Wellbutrin flows smoothly.

Alcohol, on the other hand, is a reckless driver who disrupts the normal flow of traffic. It speeds and swerves, and other drivers start getting cautious. This causes traffic to slow down and clog up the roads. When both Wellbutrin and alcohol are in your brain's city streets at the same time, they do opposite things and interfere with each other.

But they don’t just cancel each other out — just like a good driver doesn’t cancel out a bad driver. Wellbutrin is trying to keep things moving, but alcohol is slowing things down. This can lead to mixed signals, making you feel different than you would with just Wellbutrin or just alcohol alone.

Alcohol and Wellbutrin affect different brain chemicals, but there is some overlap. In the places where their effects overlap, the side effects of each substance compound. In other areas, the side effects can unpredictably seesaw from one extreme to the other. Let’s look at what happens when you drink alcohol while taking Wellbutrin.

Wellbutrin-Alcohol Interactions

Shared Side Effects

• Impulsivity. Alcohol inhibits our impulse control, and Wellbutrin increases our motivation. These work together to make us more impulsive and do things we wouldn’t do under normal circumstances.

• Insomnia. Alcohol disrupts deep sleep, and Wellbutrin’s stimulating properties can cause insomnia in some people.

• Nausea. Wellbutrin can cause nausea, and alcohol is known to irritate and unsettle the stomach, especially when we drink heavily.

• Dizziness. Alcohol inhibits our balance and our ability to orient ourselves. Wellbutrin can cause dizziness through neurochemical effects and by increasing blood pressure.

• Headaches. Alcohol causes headaches by manipulating our brain chemistry and making us dehydrated. Wellbutrin’s chemical effects also cause headaches — some people describe these as “brain zaps.”

Competing Side Effects

• Mood. Alcohol and Wellbutrin both affect our mood. When they compete to be the boss of our mood regulation, we can experience mood swings. Since alcohol is known to worsen depression, we may feel like our Wellbutrin “just isn’t working,” when in fact, its helpfulness is being undermined by alcohol.

• Blood pressure changes. Wellbutrin can affect blood pressure levels unpredictably. Some people may experience elevated blood pressure, and others may experience low blood pressure especially upon standing (this is called orthostatic hypotension). Alcohol is known to raise blood pressure. Combining these two could lead to unpredictable effects.

• Stimulation effects. Wellbutrin is a mild stimulant, and alcohol is a central nervous system depressant. This affects the way signals travel in our nerves, but it can also cause our energy levels to fluctuate rapidly.

• Level of alertness. Wellbutrin typically increases alertness, while alcohol typically decreases it. When taken together, the effect on alertness can be unpredictable.
• Cognitive function and motor function. Alcohol impairs cognitive function and reflexes by slowing down nerve signals, and Wellbutrin enhances them by making nerve signals more efficient. This combination can make it difficult to predict how our motor skills will react and can make it harder to tell if we’re thinking clearly.

How To Stay Safe

From the list of Wellbutrin-alcohol interactions above, it’s clear that these two substances do not play well together. They interact with each other on multiple levels and can create unpredictable effects.

More fundamentally, we have to ask ourselves why we use each of these substances. Wellbutrin is prescribed to improve our mental health and the physical manifestations of depression. Alcohol is used for many complex reasons, but the end result is that it tends to worsen our mental health. We are taking Wellbutrin as part of a wellness journey, and quitting back or cutting back on alcohol gives Wellbutrin the best chance of doing its job.

Let’s look at some things to keep in mind when we are considering drinking while taking Wellbutrin.

• Be honest with your healthcare provider. Openly discuss your alcohol use with your doctor so they can make the best decision for your care. You can use Reframe to track your alcohol use and get an accurate picture. Your doctor may suggest quitting or cutting back on alcohol use — prepare yourself, and consider it an opportunity to make collaborative choices for your well-being.

• Understand the risks. Continue to educate yourself about the risks of combining Wellbutrin with alcohol and how alcohol affects your overall health.

• Don’t skip medication. Do not skip doses of Wellbutrin to consume alcohol. This can lead to withdrawal symptoms and disrupt the effectiveness of your treatment even more than drinking alone.

• Track your alcohol intake. If you choose to drink alcohol, reduce your intake. Consider setting drink limits or planning dry days to give your body time to recover. Pay attention to how your body reacts, and track your progress.

• Seek support. If you're struggling to manage your alcohol use, seek out resources to help you quit or cut back. Reframe offers coaching, daily meetings, customized plans, and a thriving community of people on the same journey.

• Watch for side effects. Be vigilant about any unusual side effects or changes in mood or behavior. If you notice anything concerning, contact your healthcare provider immediately.

• Prioritize mental health. Remember that the goal of taking Wellbutrin is to manage your mental health. Prioritize that goal when making decisions about alcohol consumption.

A Final Word of Caution

If you’re sufficiently convinced that mixing Wellbutrin and alcohol is a bad idea, you may find yourself considering skipping a day of Wellbutrin to drink — this is a bad idea! Alcohol can still interact with Wellbutrin in your system for up to a week after you stop taking it, and it takes even longer for brain chemistry to normalize after stopping Wellbutrin. Skipping doses and drinking heavily are individually associated with increased risk of seizure. The risk compounds when we do both simultaneously.

Most importantly, skipping doses of Wellbutrin reduces its effectiveness. When paired with alcohol’s depressive effects, skipping doses of Wellbutrin to drink creates a negative feedback loop. It’s important to remember why we are taking Wellbutrin in the first place and prioritize our wellness.