Can You Drink Alcohol While Taking Wellbutrin XL?

Answer

Individuals taking Wellbutrin XL (bupropion extended-release), a medication used to treat depression, are advised to minimize or avoid alcohol consumption due to the possible lowering of alcohol tolerance and the seizure threshold.

In other words, the combination could make you feel the adverse effects of alcohol more strongly (e.g., nausea, dizziness, drowsiness, etc...) and put you at a higher risk of experiencing seizures.

Interaction Details

The prescribing information for Wellbutrin advises that patients taking the medication should minimize or avoid alcohol consumption during treatment. It states:

Patients should be told that the excessive use or abrupt discontinuation of alcohol or sedatives (including benzodiazepines) may alter the seizure threshold. Some patients have reported lower alcohol tolerance during treatment with WELLBUTRIN SR. Patients should be advised that the consumption of alcohol should be minimized or avoided.

Now, there are two concerns with combining alcohol with Wellbutrin:

• Wellbutrin may enhance the adverse/toxic effects of alcohol. In other words, alcohol tolerance may decrease if you are taking Wellbutrin.
• The combination of Wellbutrin and alcohol may lower your seizure threshold (i.e., put you at more risk for seizures).
  

On the first point of Wellbutrin reducing one's tolerance to alcohol, studies on the matter are mixed.

While there have certainly been case reports of the combination causing individuals to experience more alcohol-related effects (e.g., dizziness, nausea, sedation), larger-scale studies, generally, haven't reported any significant difference in how alcohol is metabolized when taken with Wellbutrin.

For example, one clinical study found that Wellbutin and alcohol did not have an impact on each other's pharmacokinetic properties or measures of mental sedation, inebriation, reaction time, or short-term memory.

The larger risk of combining Wellbutrin and alcohol is the increased risk of seizures.

Wellbutrin and heavy alcohol use (and/or abrupt discontinuation of heavy alcohol consumption) both lower the seizure threshold, and the increased risk of seizures may be additive.

Case reports (example 1, example 2) have been published describing seizures and/or death associated with Wellbutrin overdose in those with elevated blood alcohol concentrations or a recent history of heavy alcohol consumption.

In most cases, serious adverse reactions only occur with excessive alcohol consumption and high doses of Wellbutrin, but if someone is already more susceptible to seizures, or has a history of them, combining Wellbutrin and alcohol could make the risk that much greater. Other risk factors (such as liver function and age) can play a role too.

How To Manage the Interaction

If you're taking Wellbutrin to manage your depression, it's important to be aware of the potential risks associated with drinking alcohol while on the medication.

To stay safe and ensure effective treatment, it's best to minimize or avoid alcohol altogether. 

In your question, you stated you wanted to know about the safety of a very low amount of alcohol consumption (one drink per month).

It is unlikely that such a small amount would present a significant problem for most individuals. However, as mentioned, there are certain factors that can influence someone's risk for problems, such as the dose of Wellbutrin you are taking and other risk factors (e.g., history of seizures, liver function, etc...).

I highly encourage you to discuss any concerns or questions you have about combining alcohol and Wellbutrin with your healthcare provider as they know your medical situation best. They can provide individual guidance for your specific situation.

Final Words

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