Alex asked
Can I drink alcohol if I’m on bupropion? I’ve heard it can cause seizures in those who have a history of seizures but what are the risks other than that?
Answer
It is not recommended to take Wellbutrin (bupropion) if you are going to drink alcohol. This interaction can increase your risk for seizures as both bupropion and alcohol lower the seizure threshold. This risk for seizure is dose related to bupropion, meaning the higher the strength you are taking the higher the risk is for having a seizure.
Bupropion is contraindicated in patients with seizure disorder, as well as patients undergoing abrupt discontinuation of alcohol.
Bupropion And Seizure Risk
A study has found that the incidence of seizures was found in 0.4% of patients treated with bupropion at doses up to 450 mg a day. This risk is increased ten fold at doses between 450 mg and 600 mg a day. Another study tested the seizure threshold in mice with alcohol and administration of bupropion, revealing as high as a 3.5 fold increase of seizures.
The use of alcohol is not the only thing that increases the risk of seizure while taking bupropion. Other risk factors include:
- History of stroke
- Head injury
- Metabolic disorders (e.g. hypoglycemia)
- Use of other seizure threshold lowering drugs (corticosteroids, tricyclic antidepressants, etc).
The prescribing information for Wellbutrin states:
"Patients should be told that the excessive use or abrupt discontinuation of alcohol or sedatives (including benzodiazepines) may alter the seizure threshold"
One caveat that is important to be aware of, is that if you consistently drink a lot of alcohol, you should speak with your doctor before stopping. Suddenly stopping alcohol consumption after extended use can increase your risk of having seizures.
Lastly, there have been reports that individuals can have a lower alcohol tolerance while taking bupropion. Therefore, the side effects of alcohol can be increased such as dizziness, sedation and confusion.
