Can You Drink Beer If You Take Wellbutrin (Bupropion)?

Debbie asked

I am going to start Bupropion and I drink beer. Will I have any problems drinking beer on this med? I take 150 mg twice a day.

Answer

There is some concern with mixing alcohol, including beer, with Wellbutrin (bupropion).

Wellbutrin is well associated with increasing the risk of seizures in a dose-dependent manner (meaning higher doses are more likely to cause them).^[1]

Similarly, both alcohol abuse and abruptly stopping drinking (if you are a consistent drinker) can increase the risk of seizures occurring.^[2][3]

Even if you have no history of seizures, and are simply someone who drinks beer responsibility on an intermittent basis, it, unfortunately, is difficult to definitively say how risky this is for someone taking Wellbutrin.

Most of the data available points to the risk of seizures being quite low on doses of Wellbutrin less than 450 mg per day and in those who do not excessively consume alcohol.^[4][5]

Nevertheless, you should speak to your doctor about whether or not it is safe for you to consume alcohol and take Wellbutrin for your particular medical situation. There could other risk factors that you aren't aware of (like being on other medications that also affect the likelihood of seizures occurring).

Wellbutrin And Seizures

The prescribing information for Wellbutrin states the following regarding its seizure risk:

"Bupropion [Wellbutrin] is associated with seizures in approximately 0.4% (4/1,000) of patients treated at doses up to 450 mg/day. This incidence of seizures may exceed that of other marketed antidepressants by as much as 4-fold. This relative risk is only an approximate estimate because no direct comparative studies have been conducted....The estimated seizure incidence for WELLBUTRIN increases almost tenfold between 450 and 600 mg/day, which is twice the usually required daily dose (300 mg) and one and one-third the maximum recommended daily dose (450 mg)."

Due to the increased risk of seizures with Wellbutrin, it is contraindicated (i.e. should not be used) in those with a seizure disorder.

The 0.4% incidence rate of seizures is for the immediate-release formulations of Wellbutrin.

Multiple studies put the risk far lower (around 0.07%) in those using extended-release versions of the drug, such as Wellbutrin SR and Wellbutrin XL.^[6]

Alcohol And Seizures

Chronic alcohol consumption and alcohol abuse (i.e. binge-drinking) are associated with an increased risk of seizures. Additionally, alcoholics who abruptly stop alcohol consumption (i.e. stopping cold turkey) are at a higher risk of seizures as well. ^[7][8]

However, most studies suggest that low to moderate consumption of alcohol on an intermittent basis is not a risk factor for seizures if you do not have a history of them.^[9]

Wellbutrin And Alcohol Together

The prescribing information for Wellbutrin states that the use of alcohol (all types of alcohol including beer, wine, and liquor) should be avoided if possible or at least minimized.

In individuals who have no history of seizures and no risk factors for them, low doses of Wellbutrin and responsible consumption of alcohol likely won't cause problems. Nevertheless, since Wellbutrin and alcohol can cause seizures, doing so should be done with caution and you should certainly check with your doctor first.

An interesting note is that some individuals taking Wellbutrin have reported that their tolerance to alcohol is decreased when taking Wellbutrin. In other words, they feel the effects of alcohol more quickly when taking the drug.^[10]This is certainly something to be aware of and look out for.