- Bupropion (Wellbutrin) is an antidepressant that is also used to help people stop smoking; larger studies have not found a clear overall increase in birth defects, though the decision is still individualized.
- Two small early studies raised a possible question about first-trimester heart defects, but larger studies of more than 2,000 pregnancies did not confirm an increased risk, including heart defects.
- Untreated depression carries real risks in pregnancy for both parent and baby, so the choice is a balance, not simply "stop the medicine."
- Stopping an antidepressant abruptly can bring a return of symptoms and discontinuation effects, so any change should be planned with your prescriber, not made alone.
- If you are struggling, help is available now; you can call or text 988, the Suicide and Crisis Lifeline, at any time.
- The old FDA pregnancy letter categories have been retired; questions about a specific exposure can go to MotherToBaby at 1-866-626-6847.
If you take Wellbutrin and are pregnant or thinking about it, you are weighing two things at once: what is known about the medicine and what happens if depression goes untreated. Both matter. The reassuring news is that larger studies have not found a clear overall increase in birth defects with bupropion. But this is still an individual decision to make with your prescriber, because the right answer depends on your history, and because stopping an antidepressant on your own can cause real problems. This article gathers what leading U.S. sources say. It is general education only and is not a substitute for medical advice.
What Wellbutrin is and what it treats
Wellbutrin is a brand name for bupropion, an antidepressant that works differently from the more common SSRIs and SNRIs; it acts mainly on the brain chemicals dopamine and norepinephrine. Bupropion is used to treat depression, including a seasonal form, and under the name Zyban it is also used to help people stop smoking. That second use is relevant in pregnancy, because quitting smoking is one of the most valuable things a person can do for a pregnancy, and bupropion is sometimes part of that plan.
What the guidance says about pregnancy use
MotherToBaby, a service of the non-profit Organization of Teratology Information Specialists, offers a measured picture. Overall, it reports that bupropion is not expected to increase the chance of birth defects in pregnancy. Larger studies, covering more than 2,000 pregnancies, have not found an increased risk of birth defects, including heart defects.
The heart-defect question
Some readers will have seen mention of a possible heart-defect signal. MotherToBaby notes that two small early studies suggested a possible link between first-trimester bupropion use and an increased chance of heart defects. Importantly, those studies had limitations, and the larger, later studies did not confirm an increased risk. This is a good example of why one early study is not the final word, and of why it helps to look at the overall body of evidence with your clinician.
Other outcomes
For other outcomes, the data are more limited. MotherToBaby reports that bupropion is not expected to increase the chance of miscarriage, preterm birth, or low birth weight, though it also notes that some questions, such as long-term behavior and learning, have not been studied enough to answer confidently. One small study raised a possible question about ADHD, but it could not account for family history and other factors, so it is not considered conclusive. Where evidence is thin, MotherToBaby is honest about that, and the sensible response is to individualize with your prescriber rather than to assume the worst.
The other side: untreated depression is not a neutral choice
It would be a mistake to treat “stop the antidepressant” as the automatically safe option. Untreated or undertreated depression in pregnancy carries real risks for both parent and baby, which can include poor self-care and nutrition, difficulty attending prenatal care, substance use, and, in serious cases, thoughts of self-harm; some studies also link untreated depression to pregnancy complications. Depression that returns after stopping medicine can also be harder to bring back under control. This is exactly why authorities frame the choice as a balance, weighing the treatment against the risks of the illness itself, and why MotherToBaby stresses talking with your provider about the benefits of treating your condition.
Do not stop abruptly on your own
If you take Wellbutrin and are pregnant or planning pregnancy, the safest step is to contact your prescriber and OB to plan, rather than stopping on your own. Stopping an antidepressant abruptly can bring a return of depression and can cause discontinuation effects. Some people can safely continue, some may adjust, and some may switch, but that is a decision to reach with the clinician who knows your history. If you are pregnant and already taking bupropion, there is no reason for shame; many people manage depression through pregnancy with support, and the right move is a planned conversation, not a sudden stop.
If you are in crisis
Pregnancy can be an emotionally intense time, and if your mood is worsening or you are having thoughts of harming yourself, please reach out for help now. You can call or text 988, the Suicide and Crisis Lifeline, at any hour, for free and confidential support. If you feel you are in immediate danger, call 911. Telling your OB or prescriber how you are feeling is also a strong and appropriate step, and they can help you get the right level of care quickly.
A note on the old letter categories
Older references sometimes assigned antidepressants an FDA pregnancy “category” letter, such as C. That system has been retired. U.S. drug labels now use a narrative format under the Pregnancy and Lactation Labeling Rule that describes what is actually known. If you find an old letter grade for bupropion, treat it as out of date and ask your clinician for the current picture.
Breastfeeding
MotherToBaby notes that small amounts of bupropion pass into breast milk and that most exposed infants have no reported side effects, while noting two case reports of seizures in six-month-old babies that resolved after the medicine was stopped. Because this is specific to your baby and situation, discuss the plan with your clinician, who can weigh the benefits of breastfeeding and of your treatment together. MotherToBaby can also provide information for your particular case.
When to call your OB or prescriber
Reach out to your prescriber and OB if you take Wellbutrin and are pregnant or planning pregnancy, so your plan can be reviewed together. Call promptly if your mood is worsening, if you have side effects that concern you, or if you are considering stopping, so you do not stop abruptly and alone. Seek urgent help for thoughts of self-harm by calling or texting 988, or call 911 for an emergency. For questions about a specific exposure, call MotherToBaby at 1-866-626-6847, a free service that answers questions about medicines in pregnancy and breastfeeding.
Frequently asked questions
Is Wellbutrin safe to take while pregnant? Larger studies have not found a clear overall increase in birth defects with bupropion, so it is not expected to raise that risk, but the decision is individualized with your prescriber, weighing the benefits of treatment against the risks of untreated depression.
What about the heart-defect concern I read about? Two small early studies suggested a possible link with first-trimester use, but they had limitations, and larger studies of more than 2,000 pregnancies did not confirm an increased risk, including heart defects. Discuss the overall evidence with your clinician.
Should I stop taking it now that I’m pregnant? Not on your own. Stopping an antidepressant abruptly can bring back depression and cause discontinuation effects. Contact your prescriber to plan whether to continue, adjust, or switch based on your history.
Is untreated depression really a risk in pregnancy? Yes. Untreated depression can affect self-care, prenatal care, nutrition, and, in serious cases, safety, and it may contribute to complications. That is why the choice is a balance, not automatically stopping the medicine.
Can I use bupropion to quit smoking during pregnancy? Bupropion is used for smoking cessation, and quitting smoking is very beneficial in pregnancy, but whether to use it and how is an individualized decision. Talk with your OB about the safest quit plan for you.
Can I take Wellbutrin while breastfeeding? Small amounts pass into milk and most infants have no reported effects, though rare seizure case reports exist. Discuss the plan with your clinician, who can weigh breastfeeding and treatment together; MotherToBaby can also help.
This article is general education, not medical advice, and must not be used to start, stop, adjust, or taper any medication on your own. Suddenly stopping some medicines can be dangerous. Always work with the prescriber who manages your care. In an emergency call 911; for mental-health crisis call or text 988.
Sources
- MotherToBaby (Organization of Teratology Information Specialists) — Bupropion (Wellbutrin) fact sheet.
- 988 Suicide and Crisis Lifeline — crisis support resource.