Bupropion Seizure Risk: What You Need to Know About Seizure Danger and Safe Use

When you take bupropion, a common antidepressant and smoking cessation aid that works on dopamine and norepinephrine. Also known as Wellbutrin, it helps millions manage depression and quit smoking — but it carries a real, though low, risk of triggering seizures. This isn’t theoretical. The FDA warns that seizure risk rises sharply above 450 mg per day, and even more for people with eating disorders, head injuries, or alcohol dependence.

Seizures from bupropion aren’t random. They happen because the drug lowers your brain’s seizure threshold — meaning it makes it easier for abnormal electrical activity to start. People with a history of seizures, epilepsy, or brain trauma are told not to take it at all. Even if you’ve never had a seizure, factors like kidney or liver problems, or mixing bupropion with other drugs like antidepressants, medications that alter brain chemistry, often used for depression and anxiety, can push you into danger. Some antiseizure drugs, medications designed to prevent or control epileptic seizures are used to protect patients who need bupropion but have risk factors — but that’s a last-resort move.

It’s not just about dose. Skipping doses, then doubling up, or drinking alcohol while on bupropion can spike your risk. The same goes for using it with stimulants, certain cold medicines, or even some herbal supplements like St. John’s wort. Your doctor should check your medical history — not just for seizures, but for things like diabetes, high blood pressure, or past head trauma. If you’ve had a seizure before, even years ago, it matters. If you start feeling dizzy, confused, or have strange sensations in your limbs, don’t wait. Call your provider.

For many, bupropion works well with no issues. But if you’re worried, or if you’ve had bad reactions to other antidepressants, there are safer options. tricyclic antidepressants, older antidepressants that affect multiple brain chemicals but carry different risks like nortriptyline might be better for some, especially if seizure risk is a concern. Newer SSRIs like sertraline or escitalopram rarely cause seizures at all. It’s not about avoiding bupropion entirely — it’s about knowing if it’s right for you.

Below, you’ll find real patient stories, clinical data, and doctor-recommended safety tips that show exactly how bupropion seizure risk plays out in practice — and how to stay protected while getting the help you need.