Wellbutrin (bupropion) is an atypical antidepressant used to treat depression and seasonal affective disorder, and under the brand name Zyban, it's also prescribed to help people quit smoking. Hair loss isn't one of its most common side effects, but it has been reported, and research suggests the risk may be somewhat higher with bupropion than with several other antidepressants.
If you've noticed extra shedding since starting Wellbutrin, understanding why it happens can help you decide on next steps with your prescriber.
Key Takeaways
Hair loss on Wellbutrin is uncommon and often delayed: Medication-related shedding typically shows up two to four months after starting a new drug. In one large U.S. health-insurance claims study, researchers estimated that treating 242 people with bupropion rather than the SSRI fluoxetine for two years would result in one additional hair-loss diagnosis.
It's usually temporary: Most medication-related hair loss is a type called telogen effluvium, which tends to improve once the trigger is identified and addressed. However, not all hair loss has the same cause, so a clinician may need to assess other possible explanations before estimating whether or when regrowth is likely.
Don't stop Wellbutrin on your own: Talk with your prescriber, who can check for other causes, adjust your dose, or help you switch medications safely if needed.
What is Wellbutrin?
Wellbutrin is the brand name for bupropion, an atypical antidepressant that works differently from most others. Instead of acting mainly on serotonin, it affects two other brain chemicals, norepinephrine and dopamine, and is classified as a norepinephrine-dopamine reuptake inhibitor (NDRI).
Wellbutrin is FDA-approved for major depressive disorder and seasonal affective disorder, and another version of it, named Zyban, is approved for smoking cessation. It comes in three formulations: immediate-release (Wellbutrin), sustained-release (Wellbutrin SR), and extended-release (Wellbutrin XL). Prescribers sometimes use it off-label for other conditions, such as ADHD.
Wellbutrin may be considered when a patient and prescriber want to minimize certain adverse effects, such as sexual dysfunction or weight gain, that can occur with some other antidepressants. Since a medication’s benefits and risks vary by person, treatment choice should always be individualized.
Does Wellbutrin Cause Hair Loss?
Wellbutrin can cause hair loss in some people, though it's considered uncommon. U.S. prescribing information lists alopecia (the medical term for hair loss) among the reactions reported after Wellbutrin reached the market. However, the label mentions that since these reactions are reported voluntarily from an unknown population size, it is not possible to establish a frequency of occurrence, unlike side effects reported during clinical trials. Neither does this definitively prove that Wellbutrin can cause hair loss.
What the Research Shows
The largest study on this topic followed more than one million new users of 10 different antidepressants using U.S. health insurance claims from 2006 to 2014. Compared with fluoxetine (Prozac), bupropion was linked to about a 46% higher risk of a hair loss diagnosis. The other antidepressants generally had lower recorded rates of hair-loss diagnoses than bupropion. However, the strength and precision of the comparisons varied by medication, and the results should not be treated as a definitive ranking of hair-loss risk for every patient.
Moreover, the absolute risk of hair loss with bupropion remained low. The researchers estimated that about 242 people would need to take bupropion instead of fluoxetine for two years for one additional person to develop hair loss. When the results were broken down by sex, the higher risk appeared in women but was not statistically significant in men.
Because the study was observational and relied on claims data, it can identify associations but cannot prove that a medication caused hair loss in a particular person. Crucially, other factors, including severity of depression, family history of alopecia, stress, diet, and tobacco use, were not accounted for.
Case Reports
Drug safety monitoring programs have also collected individual reports. A review by the Netherlands Pharmacovigilance Centre described 13 spontaneous reports of suspected hair loss associated with bupropion, with a median onset of about six weeks. In roughly half of the cases, hair loss improved after the medication was stopped or the dose was lowered. Again, these reports, though useful for identifying a possible adverse effect, cannot establish its frequency, prove causation, or predict whether an individual patient's hair will regrow after a medication change.
Why Might Wellbutrin Cause Hair Loss?
Researchers don't know exactly why Wellbutrin may trigger hair loss in some people. Several explanations have been proposed, and more than one may play a role.
Effects on the Hair Growth Cycle
Each hair follicle cycles through phases of growth, transition, and rest. In telogen effluvium, a stressor such as illness, hormonal change, or a new medication pushes more follicles than usual into the resting (telogen) phase at the same time. Those hairs then fall out together a few months later, which is why shedding often seems to appear out of nowhere.
Dopamine and Prolactin
Because Wellbutrin affects dopamine, scientists have proposed that it may influence hair follicles through dopamine-related pathways and the hormone prolactin, which play a role in hair cycling. This theory hasn't been confirmed, but it may help explain why bupropion appears to carry a different risk than serotonin-based antidepressants.
What Does Wellbutrin Hair Loss Look Like?
In people who do experience it, medication-related hair loss tends to follow a recognizable pattern. Common features include:
Diffuse thinning: Shedding typically happens all over the scalp rather than in patches, and hair may look thinner overall.
Delayed onset: Telogen effluvium often becomes noticeable two to four months after a trigger, so it's easy to miss the connection to a medication.
More hair in brushes and drains: Collecting 100 or more hairs in a day may suggest telogen effluvium.
No scarring: In telogen effluvium, the scalp usually looks healthy, and hair follicles usually remain capable of regrowing hair. However, the appearance of the scalp alone cannot determine the cause of hair loss.
Other Possible Causes of Hair Loss
Shedding that starts after a new medication isn't necessarily always caused by that medication. Depending on your symptoms and examination, your provider may want to rule out other common triggers, such as:
Thyroid problems, since hypothyroidism can lead to chronic telogen effluvium
Significant emotional stress, which is a well-known trigger for telogen effluvium
Recent illness, high fever, or surgery
Childbirth or other hormonal shifts
Rapid weight loss or nutritional deficiencies
Inherited pattern hair loss, which develops gradually over time
Other medications started around the same time
Depression itself can bring major stress and changes in eating and sleep, so it's possible for hair loss to have more than one contributing cause.
Is Hair Loss From Wellbutrin Permanent?
For most people, medication-related hair loss is not permanent. Acute telogen effluvium is generally self-limited and reversible, and when hair loss is a medication side effect, hair growth usually returns to normal once the drug is stopped. Regrowth also depends on whether another factor is contributing to hair loss. A prescriber can help weigh the possibility of a medication side effect against the benefits of treatment and other possible causes of hair loss.
Regrowth takes patience. Because hair grows slowly, it can take several months after the trigger is addressed before you notice fuller hair again.
What to Do If You Notice Hair Loss on Wellbutrin
Noticing hair loss can be upsetting, especially when you're already working on your mental health. Taking a few deliberate steps can help you and your prescriber figure out what's going on:
Do not stop or change your Wellbutrin dose on your own: Stopping Wellbutrin suddenly could allow depression symptoms to return. Contact your prescriber to discuss the hair loss, its severity, and other possible causes. If a medication change is appropriate, your prescriber can advise whether and how to reduce or discontinue bupropion safely.
Track the timeline: Note when you started Wellbutrin, any dose changes, and when the shedding began.
Take photos: Pictures of your part line or crown taken in the same lighting can show whether things are changing.
Other possible measures: Depending on your symptoms and medical history, your clinician may recommend tests for possible contributors such as thyroid dysfunction or iron deficiency. They may also refer you to a dermatologist if the pattern is unusual, the diagnosis is uncertain, or shedding persists.
Treat your hair gently: Avoid tight hairstyles and harsh chemical treatments while hair recovers.
Treatment Options for Wellbutrin-Related Hair Loss
If your prescriber believes Wellbutrin is contributing to hair loss, there are several ways to approach it. The right choice depends on how well Wellbutrin is working for you and how much the hair loss affects your quality of life.
Adjusting the Dose
In some reported cases, hair loss improved after a dose reduction. If your prescriber suspects Wellbutrin is contributing to hair loss, they may discuss options such as monitoring, dose adjustment, or switching medication. However, evidence that dose reduction specifically treats bupropion-associated hair loss is limited, so the decision should also consider how well the medication is treating your symptoms.
Switching Medications
If hair loss is significant, switching to a different antidepressant may be an option. In the 2018 claims study, fluoxetine and paroxetine had the lowest recorded rates of hair-loss diagnoses among the antidepressants compared. However, the findings are observational and based on older data.
If switching is being considered, your prescriber should weigh the overall benefits, adverse-effect profiles, discontinuation considerations, and your treatment history rather than choosing a medication on hair-loss risk alone. Hair loss has also been reported with selective serotonin reuptake inhibitors (SSRIs), such as escitalopram, so no antidepressant is completely risk-free.
Supporting Regrowth
Topical minoxidil isn't proven to speed recovery from telogen effluvium, but it has theoretical benefits. It may be appropriate for some other types of hair loss, so ask a dermatologist whether it is suitable for your diagnosis.
When to Seek Medical Attention
Contact your healthcare provider if hair loss is sudden or severe, if it comes out in patches, or if it occurs alongside fatigue, weight changes, or feeling cold, which may point to a thyroid issue.
Seek emergency care if you develop swelling of the face or throat or difficulty breathing, which could signal a serious reaction. A severe rash, especially one accompanied by fever, blistering, or peeling skin, also requires urgent medical assessment.
If you have new or worsening thoughts of suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline.
How Blossom Health Can Help
Side effects like hair loss can make it tempting to give up on treatment, but you don't have to choose between your mental health and feeling good about how you look. Blossom Health connects you with board-certified psychiatric providers for virtual care, and every provider can review your symptoms, evaluate side effects, and adjust or change your medication when appropriate.
Blossom works with many insurance plans, so check your coverage and schedule a virtual appointment with Blossom Health.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice. If you are in crisis or thinking about harming yourself, call or text 988 or call 911.
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