Does Wellbutrin Affect Sex Drive? What the Bupropion Trials Actually Show
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Does Wellbutrin affect sex drive? Yes, and mostly in the direction people hope: bupropion, the generic behind Wellbutrin, is the one antidepressant in the largest meta-analysis of this question that did not separate from placebo on sexual side effects. Ten others did, at rates from 25.8% to 80.3% of patients. Head to head against sertraline over 16 weeks, 63% of men and 41% of women developed sexual dysfunction, against 15% and 7% on bupropion SR. The louder second claim, that Wellbutrin raises desire outright, stands on much thinner ground, and the honest version is below.
Do not stop or change your medication without your doctor. Starting an antidepressant, stopping one, switching one or adding a second is a prescriber's decision every time. Bring this page to the appointment if it helps, and change nothing on the strength of it.
- Pooling studies that asked patients directly, ten antidepressants led by sertraline produced significantly more treatment-emergent sexual dysfunction than placebo, at 25.8% to 80.3%. Bupropion was one of six showing no significant difference from placebo. The authors flag open-label studies in the pool and differing scales.
- In one 16-week randomized trial of 248 depressed outpatients who all had normal sexual functioning at entry, 63% of men and 41% of women on sertraline developed sexual dysfunction, against 15% and 7% on bupropion SR.
- Added to an SSRI for women, bupropion SR twice daily improved desire against placebo (1.74, 95% CI 1.03 to 2.44) and did not improve depressive symptoms (0.46, -0.71 to 1.63). Eleven studies, 859 women, two poolable, evidence graded low certainty.
- For low desire in women without depression, the pooled estimate is 2.845 (95% CI 0.215 to 5.475), heterogeneity 95.6%. The interval nearly touches zero and the trials disagree almost completely.
Figures from Segraves et al. 2000 (PMID 10770448), Razali et al. 2022 (PMID 35193485) and de Aquino et al. 2025 (PMID 39985829). One trial, two pooled reviews, no prescribing recommendation anywhere on this page.
"Is it the Wellbutrin, or is it me?"
Type Wellbutrin sex drive into a search bar and two confident answers come back, and they contradict each other. One says Wellbutrin leaves your libido alone. The other says it raises desire outright. The first is close to what the evidence supports. The second is a smaller, shakier body of work wearing the first one's clothes.
Three people usually land here: someone on an SSRI whose desire went flat, someone already on Wellbutrin watching for a lift that never arrived, and a woman with low desire and no depression who has read that Wellbutrin is prescribed for exactly that. The evidence answers those three with three different degrees of confidence. See also the SSRI libido drop and what helps, antidepressants and low libido, and libido after stopping antidepressants.
What the antidepressant meta-analysis actually ranked
Serretti and Chiesa pooled the studies where sexual functioning was investigated on purpose, through direct questioning and questionnaires, in patients who had no sexual difficulty before treatment. Side effects nobody asks about get reported at a fraction of their real rate, so that design choice matters.
Ten drugs came out significantly above placebo. In the authors' decreasing order of impact: sertraline, venlafaxine, citalopram, paroxetine, fluoxetine, imipramine, phenelzine, duloxetine, escitalopram and fluvoxamine. Across those ten, sexual dysfunction ranged from 25.8% to 80.3% of patients. The paper publishes that range and no per-drug percentage, so anyone quoting a figure for one specific SSRI from it is filling in a blank.
Six showed no significant difference from placebo: agomelatine, amineptine, bupropion, moclobemide, mirtazapine and nefazodone. That sentence is the entire factual basis for the reputation Wellbutrin carries, and it is a decent basis. It is also a group-level comparison against placebo, which is weaker than "this drug will leave your desire untouched." The authors add two caveats: open-label studies were in the pool, and the scales used differed between studies.
A separate review of 51 studies supplies the sentence quoted everywhere else: bupropion is generally well tolerated, it has very low rates of sexual dysfunction, and it is more likely to cause weight loss than gain. The rest of that review rarely travels with the quote. Bupropion is typically a third-line or fourth-line agent under many licences, and the authors write that it remains uncertain whether it truly augments other drugs.
The two head-to-head trials, side by side
A head-to-head trial puts two drugs in one protocol with one measuring stick, and there are two. Segraves and colleagues randomized 248 patients with moderate to severe major depression to bupropion SR or sertraline for 16 weeks, double blind. Everyone entering had to have a stable relationship and normal sexual functioning, so any dysfunction was something the trial watched happen. By the end, 63% of men and 41% of women on sertraline had developed sexual dysfunction, against 15% and 7% on bupropion SR. It showed as early as day 7 at 50 milligrams a day and lasted the full 16 weeks, and four patients quit early because of it, all on sertraline.
Sexual dysfunction that developed during 16 weeks of treatment
Percentages from one trial, Segraves et al. 2000. Orange is sertraline, blue is bupropion SR.
Source: Segraves RT et al., Journal of Clinical Psychopharmacology 2000 (PMID 10770448). One randomized double-blind multicentre trial, N = 248, 16 weeks, bupropion SR 100 to 300 milligrams a day against sertraline 50 to 200. A single trial, so read it as one data point.
The second trial added the arm the first lacked. Coleman and colleagues randomized 456 patients with recurrent major depression to bupropion SR, fluoxetine or placebo for up to eight weeks (150, 154 and 152 patients, completion 63%, 63%, 67%). The two active drugs treated the depression about equally well, and from week 2 onward significantly more patients on fluoxetine had sexual side effects than patients on bupropion SR or placebo.
Three claims about Wellbutrin, and what each one stands on
Three claims, ranked by how much evidence sits under each. They get said in the same breath and are not equally supported.
"It does not flatten desire the way SSRIs do."
A meta-analysis of studies that asked directly, plus two randomized head-to-head trials, one placebo controlled. Pooled result: no difference from placebo.
"It rescues desire an SSRI took away."
Eleven randomized trials, 859 women, two poolable. Desire improved (1.74, 95% CI 1.03 to 2.44) and the reviewers graded the certainty low.
"It raises desire in women who are not depressed."
Pooled estimate 2.845, 95% CI 0.215 to 5.475, heterogeneity 95.6%. The interval nearly touches zero, and one group's trials carry much of the weight.
Built from PMID 19440080, 10770448, 11519769, 39985829 and 35193485. None of it is advice about your prescription.
When an SSRI took the desire and bupropion is added on top
This is the most common real-world version of the question: the SSRI is working on the depression, the desire is gone, and nobody wants to trade one for the other.
de Aquino and colleagues reviewed every randomized trial of a drug treatment for antidepressant-induced sexual difficulty in women up to July 2024. Eleven studies covering 859 women qualified, aged 28 to 48, and the interventions included several botanical preparations, sildenafil, testosterone, an ephedrine preparation and one investigational compound. Only two of the eleven could be pooled, which tells you how thin this literature is. Bupropion SR twice daily improved desire against placebo at 1.74 (95% CI 1.03 to 2.44) and did not improve depressive symptoms at 0.46 (-0.71 to 1.63). The reviewers called it the most effective drug treatment here and graded that evidence low quality, in the same conclusion. Both halves are the finding.
The largest single trial is Safarinejad's: 218 women aged 25 to 45 with SSRI-induced sexual difficulty, randomized to 12 weeks of bupropion sustained release at 150 milligrams twice daily or placebo, 109 per arm, double blind and fixed dose. Total questionnaire score came out at 25.9 on bupropion (95% CI 22.2 to 29.4) against 17.2 on placebo (15.8 to 20.1), p = 0.001, and against its own baseline the desire score rose 86.4% (95% CI 64.9 to 102.2%). A single-centre Iranian trial, and one trial.
Hold the wider context next to it. Luft and colleagues network-pooled everything tried for this problem on one rating scale: 57 citations, 27 randomized controlled trials, 27 open-label trials, three crossover trials, 33 interventions, 3,108 patients. Across all of it, 44% of trials reported a successful intervention: 70% of the open-label trials and 22% of the placebo-controlled ones. Pooling the eight placebo-controlled trials on that scale, pycnogenol beat placebo (standardized mean difference -1.8, 95% credible interval -3.7 to 0.0) and sildenafil showed evidence of helping at a 6% threshold.
That 70% against 22% is the number to carry into any conversation about a fix for this. Take the placebo arm away and most things look like they work. Put it back and most stop. If you are on an SSRI through perimenopause, SSRIs, perimenopause and low libido covers both at once.
Wellbutrin and sex drive in women who are not depressed
The third claim circulates hardest, because it is the most useful thing a drug could do, and it rests on a much smaller pile of trials. Razali and colleagues pooled the trials of bupropion in women with problems of sexual desire and found it almost three-fold more favorable, at 2.845 (95% CI 0.215 to 5.475), heterogeneity 95.6%, p = 0.034. Three things about that. The interval very nearly touches zero at its lower end, so the true effect could be close to nothing. Heterogeneity of 95.6% means the trials disagree almost completely, and averaging numbers that disagree that much produces a figure nobody's trial looked like. And only dose explained the variance: 150 milligrams beat 300, the reverse of how a drug effect usually behaves. The authors conclude there is a potential role here.
Underneath it sit the individual trials. Safarinejad's second study randomized 232 treatment-seeking women with regular menstrual cycles to bupropion SR at 150 milligrams daily or placebo for 12 weeks, 116 per arm, after a one-week placebo lead-in. The composite score climbed from 15.8 at baseline to 33.9 on bupropion, while placebo went from 15.5 to 16.9. Odds of response were 3.2 (95% CI 2.1 to 6.3), personal distress fell 29.4% against 4.7%, and 65.3% of the bupropion group answered "definitely yes" to whether treatment meaningfully improved their sexual desire, against 4.3% on placebo.
Those are enormous separations, and the reason to slow down is the placebo arm. A 4% placebo response is far below what desire trials usually produce. One centre, one investigator group, a placebo response unlike the rest of the field. That does not make the trial wrong. It makes it a trial that badly needs replicating elsewhere.
The other supporting trial is older: a randomized, double-blind, placebo-controlled, multi-site escalating dose trial over 112 days in premenopausal women with acquired, global low sexual desire, which reported that all measures indicated greater sexual responsiveness on bupropion, with significant effects on responsiveness and satisfaction. Background on the diagnosis is in what HSDD actually means, and the model that reframes much of it is in responsive and spontaneous desire.
Antidepressants and desire, side by side
| Drug or class | What the pooled evidence shows | Population | Certainty |
|---|---|---|---|
| Sertraline (first in impact order) | More than placebo. Head to head, 63% of men and 41% of women developed it, against 15% and 7% on bupropion SR | 248 outpatients, 16 weeks | Meta-analysis plus one randomized trial. Those percentages are from that trial alone |
| Venlafaxine, citalopram, paroxetine (positions two to four); then imipramine, phenelzine, duloxetine, escitalopram, fluvoxamine (six to ten) | More than placebo. Across all ten drugs above placebo the rate ran 25.8% to 80.3%, with no per-drug figure published | Patients with no sexual difficulty before treatment | Meta-analysis. Open-label inclusion, differing scales |
| Fluoxetine (position five) | More than placebo. In a three-arm trial, sexual side effects and sexual desire disorder were more often associated with it than with bupropion SR or placebo, from week 2 on | 456 patients, 8 weeks | Meta-analysis plus one placebo-controlled trial |
| Bupropion (Wellbutrin), sole antidepressant | No significant difference from placebo, with agomelatine, amineptine, moclobemide, mirtazapine and nefazodone. A review of 51 studies calls it well tolerated with very low rates of sexual dysfunction | Same pool, plus 51 studies | Best supported here, still a group-level comparison against placebo |
| Bupropion added to an SSRI, in women | Desire improved (1.74, 95% CI 1.03 to 2.44); depressive symptoms did not (0.46, -0.71 to 1.63) | 11 studies, 859 women, ages 28 to 48, only two pooled | GRADE low, stated by the reviewers |
| Bupropion for low desire in women without depression | Pooled estimate 2.845 (0.215 to 5.475), p = 0.034. Only dose explained the variance, 150 milligrams beating 300 | Women with sexual desire disorder | Weakest here. Heterogeneity 95.6%, interval nearly touching zero |
"I've tried everything and my drive is nowhere to be found"
If you are already on Wellbutrin and the lift never came, nothing above says you did it wrong. The strongest claim here is a comparison against placebo across hundreds of people, and it says very little about any one evening. Depression itself flattens desire, whatever is taken for it, which is the subject of depression and low libido. Then there is the rest of the medication list: lamotrigine and sex drive, Adderall and sex drive and blood pressure medication and sex drive each carry their own signal. If your bloodwork came back unremarkable, normal labs, low libido is written for that position, and brain fog and sex drive covers the tired-all-the-time bundle that arrives with it.
What to take to your prescriber
The appointment will be shorter than you want, so bring this list.
- Say the sexual side effect out loud, early. This literature exists because patients under-report it unless asked directly.
- Name which of the three questions is yours: adding something to your current drug, switching drugs, or treating low desire on its own.
- Bring the timeline and the whole medication list, prescription and over the counter. When the desire changed relative to when the medication started is the detail that gets skipped.
- Ask what the plan checks against and when. The trials that measured desire going up ran 12 weeks to 112 days, so a two-week verdict is no verdict.
- Ask what the evidence looks like for whatever gets suggested. That 44% of trials reporting success, splitting into 70% open-label and 22% placebo-controlled, is worth holding in mind.
None of that is a plan to carry out on your own. Do not stop or change your medication without your doctor.
The everyday levers, and where a botanical fits
Before anything else here: if you take blood pressure medication, or you have a cardiovascular, renal, or pulmonary condition, or you are sensitive to any of the ingredients, NUUD's own label says to avoid use. That sentence is printed on the product, and for many people reading this page it is the whole answer. Talk to your doctor first and bring the label.
And a line that has to be said once, plainly: a prescription antidepressant and a botanical supplement are different categories of thing, and nothing here places one beside the other as a choice. If you take an antidepressant, your prescriber decides whether any supplement belongs in the picture.
Separate from anything clinical, a few ordinary things move desire.
- The prescribing conversation itself, where every question on this page gets settled.
- Sleep, in quantity and quality, since fatigue eats desire before the evening starts.
- Care for your mood on its own terms.
- Movement you actually enjoy, which does its own work on energy.
- Time and safety, with no expectation attached.
- A botanical supplement, if you want one, as the smallest lever on the list.
NUUD is a botanical supplement built around desire in general. It does nothing for depression, nothing for any antidepressant's side effects, and has no role in managing a medical condition. The formula is anchored by the NUUD Mushroom Complex™, with Muira Puama, Boiled Rehmannia Root, Tribulus Terrestris, and Piper Nigrum for absorption, on a timeline of roughly 30 to 60 minutes. If your prescriber has looked at the label and has no objection, and you want one more small thing on the desire side, that is what our women's libido gummies are for, and there is a men's version.
"Nothing is wrong with you"
You have probably been handed two unhelpful answers already. One is a shrug in an appointment that ran nine minutes. The other is a confident voice online saying Wellbutrin is the antidepressant that fixes this, so if it has not fixed yours, something is wrong with you.
The research supports neither. It supports one clear finding, that bupropion did not separate from placebo on sexual side effects while ten other antidepressants did, and a second, thinner one, that bupropion can raise desire in some women, on evidence its own reviewers graded low. Between a group-level finding and your own Tuesday night there is a lot of room, and that room is where most people live. If you have been quietly wondering whether you are broken: no. Why is my libido so low walks through the rest, low libido in women covers the wider picture, and there is a men's version too.
Keep reading
- Antidepressants and low libido
- The SSRI libido drop, and what helps
- Libido after stopping antidepressants
- Depression and low libido
- Normal labs, low libido
Frequently asked questions
Does Wellbutrin increase sex drive?
Sometimes, and this is the weakest claim on the page. Pooled across the trials in women with problems of sexual desire, the estimate was 2.845 (95% CI 0.215 to 5.475), heterogeneity 95.6%, p = 0.034: the interval nearly touches zero and the trials disagree almost completely. Added to an SSRI, bupropion SR twice daily improved desire against placebo (1.74, 95% CI 1.03 to 2.44) on evidence the reviewers graded low certainty. This is an off-label prescribing decision for a doctor who knows your history.
Does Wellbutrin lower sex drive the way SSRIs do?
No. In a meta-analysis of studies where sexual functioning was investigated on purpose, bupropion showed no significant difference from placebo on treatment-emergent sexual dysfunction, alongside agomelatine, amineptine, moclobemide, mirtazapine and nefazodone, while ten others led by sertraline came out significantly above placebo, at 25.8% to 80.3%. In a 16-week randomized trial of 248 depressed outpatients who all had normal sexual functioning at entry, 63% of men and 41% of women on sertraline developed sexual dysfunction, against 15% and 7% on bupropion SR, from that one trial.
Is Wellbutrin used for low libido in women?
Yes, off label, and the evidence is thinner than the reputation. One randomized double-blind trial gave 232 women with regular menstrual cycles bupropion SR at 150 milligrams daily or placebo for 12 weeks; the composite score climbed from 15.8 to 33.9 on bupropion while placebo went from 15.5 to 16.9, odds of response 3.2 (95% CI 2.1 to 6.3). The placebo response there was around 4%, far below what desire trials usually produce, at a single centre. A separate 112-day trial in premenopausal women reported greater sexual responsiveness. Pooled, the trials give 2.845 (95% CI 0.215 to 5.475), heterogeneity 95.6%.
How long does Wellbutrin take to affect sex drive?
The trials ran 12 weeks to 112 days, and none was designed to find the first day anything changed. The add-on trial in women ran 12 weeks, the trial in ovulating women 12 weeks after a placebo lead-in, and the escalating dose trial 112 days. On the comparison side, sexual dysfunction was noted as early as day 7 in sertraline patients, and separation from placebo appeared from week 2 in the fluoxetine trial. So the honest answer is weeks to months, and your prescriber sets your check-back date.
Can I take a botanical supplement with Wellbutrin?
Ask your prescriber first, before you buy anything. Botanicals can interact with prescription medications, and the person holding your full medication list is the only one who can weigh that. NUUD is a botanical supplement built around desire in general, with no role in depression or in any drug's side effects. Its label says to avoid use if you are on blood pressure medication, have cardiovascular, renal, or pulmonary conditions, or if you are sensitive to any of the ingredients.
References
- Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. Journal of Clinical Psychopharmacology. 2009;29(3):259-66. https://pubmed.ncbi.nlm.nih.gov/19440080/
- Segraves RT, Kavoussi R, Hughes AR, et al. Evaluation of sexual functioning in depressed outpatients: a double-blind comparison of sustained-release bupropion and sertraline treatment. Journal of Clinical Psychopharmacology. 2000;20(2):122-8. https://pubmed.ncbi.nlm.nih.gov/10770448/
- Coleman CC, King BR, Bolden-Watson C, et al. A placebo-controlled comparison of the effects on sexual functioning of bupropion sustained release and fluoxetine. Clinical Therapeutics. 2001;23(7):1040-58. https://pubmed.ncbi.nlm.nih.gov/11519769/
- Patel K, Allen S, Haque MN, et al. Bupropion: a systematic review and meta-analysis of effectiveness as an antidepressant. Therapeutic Advances in Psychopharmacology. 2016;6(2):99-144. https://pubmed.ncbi.nlm.nih.gov/27141292/
- de Aquino ACQ, Sarmento ACA, Teixeira RLA, et al. Pharmacological treatment of antidepressant-induced sexual dysfunction in women: A systematic review and meta-analysis of randomized clinical trials. Clinics (Sao Paulo). 2025;80:100602. https://pubmed.ncbi.nlm.nih.gov/39985829/
- Safarinejad MR. Reversal of SSRI-induced female sexual dysfunction by adjunctive bupropion in menstruating women: a double-blind, placebo-controlled and randomized study. Journal of Psychopharmacology. 2011;25(3):370-8. https://pubmed.ncbi.nlm.nih.gov/20080928/
- Safarinejad MR, Hosseini SY, Asgari MA, Dadkhah F, Taghva A. A randomized, double-blind, placebo-controlled study of the efficacy and safety of bupropion for treating hypoactive sexual desire disorder in ovulating women. BJU International. 2010;106(6):832-9. https://pubmed.ncbi.nlm.nih.gov/20151970/
- Razali NA, Sidi H, Choy CL, Roos NAC, Baharudin A, Das S. The Role of Bupropion in the Treatment of Women with Sexual Desire Disorder: A Systematic Review and Meta-Analysis. Current Neuropharmacology. 2022;20(10):1941-1955. https://pubmed.ncbi.nlm.nih.gov/35193485/
- Segraves RT, Clayton A, Croft H, Wolf A, Warnock J. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. Journal of Clinical Psychopharmacology. 2004;24(3):339-42. https://pubmed.ncbi.nlm.nih.gov/15118489/
- Luft MJ, Dobson ET, Levine A, Croarkin PE, Strawn JR. Pharmacologic interventions for antidepressant-induced sexual dysfunction: a systematic review and network meta-analysis of trials using the Arizona sexual experience scale. CNS Spectrums. 2021;Apr 12:1-10. https://pubmed.ncbi.nlm.nih.gov/33843553/
This article is for general education and is not medical advice. Depression is a medical condition that only a licensed clinician can diagnose and manage, and Wellbutrin (bupropion) is a prescription medication. NUUD is a botanical supplement with no role in diagnosing, treating, curing, or preventing depression, any other disease, or the side effects of any medication, and these statements have not been evaluated by the Food and Drug Administration. Talk with your doctor before starting any new supplement. Do not stop or change your medication without your doctor.
