Can Bupropion be ototoxic? (5+ factors)

In this article, we will discuss whether Bupropion can cause ototoxicity. Furthermore, we will talk about research studies, contributing factors, what should be done if Bupropion causes ototoxicity, and what other side effects can be experienced by patients while taking Bupropion. 

Can Bupropion be ototoxic?

Yes, Bupropion can be ototoxic; however, it is a rare side effect. It is important to note that rare side effects do not occur in every individual taking Bupropion. However, there might be a possibility that hearing problems can occur as Bupropion is an antidepressant.

Antidepressants are known to be ototoxic, causing tinnitus or other hearing problems (1). Bupropion is an antidepressant that affects certain neurotransmitters in the brain, such as norepinephrine and dopamine. Bupropion should only be taken if prescribed by your healthcare provider.

Bupropion is FDA-approved for the treatment of adult depression, seasonal affective disorder, and smoking cessation (2). Ototoxicity is a medical term that means certain medications can cause harm to your inner ear or hearing nerve. Symptoms of ototoxicity may include tinnitus, hearing loss, or balance problems (3).  

What does research suggest?

There are not enough research studies to support that Bupropion can be ototoxic. However, Bupropion has been included in the list of ototoxic drugs. If a side effect of the medicine is listed, it does not mean that everyone taking Bupropion will experience ototoxicity.

Bupropion can also be used to treat anti-depressant-induced sexual dysfunction, attention-deficit/hyperactivity disorder (ADHD), depression associated with bipolar disorder, and obesity. It is also used for ADHD in children (2).

Bupropion mainly regulates dopamine, which is involved in pleasure and motivation. Bupropion also has a mild effect on nicotinic and serotonin receptors, which are related to mood, sleep, stress response, and other brain functions (1).

Ototoxicity can be a common side effect of many medicines, and if left untreated, it can lead to permanent hearing loss. The effect and severity of ototoxicity depend on individual risk factors (3).   

What other factors can contribute to ototoxicity with Bupropion?

There might be some other underlying factors that contribute to ototoxicity with Bupropion, such as:

  • Age can be a contributing factor to ototoxicity, and elderly people may be more susceptible (4). 
  • Higher doses of medications may increase the risk of hearing problems. 
  • Taking multiple medications with ototoxic potential may increase the risk. 
  • The longer you take the medication, the greater the chances of hearing problems. 
  • Patients’ susceptibility can be influenced by genetic and medical history.
  • Certain medical conditions may also increase the risk of ototoxicity (5). 

What to do if Bupropion causes ototoxicity?

If you suspect that Bupropion is causing ototoxicity, please inform your doctor. They will evaluate your current symptoms, family/medical history, and response to the medication. They will also evaluate other factors and guide you accordingly.

If necessary, your doctor may reduce the dosage gradually with a proper tapering plan over a few weeks or months, depending on your current depression and ototoxicity symptoms.

If necessary, your doctor may switch you to other medications which does not cause ototoxicity such as Alprazolam or Amitriptyline. However, do not use these medications without consulting your healthcare provider.

Some lifestyle modifications can help you cope with ototoxicity symptoms, such as tinnitus, including using white-noise machines when trying to sleep or removing excess ear wax. A few therapies can also ease your symptoms of ototoxicity such as Tinnitus retraining therapy (TRT) and Cognitive behavioural therapy (CBT) (6). 

What other side effects are related to Bupropion?

Bupropion may cause some other side effects. If you experience any of these side effects, please immediately reach out to your healthcare provider. 


There is limited research available to support the ototoxicity of Bupropion. Bupropion can cause harm to the inner ear or hearing nerve; however, it is important to note that rare side effects, such as ototoxicity, do not occur in every patient taking Bupropion.

The decision to use Bupropion should be made in consultation with a healthcare provider, carefully weighing the benefits and potential risks for each patient’s specific needs and physiological responses. 

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Zhong PX, Li IH, Shih JH, Yeh CB, Chiang KW, Kao LT. Antidepressants and risk of sudden sensorineural hearing loss: a population-based cohort study. Int J Epidemiol. 2021 Nov 10;50(5):1686-1697. doi: 10.1093/ije/dyab023. PMID: 33742212. Available from: 


Huecker MR, Smiley A, Saadabadi A. Bupropion. 2023 Apr 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29262173. Available from: 


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Joo Y, Cruickshanks KJ, Klein BEK, Klein R, Hong O, Wallhagen MI. The Contribution of Ototoxic Medications to Hearing Loss Among Older Adults. J Gerontol A Biol Sci Med Sci. 2020 Feb 14;75(3):561-566. doi: 10.1093/gerona/glz166. PMID: 31282945; PMCID: PMC7328195. Available from: 


Bisht M, Bist SS. Ototoxicity: the hidden menace. Indian J Otolaryngol Head Neck Surg. 2011 Jul;63(3):255-9. doi: 10.1007/s12070-011-0151-8. Epub 2011 Feb 23. PMID: 22754805; PMCID: PMC3138949. Available from: 


Theodoroff SM, McMillan GP, Zaugg TL, Cheslock M, Roberts C, Henry JA. Randomized Controlled Trial of a Novel Device for Tinnitus Sound Therapy During Sleep. Am J Audiol. 2017 Dec 12;26(4):543-554. doi: 10.1044/2017_AJA-17-0022. PMID: 29090311. Available from: 


Bupropion. MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [last revised 15th Feb 2018]. Available from: 

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