Bupropion

Summary

Bupropion is a medication used to treat depression and promote smoking cessation. It is a dopamine and norepinephrine reuptake inhibitor, working to increase the signaling of both neurotransmitters in the brian. It’s important to know that bupropion is contraindicated in patients with bulimia and anorexia nervosa as it can cause seizures in these patients. In contrast to other antidepressants, bupropion promotes weight loss and does not have any sexual side effects. Finally, bupropion can also cause nonspecific side effects like tachycardia, insomnia, and headaches.

Key Points

• Bupropion
  • Mechanism
    • Inhibits norepinephrine and dopamine reuptake
      • Does not affect serotonin levels
  • Clinical Indications
    • Treats depression and related depressive mood disorders
      • Generally used as a 2nd/ 3rd line pharmacologic choice after SSRIs (which are definitive 1st line)
      • Can also be used as adjunct therapy
      • Classified as an atypical antidepressant.
    • Promotes smoking cessation
      • Reduces withdrawal symptoms in nicotine addiction and smoking cessation.
  • Side Effects
    • Seizures
      • Contraindicated in bulimia/anorexia nervosa and seizure disorders
        • Seizures are the most significant side effect and the drug is contraindicated in patients with bulimia or anorexia nervosa.
        • Mechanism of sz in bulimia is not well understood, but is super high-yield
    • Does not cause sexual side effects
      • Contrast vs. SSRIs which cause sexual dysfunction
    • Promotes weight loss
      • Contrast to SSRIs and mirtazapine which cause weight gain
    • Stimulant effects (tachycardia and insomnia)
    • Headache