Bupropion

Summary

Bupropion is an atypical antidepressant used to treat depression and help with smoking cessation. The biggest adverse effect is that bupropion can cause seizures. The patient should avoid alcohol, as well as crushing or chewing the pills, as both of these things can increase the risk of seizures.

Key Points

• Mechanism
  • Atypical Antidepressant
    • Inhibits norepinephrine, dopamine, and serotonin reuptake
  • Clinical Use
    • Depression
      • Major depressive disorder
      • Persistent depressive disorder
      • Seasonal affective disorder
    • Smoking cessation
      • Mimics the effects of nicotine
  • Side Effects and Adverse Reactions
    • Seizures
      • Bupropion lowers the seizure threshold. The higher the dose, the higher chance of experiencing seizures.
        • The medication should be taken at the same time every day, and missed doses should be skipped rather than doubled
      • Advise patient to limit alcohol intake, as alcohol can lower the seizure threshold even further
      • The medication should not be crushed or chewed, as this can lead to high absorption and doses leading to seizures
      • Contraindicated with history of seizures or epilepsy
    • Increased risk for suicidal behavior
      • May be seen at the beginning of treatment especially with adolescents and young adults, should diminish with time
      • Due to an increase in energy that occurs before an increase in mood
      • Monitor patient for worsening depression, sudden or unusual behavior
    • Weight loss
      • Note this is different from most other antidepressants which cause weight gain
    • Anxiety, agitation