What is bupropion? |

History of Use

Bupropion is a widely prescribed antidepressant, at one time the fourth-most prescribed antidepressant in the United States. It was invented in 1969 by GlaxoSmithKline (then Burroughs Wellcome) and was designed and synthesized by Nariman Mehta. It was approved as an antidepressant in 1985 by the US Food and Drug Administration, withdrawn in 1986 because of concerns over seizures, and reintroduced to the market in 1989, after the maximum dosage was adjusted. Bupropion was approved in 1997 as an aid for smoking cessation (under the name Zyban). Under the name Wellbutrin XL, it has also been approved to treat seasonal affective disorder, a mood disorder prevalent in either the winter or the summer months.

Treatment

Patients are instructed to start taking bupropion one week before they plan to stop smoking. It takes about one week for this medication to reach adequate levels in a person’s system, and patients are instructed to target a specific quit date during the second week that they are taking bupropion. If a dose is missed, patients are instructed to skip it and to stay with their regular dosing schedule. Taking too much bupropion at one time can cause seizures.

Effects and Potential Risks

Most people do not have side effects from taking bupropion for smoking cessation. If side effects do occur, they can usually be minimized. In addition, side effects are most often temporary, lasting only as long as one is taking the medication.

There are rare but serious side effects that patients should be aware of. In some people, medications like bupropion may cause severe mood and behavior changes, including suicidal thoughts. Young adults may be more at risk for these side effects.

Other side effects include anxiety; buzzing or ringing in the ears; headache (severe); and skin rash, hives, or itching. Side effects that may occur frequently or become bothersome include abdominal pain, constipation, decrease in appetite, dizziness, dry mouth, increased sweating, nausea or vomiting, trembling or shaking, insomnia, and weight loss.

Symptoms of an overdose may be more severe than side effects seen at regular doses, or two or more side effects may occur together. They include fast heartbeat, hallucinations, loss of consciousness, nausea or vomiting (or both), and seizures.

Bupropion should not be combined with other medications that lower the threshold for seizures. These medications include theophylline, antipsychotic medications, antidepressants, Tramadol (Ultram), Tamoxifen, steroids, diabetes drugs, and Ritonavir.

Bibliography

Cahill, Kate, Sarah Stevens, and Tim Lancaster. "Pharmacological Treatments for Smoking Cessation." Journal of the American Medical Association 311.2 (2014): 193–4. Print.

Fiore, M. C., et al. “Treating Tobacco Use and Dependence: 2008 Update.” Tobacco Use and Dependence Guideline Panel. Rockville, MD: Department of Health and Human Services, 2008. Print.

Hong, Arthur S., Muhamad Y. Elrashidi, Darrell R. Schroeder, and Jon O. Ebbert. "Depressive Symptoms among Patients Receiving Varenicline and Bupropion for Smoking Cessation." Journal of Substance Abuse Treatment 52 (2015): 78–81. Print.

Hughes, J. R., L. F. Stead, and T. Lancaster. “Antidepressants for Smoking Cessation.” Cochrane Database of Systematic Reviews 1 (2007): CD000031. Print.

McDonough, Mike. "Update on Medicines for Smoking Cessation." Australian Prescriber 38.4 (2015): 106–11. Print.

Wu, P., et al. “Effectiveness of Smoking Cessation Therapies: A Systematic Review and Meta-Analysis.” BMC Public Health 6 (2006). Print.