Bupropion

Brand names

• Wellbutrin
• Zyban

Usage

To relieve symptoms of major depression. Bupropion is also used as a nicotine free agent to help stop smoking. It should be used as a part of a comprehensive smoking cessation program carried out under the supervision of your doctor.

How it works

While the exact mechanism of action of bupropion is not known, it appears to help balance the levels of neurotransmitters (brain chemicals) that are thought to be linked to mood, emotions, and mental state. Unlike other smoking cessation medications, bupropion does not contain nicotine. It is believed that bupropion's effects on brain chemistry help to curb the desire for nicotine and enhance the patient's ability to abstain from smoking.

Side effects

Serious

When treating depression: hallucinations, heartbeat irregularities, confusion, skin rash, insomnia, severe headache, excitement or agitation, seizures. Seek medical help immediately. Smoking cessation: none reported.

Common

When treating depression: nausea or vomiting, constipation, unusual weight loss, dry mouth, loss of appetite, dizziness, increased sweating, trembling or shaking. Smoking cessation: dry mouth, insomnia.

Less common

When treating depression: fever or chills, concentration difficulties, drowsiness, fatigue, change in or blurred vision, unusual feeling of euphoria, hostility or anger. Smoking cessation: mild rash, tremor.

Possible interactions

Other medicaments:

The following medicaments taken concurrently with bupropion may increase the risk of major seizures:

• antidepressants (tricyclic) or other bupropion containing medicines.
• clozapine (Clozaril).
• fluoxetine (Prozac).
• haloperidol (Haldol).
• lithium (Lithobid, others).
• loxapine (Loxitane).
• maprotiline (Ludiomil).
• molindone (Moban).
• phenothiazines.
• thioxanthenes.
• trazodone (Desyrel).

Bupropion taken concurrently with:



• carbamazepine (Tegretol) may result in lowered carbamazepine levels.
• cimetidine (Tagamet) may lead to increased bupropion levels.
• levodopa results in increased nausea, restlessness and tremor.
• MAO inhibitors can lead to sudden toxicity. Do not combine.
• phenobarbital may result in decreased levels.
• phenytoin (Dilantin) or fosphenytoin (Cerebyx) may result in decreased phenytoin or fosphenytoin levels.
• ritonavir (Norvir) and probably other protease inhibitors may lead to increased blood levels of bupropion and toxicity-do not combine.
• zolpidem (Ambien) may lead to hallucinations.

Herbal medicines or minerals:

Ginseng, ma huang, yohimbe and St. John's wort may interact with antidepressants, so combining those herbals with these medicines is not recommended.

Alcohol:

Avoid completely. Alcohol may predispose to the development of seizures.

Marijuana smoking:

Avoid completely; it may lead to psychotic behavior.

Discontinuation:

Do not stop this medicament abruptly. Ask your doctor for help.