Introduction of Bupropion
Bupropion is a drug commonly known with its brand names Wellbutrin and Zyban. Bupropion was formulated by Nariman Mehta, who worked at Burroughs Wellcome in 1969. It is, in reality, a norepinephrine–dopamine reuptake inhibitor and a nicotinic receptor antagonist. It is mainly an atypical antidepressant used to treat major depressive disorder and help stop smoking.
Bupropion is quite a nice drug with several features that distinguish it from other antidepressants.
- Usually, it does not cause any sexual dysfunction.
- It does not cause weight gain or sleepiness.
- It is proven to be more effective than SSRIs for treating hypersomnia and fatigue.
Common adverse effects of Bupropion
- Bupropion causes dry mouth, nausea, constipation, insomnia, anxiety, tremor, and excessive sweating.
- It also is known to cause raised considerable blood pressure.
- Serious side effects include seizure, liver toxicity, psychosis, and risk of overdose.
- Bupropion use during pregnancy may be associated with increased odds of congenital heart defects.
Uses of Bupropion
Bupropion is very efficient in the treatment of depression. In the winter season, this powerful drug prevents seasonal depression in patients who suffer seasonal episodes of depression. Bupropion also improves depression in bipolar disorder efficiently.
This wonderful medicine helps to come out of the clutches of smoking and also reduces the urge to eat tobacco and their withdrawal symptoms. The symptoms range from depression, irritability, and unfocussed work, etc. The bupropion treatment affects up to twelve weeks. After the time relapses, the effectiveness of the medicine declines slowly.
This drug helps treat attention deficit hyperactivity disorder according to the guidelines of the American Academy of Paediatrics. Still, When patients take this drug, they don’t complain about sleepiness.
This drug has not reportedly caused any sexual dysfunction. The sexual side effects caused by other antidepressants are much less than other medications.
This drug is used to treat overweight for 12 months to result in an average weight loss of 2.7 kg. The weight loss produced by other weight loss medications also has similar results. It has received no reports about the weight gain.
- This drug should not be administered to patients who have epilepsy or with disorders like anorexia nervosa, bulimia nervosa, benzodiazepine, or alcohol withdrawal.
- This drug must be avoided in people with monoamine oxidase inhibitors (MAOIs).
- If someone is already using MAOIs and then want to take Bupropion, it is important to take a certain period to wash out for 2 weeks.
- Bupropion should be carefully administered while treating people with liver damage, severe kidney disease, and severe hypertension in children, adolescents, and young adults due to the increased risk of suicidal ideation.
Side effects of Bupropion
- The common adverse effects of Bupropion are it causes dry mouth and nausea.
- It also is known to cause constipation, insomnia, and anxiety.
- It is also associated with sudden tremors and excessive sweating in some cases.
- Bupropion has the highest effect on sleep.
- In a few patients, it is seen that there is a 20% increased risk of headache.
- Bupropion shows an increase in the systolic blood pressure by 6 mm Hg and the heart rate by 7 beats per minute.
- By viewing the information of previous cases, this drug is known to cause severe hypertension.
- Cardiovascular conditions are also seen to worsen, but there is a lack of evidence and data.
- A seizure cannot be overruled as it is a rare but serious adverse effect of Bupropion. It depends on the dosage.
- While administering Bupropion, cases of liver toxicity were observed, which led to death or liver transplantation. These cases have been reported for Bupropion. Therefore this drug is considered one of several antidepressants with a greater risk of hepatotoxicity.
- The prescribing information starts with a warning about Bupropion triggering an angle-closure glaucoma attack. But it should also be noted that, on the other hand, Bupropion can decrease the risk of development of open-angle glaucoma.
- If Mothers use Bupropion in the first trimester of pregnancy, the risk is such, which is associated with a 23% increase of the odds in congenital heart defects in their children.
- It is, however, rare that Bupropion is associated with instances of Stevens-Johnson syndrome.
- Psychiatric- The FDA has stated that all antidepressants, including Bupropion, carry a boxed warning that antidepressants have more chances of increasing the risk of suicide in persons younger than 25. This has to be taken very seriously.
- When Bupropion is prescribed for smoking cessation, it commonly results in about a 25% total increase in the risk of psychiatric side effects. It causes anxiety (an overall 40% increase) and insomnia (an 80% increase). However, the evidence is insufficient to say correctly that Bupropion is associated with suicides or suicidal behavior.
- In rare cases, psychosis, which Bupropion induces, may develop. This is directly related to the high doses of bupropion intake that means when taken at a higher than the recommended dosage.
- Parallel antipsychotic medication should be administered in order to protect. By reducing the dose most of the time, it is seen that the symptoms are eliminated. Also, it can be checked by stopping the treatment or adding antipsychotic drugs.
- Another problem is associated due to the few cases that have reported that the abrupt discontinuation of Bupropion may cause the antidepressant discontinuation syndrome.
Taking Bupropion more than the recommended dosage is known to be moderately dangerous in overdose.
The prescriptions should be correctly adjusted for the intake of the medicines of Bupropion and venlafaxine, which are the new generation’s antidepressants, to decrease the mortality and morbidity as they are known to cause them. This is a recommendation and warning given by the US National Poison Data System.
When the drug is taken in significant overdose, seizures were reportedly found to occur in most cases. Some of the other side effects seen are hallucinations, loss of consciousness, and abnormal heart rhythms.
These symptoms, which were seen when Bupropion was one of several kinds of pills taken in an overdose, were fever, muscle rigidity, muscle damage, hypertension or hypotension, stupor, coma, and respiratory failure reportedly.
Therefore, Some patients are seen to recover from these severe side effects, while some people have died suffering from multiple uncontrolled seizures and heart attacks.