Q: 22 years old female is admitted to ICU with severe electrolyte imbalance due to underlying bulimia nervosa. After repletion, patient's electrolyte profile improved. Patient's bulimia nervosa seems related to her desire to lose weight. She read on internet that Bupropion helps in depression as well as it leads to weight loss. It may be a good idea to prescribe Bupropion.
A) True
B) False
Answer: B
Patients with bulimia nervosa or anorexia nervosa seem to have an extremely high risk of developing seizures from bupropion. In fact this drug is contraindicated in such patients.
Bupropion increases risk of seizures, especially with immediate-release formulations. This risk is dose-dependent and increases with higher dosage.
Although Bupropion does indeed help in weight reduction, it would not be prudent to use this drug solely for the purpose of weight reduction.
#pharmacology
#neurology
References:
1. Fava M, Rush AJ, Thase ME, et al. 15 years of clinical experience with bupropion HCl: from bupropion to bupropion SR to bupropion XL. Prim Care Companion J Clin Psychiatry 2005; 7:106.
2. Johnston JA, Lineberry CG, Ascher JA, Davidson J, Khayrallah MA, Feighner JP, Stark P. A 102-center prospective study of seizure in association with bupropion. J Clin Psychiatry. 1991 Nov;52(11):450-6. PMID: 1744061.
3. Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry 2010; 71:1259.
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