Contraindications of Bupropion

Q: 34 years old overweight male (BMI of 32) with previous history of smoking history, alcoholism, hypertension (HTN), and depression is admitted to ICU with new-onset seizures. Patient acknowledges that recently he used his friend's bupropion to decrease his weight. Name few contraindications for Bupropion?

Answer: In the last few years, off-label use of bupropion has risen due to its easy availability and relatively cheaper price. A few of the relative contraindications are

• Seizure disorders, including alcohol withdrawal seizures (bupropion decreases the seizure threshold)
• Bulimia nervosa
• Pregnancy
• Uncontrolled HTN
• Chronic opioid use
• Renal insufficiency
• Hepatic insufficiency
• Use of monoamine oxidase inhibitors within last two weeks

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References:

1. Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Bupropion. 2023 Jul. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582611/

2. Beyens MN, Guy C, Mounier G, Laporte S, Ollagnier M. Serious adverse reactions of bupropion for smoking cessation: analysis of the French Pharmacovigilance Database from 2001 to 2004. Drug Saf. 2008;31(11):1017-26. doi: 10.2165/00002018-200831110-00006. PMID: 18840021.

3. Stahl SM, Pradko JF, Haight BR, Modell JG, Rockett CB, Learned-Coughlin S. A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. Prim Care Companion J Clin Psychiatry. 2004;6(4):159-166. doi: 10.4088/pcc.v06n0403. PMID: 15361919; PMCID: PMC514842.