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 Depression  Holistic-online.com

Bupropion (Wellbutrin)

Buproprion is believed to inhibit the reuptake of dopamine as well as serotonin and norepinephrine.

Bupropion is used to treat the entire range of depression severity. Preliminary studies suggest that it may also be useful for a number of other problems, including smoking cessation, social phobia, and attention deficit disorder.

A new use for bupropion is to enhance the effects of the SSRI antidepressants by using it in combination with SSRIs. For example, bupropion has been added to SSRI antidepressants in an attempt to combat the sexual side effects of SSRIs, such as loss of libido and difficulties in having orgasms.

Doses of Bupropion

Usual dose for bupropion range from 200 to 450 mg per day.

At doses below 450 mg, the risk of seizures appears to be about four patients per 1,000. The risk of seizure increases dramatically (ten times higher) at doses above 450 mg per day-four patients per 100 experience seizures.

Side Effects of Bupropion

Because of the seizure risk, the manufacturer recommends that bupropion not be prescribed to anyone with a history of epilepsy, a major head injury, a brain tumor, bulimia, or anorexia nervosa.

The most common side effects of buproprion are:

Dry mouth
Sore throat
Upset stomach
Loss of appetite
Stomach pain
Sweating
Headache
Insomnia
Restlessness
Tremor
Anxiety
Sweating
Dizziness
Rash
Ringing in ears
Seizures

Unlike the tricyclics, bupropion does not cause dry mouth, constipation, dizziness, or tiredness. It also does not stimulate the appetite and hence do not cause weight gain. However, some patients have reported upset stomach (nausea) and insomnia.

Drug Interactions for Bupropion

Because of the risk of seizures, bupropion should not be combined with other drugs that can also make a person more vulnerable to seizures. This includes the tricyclic and tetracyclic antidepressants, the SSRIs, the two serotonin antagonists (trazodone and nefazodone), and many of the major tranquilizers (neuroleptics). Bupropion is especially risky for alcoholics and for individuals taking sedatives or tranquilizers regularly.

Many nonpsychiatric drugs like corticosteroids can increase the risk of seizures. Therefore, great caution must be exercised if bupropion is combined with any of these drugs, especially if the dose of bupropion is high.

Other drug interactions involving bupropion

bulletBarbiturates can cause the level of bupropion in the blood to fall. This could make the bupropion ineffective.
bulletPhenytoin (Dilantin) can also cause bupropion levels to fall.
bulletCimetidine (Tagamet) may increase bupropion levels in the blood. This can increase the likelihood of side effects or toxic effects, including seizures.
bulletBupropion must not be combined with the MAOIs. There is a risk of a hypertensive crisis.
bulletL-dopa increases the side effects of buproprion. Caution is advised when these drugs are combined.

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