Bupropion Hydrochloride

It is a selective inhibitor of the neuronal re-uptake of catecholamines (noradrenaline and dopamine) with minimal effect on there uptake of indolamines (seretonin), and does not inhibit monoamine oxidase. It is presumed that this action is medicated by noradrenergic and/or dopaminergic mechanisms.

Indications

-Treatment of major depressive disorder (MDD) -Seasonal affective disorder (SAD) -Smoking cessation aid (under brand names like Zyban)

Dosage

The initial dose is 150mg taken daily for three days increasing to 150mg twice daily. The maximum single dose should not exceed 150mg and the total daily dose should no exceed 300mg. Patients should be treated for at least 7 weeks. Discontinuation should be considered if the patient has not made significant progress towards abstinence by the seventh week of therapy.

Contra-Indications

Hypersensitivity, Seizure disorder, bulimia or anorexia nervosa, monoamine oxidase inhibitors.

Special Precautions

Patient under 18 years the recommended dose should not be exceeded. Liver impairment, the recommended dose should not be exceeded. Renal impairment. It may precipitate a manic episode in patients with bipolar disorder during the depressed phase of there illness and may activate latent psychosis in other susceptible patients. Concomitant therapy with drugs predominantly metabolised by this isoenzyme (such as cetrain beta-blockers, antiarrhythmics, SSRIS, TCAs, Antisychotics) should be initiated a

Side Effects

Fever, chest pain, asthenia, tachycardia, vasodilation, postural hypotension, increased blood pressure (in some case severe), flushing, syncope, seizures, insomnia, tremor, concentration disturbance, headache, dizziness, depression, confusion, agitation, anxiety, irritability hostility, anorexia, dry mouth, gastrointestinal disturbance including nausea and vomiting abdominal pain constipation, rash, pruritus, sweating.

Drug Interactions

-MAO inhibitors: Concomitant use can lead to serious, potentially fatal interactions. -Alcohol: May increase the risk of seizures. -Drugs metabolized by CYP2B6: Bupropion may affect their metabolism.