Bupropion may contribute to hypertension high blood pressure. If you have high blood pressure or a history of cardiovascular issues, make sure you inform your healthcare provider before using bupropion. Though rare, depending on dosage, anywhere from.
Conditions that may increase your seizure risk include:. Use of other drugs that may affect your seizure susceptibility, such as other antidepressants, antipsychotics, systemic corticosteroids or theophylline.
Bupropion may also not be a suitable treatment for people with liver or kidney issues, diabetes or certain mental health conditions such as bipolar disorder. This warning is found on bupropion medications used for treating depression — bupropion smoking cessation aids do not carry the same warning.
Studies do not show that this risk occurs in people aged 24 and older. Bupropion can interact with other medications, including over-the-counter medications, herbal products and health supplements. These interactions may increase the amount of bupropion in your body or make the medication less effective.
In some cases, the use of bupropion can cause dangerous interactions with other medications. Dangerous interactions can occur when bupropion is used with monoamine oxidase inhibitors MAOIs — another type of antidepressant medication. If you have used an MAOI medication, such as phenelzine, isocarboxazid, tranylcypromine, selegiline or others, you must inform your healthcare provider before being prescribed bupropion. Make sure to tell your healthcare provider if you currently use or have recently used any other medications to treat depression.
Other medications that can interact with bupropion include antipsychotics, beta-blockers, blood thinners, corticosteroids, antiarrhythmics, theophylline, amantadine, dopamine precursors such as levodopa and transdermal nicotine patches. To avoid interactions, inform your healthcare provider of all medications you currently use or have recently used, as well as any relevant health conditions, before using bupropion.
Take bupropion as directed by your healthcare provider. You can take bupropion with or without food. They may recommend starting bupropion several days before you plan to quit smoking. Do not suddenly stop using bupropion, adjust your dosage or start using additional smoking cessation aids without first talking to your healthcare provider.
If you forget to take bupropion, skip the missed dose and continue using the medication as you normally would. You should not take a double dose of bupropion to make up for a missed dose. Drinking alcohol with bupropion is not recommended.
If you drink alcohol while using bupropion for depression or smoking cessation, you may be more likely to experience side effects from the alcohol and the bupropion. If you drink beer, wine or other alcoholic beverages frequently, talk to your healthcare provider about drinking alcohol while using bupropion before you start taking this medication. Like other widely used antidepressants, bupropion has the potential to cause certain withdrawal symptoms if you suddenly stop using it without tapering your dosage.
Common bupropion withdrawal symptoms of bupropion include difficulty sleeping, balance issues, anxiety, depression, mood changes, flu-like symptoms, sweating and more. Instead, talk to your healthcare provider about adjusting your dosage, safely tapering your bupropion dosage over time or changing to a different antidepressant or smoking cessation aid. As a smoking cessation aid, its exact mechanism of action is not known, but scientists believe it may work by reducing cravings for nicotine by changing the levels of certain neurotransmitters in your brain.
However, you should talk to your healthcare provider before you use bupropion with nicotine gum, lozenges, patches or other products containing nicotine. I also use this strategy when starting bupropion in a patient with bipolar depression. Although I try to avoid antidepressants in that population bupropion does have a lower risk of causing manic switches.
I have reason to doubt this one. In a meta-analysis of 10 randomized controlled trials of depression with anxiety, outcomes for anxiety were not significantly different between bupoprion and the SSRIs, including several large trials where it was compared head-to-head with an SSRI. The same authors of that paper reanalyzed the data looking specifically at patients with very high levels of anxiety. Those studies were done in patients with anxious depression, but what about patients with a separate anxiety disorder.
Here bupropion may not fare as well, unless that anxiety disorder is the generalized type GAD. In GAD, bupropion performed just as well as escitalopram Lexapro in a small head-to-head controlled trial. This one is partly true. Bupropion along with desvenlafaxine does carry a higher risk of causing initiation insomnia than the other antidepressants, but the difference is very small. Most second-generation antidepressants can cause insomnia, and the rates are similar. Depression impairs sleep architecture in several ways.
Bupropion reverses[7] those changes, while the SSRIs tend to make them worse. On the other hand, bupropion does stand out among the antidepressants as having a positive effect on energy.
Dr Aiken does not accept honoraria from pharmaceutical companies but receives royalties from W. Pharmacopsychiatry, ;51 4 Second-generation anti-depressants and risk of new-onset seizures in the elderly. This information is being provided as a community outreach effort of the College of Psychiatric and Neurologic Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication.
Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein.
The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein. Search Close Menu. Sign In About Mental Illness. About Mental Illness Treatments. About Mental Illness Research. Your Journey Individuals with Mental Illness. Your Journey Family Members and Caregivers. Your Journey Identity and Cultural Dimensions.
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Caution is advised with breastfeeding since bupropion does pass into breast milk. Symptoms of your condition that bother you most If you have thoughts of suicide or harming yourself Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, but others may require an adjustment in the medication.
Any other psychiatric or medical problems you have, including a history of bipolar disorder All other medications you are currently taking and any medication allergies you have. This will help your prescriber assess for potential drug interactions. Other non-medication treatment you are receiving such as psychotherapy i. Your provider can explain how these different treatments work with the medication.
If you are pregnant, plan to become pregnant, or are breastfeeding If you drink alcohol or use drugs How Should I Take Bupropion? Bupropion XL is usually taken once daily in the morning. Common side effects Headache, weight loss, dry mouth, trouble sleeping insomnia , nausea, dizziness, constipation, fast heartbeat, and sore throat. Summary of FDA Black Box Warnings Suicidal thoughts or actions in children and adults Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.
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