bupropion

bupropion, drug that is used to treat depression, to prevent depression in persons with seasonal affective disorder, or sometimes to aid in smoking cessation. Bupropion typically is taken orally in the form of bupropion hydrochloride.

Historical developments

Bupropion was developed in 1966 and patented in 1974 by Burroughs Wellcome (later GlaxoSmithKline). In 1985 it was approved by the U.S. Food and Drug Administration (FDA) and marketed under the name Wellbutrin. Initially, patients given the drug were administered doses between 400 and 600 mg. The following year the drug was taken off the market, owing to the occurrence of seizures. In 1989, following a reduction in the maximum prescribed dose, to 450 mg, the drug was reintroduced.

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smoking: Bupropion

The later development of a sustained-release tablet led to approval of a new version of bupropion by the FDA in 1996. The sustained-release form allowed a controlled amount of the drug to be absorbed by the body, thereby reducing the number of seizures experienced by patients. The sustained-release tablet was marketed under the name Zyban. In 2003, under the name Wellbutrin XL, an extended-release version of the drug was made available. This form allowed patients to take the drug just once a day and reduced the probability of suffering a seizure to be equivalent to that of most other antidepressants.

Uses

Bupropion primarily is used in the treatment of major depressive disorder, in which affected individuals suffer severe symptoms of depression. Treatment usually is long-term, with the intention of helping to prevent depressive symptoms from returning once patients have recovered. For seasonal affective disorder, extended-released bupropion typically is taken once a day in the morning starting in early fall and continuing throughout winter (the months when seasonal affective disorder is most common). Usually, a lower dose is prescribed two weeks prior to the end of the treatment to ease the process of stopping the medication. Bupropion is sometimes used to treat patients with bipolar disorder when episodes of depression are reported. In some cases, it may be prescribed to patients with attention-deficit/hyperactivity disorder.

Bupropion often is incorporated into programs to help individuals stop smoking. The medication itself does not contain nicotine, the chemical responsible for addiction to smoking, and, thus, nicotine-replacement products typically are used alongside bupropion as part of a successful smoking-cessation program. In this application, bupropion helps to reduce nicotine cravings and eases the symptoms of withdrawal. Patients usually start taking bupropion one to two weeks before they actually quit smoking in order to allow a base level of the drug to build up in the body. It is also recommended that it be taken for 7 to 12 weeks after quitting smoking.

Side effects

Various side effects have been reported in patients who take bupropion. Side effects include dry mouth, blurred vision, drowsiness, eye pain, mood changes, confusion, weight loss, headaches, muscle and joint pain, and an increase in blood pressure. Seizures, irregular heartbeats, and hallucinations may also occur. On rare occasions, individuals taking bupropion have experienced thoughts of suicide. Therefore, patients on the medication generally are monitored by a doctor for the duration of treatment.