Safety Risks of Bupropion When Combined With Alcohol

Seizure Risk and Contraindications

• Abrupt discontinuation of alcohol in patients receiving bupropion is an absolute contraindication because it markedly raises the risk of bupropion‑induced seizures. 1
• The baseline seizure risk with therapeutic‑dose bupropion is approximately 0.1 % (1 in 1,000); concurrent alcohol consumption substantially increases this risk. [2][3]

Approved Therapeutic Uses of Bupropion

Smoking Cessation

• In individuals attempting to quit smoking, bupropion combined with behavioral support yields abstinence rates that are 9–10 percentage points higher than placebo. [2][1]3

Major Depressive Disorder

• Bupropion provides antidepressant efficacy comparable to selective serotonin reuptake inhibitors (SSRIs) while producing lower rates of sexual dysfunction. [1][3]

Comorbid Depression and Smoking in Patients With Alcohol Use Disorder

• Limited evidence suggests bupropion may simultaneously address depressive symptoms and nicotine dependence in patients with alcohol use disorder, though data are sparse. 3

Recommended Pharmacologic Options for Reducing Alcohol Cravings

• Naltrexone (oral or extended‑release injectable) is FDA‑approved for decreasing heavy‑drinking days and alcohol cravings. 1
• Disulfiram is appropriate for highly motivated patients who prefer an aversive therapy approach. 1