Bupropion and DOT Certification

Key Considerations for DOT Certification with Bupropion

• Bupropion is contraindicated for patients with seizure risks, including those with history of seizures, stroke, or brain metastases, as stated by the National Comprehensive Cancer Network 3, 1
• The risk of seizures with bupropion is approximately 1 in 1000, which is similar to other antidepressants, according to Thorax 4
• The American Academy of Family Physicians recommends that DOT medical examiners carefully evaluate the risk of seizures in patients taking bupropion, as seizures while operating commercial vehicles could be catastrophic 1
• Bupropion may cause neuropsychiatric side effects including insomnia, anxiety, and agitation, as reported by the American Academy of Family Physicians 1
• Medical examiners should monitor for the development or worsening of serious neuropsychiatric issues including depression and suicidal ideation/behavior, as advised by the National Comprehensive Cancer Network 3
• The American Academy of Family Physicians suggests that medical examiners assess the stability of patients on bupropion for at least 30 days with no significant side effects, and ensure the dosage does not exceed 450 mg/day to minimize seizure risk 1
• The National Comprehensive Cancer Network recommends that patients taking bupropion should not have a history of seizures or other conditions that lower seizure threshold, and should not take concurrent medications that might lower seizure threshold 3
• Patients taking bupropion should be monitored regularly by their prescribing physician, with periodic reassessment of medication effectiveness and side effects, as recommended by the National Comprehensive Cancer Network and the American Academy of Family Physicians 3, 1