Bupropion Usage Considerations

Indications and Benefits

The FDA approves bupropion as an antidepressant and for smoking cessation, with a daily dose of 300 mg being effective for long-term treatment of recurrent major depressive disorder 1
Bupropion may be considered for treating overweight or obesity in patients trying to quit smoking and in patients with depression 3, 2
The American College of Cardiology is not mentioned in this context, however, a small open study in women with major depressive disorder showed significant improvement in depressive symptoms maintained at 24 weeks of therapy with naltrexone-bupropion ER at FDA-approved doses 1

Patients with seizure disorders should avoid bupropion, and it should be used with caution in patients at risk of seizures, with a contraindication for concomitant use with opioid medications 1, 3, 2
Bupropion is contraindicated in patients treated with, or within 14 days after, monoamine oxidase inhibitors 1, 3
Uncontrolled hypertension is a contraindication for bupropion use 3, 2

Regular monitoring of vital signs, especially blood pressure and heart rate, is recommended, particularly during the first 12 weeks of treatment 3, 2
Patients on long-term bupropion-naltrexone ER should consider periodic monitoring of serum bicarbonate levels 3
Patients, especially those under 24 years, should be observed for neuropsychiatric adverse effects, including suicidal thoughts and behaviors 1
Concomitant use with monoamine oxidase inhibitors or opioid medications is contraindicated 1, 3, 2