Bupropion for Smoking Cessation in Schizophrenia

Critical Dosing and Administration

• The National Comprehensive Cancer Network recommends using bupropion SR 150 mg twice daily (300 mg total daily dose) for smoking cessation, starting 1-2 weeks before the target quit date, with a treatment duration of 7-12 weeks 1, 2
• The maximum dose must not exceed 300 mg per day for smoking cessation to maintain seizure risk at 0.1% 2

Seizure Risk Considerations

• The primary safety concern is seizure risk, which is approximately 1 in 1,000 (0.1%) at recommended doses, according to Thorax 3, 2

Monitoring Requirements

• The National Comprehensive Cancer Network recommends close monitoring during the first few weeks of treatment, particularly for neuropsychiatric symptoms, and recent large-scale trials show no significant increase in neuropsychiatric events with bupropion compared to nicotine patch or placebo 1, 2

Important Clinical Caveat

• Combining bupropion with behavioral interventions significantly improves outcomes, as reported in Thorax 3