Bupropion: Therapeutic Value, Side Effects, and Risks of Seizures in Depression and Smoking Cessation

Bupropion is a widely used medication in the treatment of depression and smoking cessation. Since its introduction in 1985, it has proven to be a valuable tool in the therapeutic arsenal of physicians. However, as with any medication, it is crucial to understand both its benefits and potential side effects to optimize its use in clinical practice.

Profundizando en el uso de Bupropión

Bupropion is an antidepressant of the aminoketone class, primarily acting by inhibiting the reuptake of dopamine and norepinephrine, without significantly affecting serotonin levels. This characteristic distinguishes it from other antidepressants and gives it a unique profile of side effects and therapeutic benefits. In addition to its use in depression, bupropion is approved for the treatment of smoking cessation, where it has shown to increase abstinence rates compared to placebo and other treatments [1](https://pubmed.ncbi.nlm.nih.gov/10804045).

Regarding side effects, bupropion is generally well tolerated, but it can cause insomnia, dry mouth, and nausea. A significant adverse effect is the risk of seizures, especially at doses exceeding 450 mg daily, which led to its temporary withdrawal from the market in 1986 [2](https://pubmed.ncbi.nlm.nih.gov/35593803). This risk is particularly relevant in patients with a history of seizures or eating disorders.

In the context of smoking cessation, bupropion has proven effective, even in patients with comorbid depression, who often exhibit greater nicotine dependence and an elevated risk of relapse [3](https://pubmed.ncbi.nlm.nih.gov/22558621). However, it is important to monitor mood changes in these patients, as they may experience an increase in depressive symptoms during the withdrawal process [4](https://pubmed.ncbi.nlm.nih.gov/22073240).

Conclusiones

Bupropion is a valuable therapeutic option for both depression and smoking cessation, offering significant benefits in both contexts. Nevertheless, its use should be carefully considered in patients with risk factors for seizures and should include close monitoring of psychiatric symptoms. Understanding its side effect profile and mechanism of action allows physicians to maximize its benefits while minimizing associated risks.

Referencias

• [1] Bupropion: a review of its use in the management of smoking cessation.
• [2] Bupropion Toxicity.
• [3] Smoking and depression--a review.
• [4] Suicidal behavior and depression in smoking cessation treatments.

Created 6/1/2025