Bupropion is a medication prescribed by your healthcare provider, selected based on current evidence-based guidelines to best address specific mental health conditions. While effective, it's important to understand that all medications come with potential side effects. As a patient or caregiver, being informed about these risks and benefits is crucial. Equally essential is knowing how to monitor for side effects, and understanding the strategies to reduce their occurrence or manage them effectively. This guide aims to empower you with this knowledge, ensuring a well-informed approach to your or your child's treatment.

What is Bupropion?

Bupropion is a Dopamine Norepinephrine Reuptake Inhibitor. Bupropion works by increasing the levels of dopamine and norepinephrine in the brain.

When is Bupropion prescribed to Children & Adolescents?

Your doctor may prescribe Bupropion  for

• Depression
• Seasonal Affective Disorder
• Post-traumatic Stress Disorder (PTSD)
• Post Menstrual Dysphoric Disorder (PMDD)
• Attention Deficit Hyperactivity Disorder (ADHD)
• To help with stopping smoking 
• Antidepressant induced sexual dysfunction

What is the Dose of  Bupropion?

• For sustained release (SR) formulations, dose typically ranges from 100 to 400 mg and for extended release (XR) formulations, from 150 to 450 mg.
• Started at a low dose, gradually increasing to effectiveness.
• Capsules should be swallowed whole and not chewed or crushed.
  

Medication Guidelines: What you need to know

• Take your medication consistently every day as directed by your healthcare provider, rather than using it only when you feel you need it.

• While some patients may notice improvement within the first two weeks of starting treatment, it may take up to eight weeks to experience the medication's full benefits.

• Abruptly stopping SSRIs can lead to a discontinuation syndrome, which may cause symptoms like dizziness, chills, lightheadedness, fatigue, headache, muscle aches, nausea, diarrhea, tremors, shock-like sensations, and tingling.

• After the first episode of depression is resolved, staying on the effective dosage for at least one year is needed to minimize the risk of symptom recurrence. Following this period, your healthcare provider will guide you through a gradual tapering-off process and stop the medication entirely. This approach ensures a smoother transition and reduces the likelihood of relapse. For second and subsequent episodes of depression and for other mental health disorders, treatment may need to be indefinite.

• Combining Bupropion with certain medications can lead to a dangerous condition called Serotonin Syndrome, caused by excessive serotonin levels in the body. Symptoms include anxiety, agitation, confusion, sweating, rapid heartbeat, high blood pressure, fever, stomach problems, tremors, muscle stiffness, spasms, and heightened reflexes. Over-the-counter agents and supplements such as Dextromethorphan (DXM), St. John's Wort, certain cough and cold medications, over-the-counter migraine medications, 5-HTP, and L-tryptophan can also interact with Bupropion  to induce serotonin syndrome. It's vital to consult your primary care provider or psychiatrist before starting any new prescription or over-the-counter medication.

What can be the possible

side-effects from the medication?

Your child may experience some side effects from the medication initially. Most of these side effects are mild and improve over time. The medication is started at a low dose to minimize these side effects. If side effects persist, consult your healthcare provider.

Nausea: These can be mitigated by taking your medication with meals.

Sleep Disturbances: If you find it difficult to sleep, try taking your medication in the morning.

Dry Mouth, Constipation: Regular hydration can alleviate this symptom. Try to drink water frequently throughout the day.

Headache: May happen initially but usually improves over time. Consult with your provider if persistent. Reducing the dosage or splitting it into two daily doses might help. 

Activation (feeling unusually energized, restless anxious or agitated): Lowering the dose temporarily can be helpful. Contact your provider for guidance on how much to reduce and how to slowly increase it again as your body adapts to the medication.

Decreased Appetite: May happen initially but usually improves over time. Adding high healthy high calorie snacks to diet can be helpful.

Tremor: Reducing the dosage or splitting it into two daily doses might help. As your body adjusts, your provider may gradually increase the dose back to the original level if needed.

Stomach upset: Reducing the dosage or splitting it into two daily doses might help. As your body adjusts, your provider may gradually increase the dose back to the original level if needed.

Serious but Rare Side-Effects

Risk of Increased Suicidal Thoughts with Antidepressants

 

Antidepressant medications can sometimes lead to increased suicidal thoughts or actions, particularly in children, teenagers, and young adults during the early stages of treatment. Research indicates a small but notable elevation in the risk of suicidal thoughts and behaviors among these groups, although these do not typically extend to actual suicide deaths. The current evidence is not definitive in establishing a clear link between antidepressants and these increased risks.

Risk-Benefit Analysis:

Despite these concerns, the advantages of treating depression significantly outweigh the potential risks. It's crucial, however, to vigilantly monitor for this side effect.

Monitoring Guidelines:

Pay careful attention to any shifts in mood, behavior, thoughts, or feelings. This is particularly critical when starting a new antidepressant or adjusting the dosage. Watch for any sudden changes, as these can be indicative of increased risks and may require immediate action.

By closely observing and reporting these changes, the effectiveness and safety of the treatment can be maximized, ensuring the best possible outcome for the patient.

• • Seizures: Not a common side effect. Risk is higher with rapid dose increases, with doses above the recommended maximums and in patients at risk for seizures. Risk of seizure also depends on dose and formulation and is higher with immediate release formulations as compared to sustained release and extended release formulations. With extended formulations at doses within the recommended dose range is comparable to other antideprssants. Chewing dividing or crushing SR or ER tablets can also increase the risk of seizures.
    
    
    
  • Angle Closure Glaucoma: Bupropion has been linked to an increased risk of acute angle-closure glaucoma, especially in adults under 50, according to a case-controlled study. In contrast, other studies indicate it may lower the risk of open-angle glaucoma. If you experience symptoms such as eye pain, vision changes, swelling, or redness, please seek immediate emergency medical care, as untreated angle-closure glaucoma can lead to permanent blindness.

To learn more about this medication please visit MedlinePlus, a official US government website, part of National Library of Medicine and managed by National Institute of Health by clicking HERE