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bupropion (cont.)

PREGNANCY: There are no adequate studies of bupropion in pregnant women. In one study, there was no difference between bupropion and other antidepressants in the occurrence of birth defects. Bupropion should only be used in pregnancy if the benefit outweighs the potential risk.

NURSING MOTHERS: Bupropion is secreted in breast milk.

SIDE EFFECTS: The most common side effects associated with bupropion are agitation, dry mouth, insomnia, headache, nausea, constipation, and tremor. In some people, the agitation or insomnia is most marked shortly after starting therapy. Some patients may experience weight loss. Uncommonly, patients may experience manic episodes or hallucinations. Four of every 1000 persons who receive bupropion in doses less than 450 mg/day experience seizures. When doses exceed 450 mg/day, the risk increases ten-fold. Other risk factors for seizures include past injury to the head and medications which can lower the threshold for seizures. (See drug interactions.)

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Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of bupropion or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

HOW TO USE: This medication may be taken with food if stomach upset occurs. Take doses at regularly scheduled times each day. Do not take more or less medication than prescribed. Taking more than the recommended dose of bupropion will increase your risk of having a seizure. The maximum dose of bupropion is 300 - 450 milligrams per day, depending on your medical condition (stop smoking therapy vs. psychiatric conditions). If you have very severe liver disease, the maximum dose is 150 milligrams every other day. Do not stop taking this medication without notifying your doctor. Since this drug may cause sleeplessness at first, it is best not to take this near bedtime. It may take 4 weeks or more before the full effects of this medication are noticed.

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