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Many of the refs are old. Some of the conclusions appear a little too positive. Needs updating and removal of primary sources. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 00:04, 23 January 2014 (UTC)
The section on contraindications needs to be corrected on the subject of alcohol and benzodiazepines. It is correct that conditions and drugs that lower the seizure threshold would be contraindications to taking buprioprion because buproprion also lowers the seizure threshold.
I would suggest an edit to the beginning of the contraindication section along the lines of:
"GlaxoSmithKline advises that bupropion should not be prescribed to individuals with epilepsy or other conditions that lower the seizure threshold, such as anorexia nervosa, bulimia nervosa, active brain tumors, or withdrawal from alcohol or benzodiazepines."
Use of alcohol or benzodiazepines while taking buproprion does not lower the seizure threshold. Abrupt withdrawal from these drugs lowers the seizure threshold.
Low to moderate alcohol intake while taking buprioprion, such that stopping for a while would not precipitate withdrawal, is not contraindicated while taking buproprion. It's still not adivsable when taking buproprion for depression, of course, because alcohol is a CNS depressant. It would tend to undermine the effects of buproprion. Buproprion can also decrease one's alcohol tolerance (so one would be impaired with less alcohol).
Heavier drinkers (and those already in withdrawal) shouldn't take buproprion because 1) heavy drinking with buproprion can increase side effects, and 2) if they decrease their intake substantially (or start to abstain), alcohol withdrawal puts them at higher risk for seizure (lowers their seizure threshold).
Benzodiazepines lower the seizure threshold. So much so, that they are first-line medications for interrupting seizures. IV lorazepam (Ativan) is typically the first med given for seizures. It is also what is given as needed for patients going through alcohol withdrawal - partly because it decreases their withdrawal symptoms (because many of the pharmacologic effects are similar to alcohol), and because it decreases their risk of seizure. Abrupt withdrawal from regular benzodiazepine usage, however, does lower the seizure threshold - similar to alchol.
1) Wellbutrin tablet package insert: http://us.gsk.com/products/assets/us_wellbutrin_tablets.pdf 2) /info/en/?search=Alcohol_withdrawal#Treatment 3) /info/en/?search=Benzodiazepine#Seizures
(Wikipedia entries aren't the most authoritative, but they're more accessible than pharmacology texts for the average reader - and are sourced in the reference section). — Preceding unsigned comment added by Gnirps05 ( talk • contribs) 13:58, 7 March 2014 (UTC)
This article in the British Columbia Medical Journal "Bupropion toxicity with unintentional exposure or abuse: More common than you think" may be worth mentioning in this article. This is a television news article about the study. Eastmain ( talk • contribs) 04:33, 20 November 2014 (UTC)
There are several opportunities for improvement in this section. I outline these below followed by a proposed change in the text.
— Preceding unsigned comment added by Formerly 98 ( talk • contribs) 16:23, 21 December 2014 (UTC)
References
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Hi, I've noticed that the lead has picked up some erroneous naming info. Bupropion is the INN and BAN (according to Martindale) while bupropion hydrochloride is the USAN for this salt specifically (no USAN for freebase bupropion is mentioned, in this source). Amfepramone was the former INN. I felt I should raise this issue here, instead of just editing the article accordingly off the bat because I felt anyone that made these changes must have had a decent reason which should be heard. Brenton ( contribs · email · talk · uploads) 06:50, 30 April 2015 (UTC)
Bupropion is technically of the amphetamine "class" or "family"... Moralistic hysteria does not require us to self-censor... — Preceding unsigned comment added by 2602:304:B34B:A940:F051:AB0F:3A76:DE48 ( talk) 18:17, 18 June 2015 (UTC)
I would suggest adding the following sentence at the end of Pharmacokinetics paragraph: "However, a 2011 study found that therapeutic use of bupropion could and did appear to cause false positives for amphetamines."
Here's the reference: Casey, E.R.; Scott, M.G.; Tang, S.; Mullins, M.E. (2011) "Frequency of false positive amphetamine screens due to bupropion using the Syva EMIT II immunoassay." J Med Toxicol 7:105–108 DOI 10.1007/s13181-010-0131-5 — Preceding unsigned comment added by Domineditor ( talk • contribs) 01:36, 11 December 2015 (UTC)
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A randomized placebo-controlled double-blind crossover study of the subjective effects produced by bupropion (given at a clinical dose, i.e., in its slow-relase form, 150 mg twice daily) vs caffeine in male smokers found subjective effects, i.e., pronounced self-rating of "high" in 6% of the tested subjects (total sample size = 50) suggesting that bupropion, like caffeine, might be of some abuse liability in about 6% of the smokers (PMID: 15001822). I think that this is important information with respect to estimating the abuse liability of bupropion. That bupropion may be of some abuse liability for some patients/users is supported by an ever-increasing number of case reports reporting abuse (some of which are cited on the Bupropion page in wiki). Anecdotally, some intravenous drug users also do abuse bupropion, although I have no data on that. Therefore, I would like to add that information and the reference to the bupropion page. I did and Doc James removed my text (I already have contacted Doc James and asked him why, he seems to be on vacation). I am a new user, so please advise what I have to do to get that information stably inserted into the bupropion page. Thank you very much! Stoopormundi, April 5, 2016 Stoopormundi ( talk) 15:49, 5 April 2016 (UTC)
Dear Sizeofint, thank you very much for your help! I understand the meta-analysis / review approach. However, in the bupropion page, I have counted two CASE REPORTS among the references. The trial I was referring to was a randomized placebo-controlled crossover in 50 (FIFTY) smokers. So I think it only fair to include it as well (50 subjects tested under controlled experimental conditions with the best possible design as opposed to CASE reports). What about the following text, a very brief and concise one: "In a randomized controlled trial, 6% of the bupropion users reported a profound "high", suggesting that bupropion may have abuse liability in some. [1]"
References
Stoopormundi Stoopormundi ( talk) 04:56, 9 April 2016 (UTC)
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Cheers.— cyberbot II Talk to my owner:Online 19:38, 4 July 2016 (UTC)
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I have a problem with the summary where it says: "However, bupropion does not appear to have significant dopaminergic actions in humans under normal clinical circumstances." I had a look in reference [13] it says no such thing. Actually the opposite, so this sentence should be removed. -- ADDextron ( talk) 13:25, 5 January 2018 (UTC)
User:Sbelknap this was way, way over the top. Please see Oseltamivir#Medical_use for how we handle it when meta-analyses and clinical guidelines are in tension. Jytdog ( talk) 01:03, 15 July 2018 (UTC)
@ Sbelknap: You may want to use this tool to generate a citation template for sources with a PMID number. All you need to do is click the "Add ref tag" check box, copy/paste an article's PMID number into the text field, and hit submit; it will provide you with a formatted citation template.
This wikitext – <ref name=pmid24402784/>
– only works in an article if there's already a pre-existing citation template in the article. A citation template is a block of code that looks like this: <ref name="pmid24402784">{{cite journal | vauthors = Hughes JR, Stead LF, Hartmann-Boyce J, Cahill K, Lancaster T | title = Antidepressants for smoking cessation | journal = The Cochrane Database of Systematic Reviews | volume = | issue = 1 | pages = CD000031 | date = January 2014 | pmid = 24402784 | doi = 10.1002/14651858.CD000031.pub4 | url = }}</ref>
. The tool I've linked generates that citation template.
Seppi333 (
Insert 2¢)
04:02, 15 July 2018 (UTC)
So, running
this search "bupropion"[Title/abstract] AND ("depression"[Title/abstract] OR "depressive disorder"[Title/abstract] OR "major depressive disorder"[Title/abstract] OR "antidepressant"[Title/abstract]) AND (Meta-Analysis[ptyp] OR "meta-analysis"[Title/abstract]) AND ("2012/07/18"[PDat] : "2018/07/15"[PDat])
, I found 23 potentially relevant meta-analyses, including the recent Bayesian one (i.e., the 2nd entry in this list). I'll go through it now and see what we have. If anyone has a better idea for a search string, feel free to tell me!
Seppi333 (
Insert 2¢)
06:12, 15 July 2018 (UTC)
Meh. I'll go through the other 5 tomorrow. This is a lot of reading. Seppi333 ( Insert 2¢) 06:47, 15 July 2018 (UTC)
Methodologically more robust trials support the superiority of bupropion over placebo, and most head-to-head antidepressant trials showed an equivalent effectiveness, though some of these are hindered by a lack of a placebo arm.So, this basically says that the evidence suggests it has comparable effectiveness to other drugs, but some of that evidence is low-quality.
Thanks to Jytdog, I have the last meta-analysis – " Comparative Efficacy, Acceptability, and Tolerability of Augmentation Agents in Treatment-Resistant Depression: Systematic Review and Network Meta-Analysis" (uploaded here for accessibility). It doesn't state this outright, but based upon the statistical tables, there's insufficient evidence on bupropion augmentation to support its efficacy vs placebo or other any of the other augmentation agents in the study. That's sort of consistent with what the other meta-analysis [1] discussed re: bupropion as an add-on therapy. I might add something on the lack of evidence on effectiveness as an add-on therapy within the next week, citing both meta-analyses, but I need to finish adding content in 2 other articles before I get around to summarizing that. Seppi333 ( Insert 2¢) 18:50, 29 July 2018 (UTC)
References
I'm curious why the list of adverse effects of bupropion is in a separate article. I suggest that this separate article be merged into the main bupropion article. I would simply make this change, but this is a featured article, so thought I'd ask here on the talk page first. Sbelknap ( talk) 04:37, 14 March 2019 (UTC)
I don't know how to make changes, but bupropion is NOT an SSRI. According to this article's own source, it is an NDRI.
This seems like a significant oversight. The Cl group on the phenyl ring is clearly stated as being in the 3 position (3-Chloro-N-tert-butyl-β-keto-α-methylphenethylamine) however in both images representing the chemical structure of bupropion, the Cl group is in the 5 position. Is this intentional? I feel as though this could lead to some confusion. Any input? — Preceding unsigned comment added by TropickTX ( talk • contribs) 17:24, 30 August 2020 (UTC)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2916165/ Kindly update the page if you are a moderator with the following research outcome. I oppose the use of the word 'weak' as it is not referenced in any of the articles you have referenced and creates a presumption which is not based on any correlational nor cause and effect methodology. Kindly stick to science, as well expand the matter due to the number of related deaths being claimed in the USA in specific jurisdictions being that this is a point of reference for many, additionally consider updating the /info/en/?search=Methamphetamine page concurrently noting it does not reference what is referenced here. Additionally this page should be frequently updated with regular updates on all science and medical journal publications related to the same (both the medications and the article in reference to the substance. — Preceding unsigned comment added by WM324AHI ( talk • contribs) 07:41, 24 January 2021 (UTC)
Package insert doesn't say it's an antidepressant anymore, some insurance won't pay for it now
Weird I wonder what country you live it its still covered in the United States by my insurance — Preceding unsigned comment added by 64.222.180.90 ( talk) 19:17, 7 February 2022 (UTC)
Insurance still covers in the US. But they might not cover if you're already taking a similar drug ? Danski14 (talk) 12:12, 26 March 2023 (UTC)
Is true that bupropion causes a higher risk of seizures compared to other antidepressants? A reference would be good if that is the case: I see some sources saying that is a myth. 95.127.161.43 ( talk) 06:44, 21 December 2021 (UTC)
Are bupropion and methylphenidate TAAR-active? Requesting binding profile. -- 0dorkmann ( talk) 08:15, 11 February 2023 (UTC)
If the half life is 10-19 hours, which several studies attest to, then why in the figure in the "History" section does it look like the half-life is only ~4-5 hours for the immediate/instant release formulation? Is it two-compartment kinetics? What is more clinically meaningful, the blood level, or the level in tissue? I'm confused... By the way, I have taken immediate release, and the chief effects seem to diminish after a few hours.. Danski14 (talk) 12:12, 26 March 2023 (UTC)