A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor

Stahl, Stephen M.; Pradko, James F.; Haight, Barbara R.; Modell, Jack G.; Rockett, Carol B.; Learned-Coughlin, Susan

doi:10.4088/pcc.v06n0403

Cited by 409 publications

(336 citation statements)

References 73 publications

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“…Bupropion is approved for the treatment of depression and nicotine dependence, with a monoamine uptake inhibition effect (GlaxoSmithKline, 2004;Richmond and Zwar, 2003). Similar to stimulants such as cocaine, it can occupy the dopamine (DA) transporter to inhibit reuptake and increase DA concentration in the synaptic cleft (Stahl et al, 2004). It has been shown to be effective in improving symptoms of attention-deficit/hyperactivity disorder (ADHD) in adults (Wilens et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Bupropion for the Treatment of Methamphetamine Dependence

Elkashef

Rawson

Anderson

et al. 2007

Neuropsychopharmacol

197

188

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Bupropion was tested for efficacy in increasing weeks of abstinence in methamphetamine-dependent patients, compared to placebo. This was a double-blind placebo-controlled study, with 12 weeks of treatment and a 30-day follow-up. Five outpatient substance abuse treatment clinics located west of the Mississippi participated in the study. One hundred and fifty-one treatment-seekers with DSM-IV diagnosis of methamphetamine dependence were consented and enrolled. Seventy-two participants were randomized to placebo and 79 to sustained-release bupropion 150 mg twice daily. Patients were asked to come to the clinic three times per week for assessments, urine drug screens, and 90-min group psychotherapy. The primary outcome was the change in proportion of participants having a methamphetamine-free week. Secondary outcomes included: urine for quantitative methamphetamine, self-report of methamphetamine use, subgroup analyses of balancing factors and comorbid conditions, addiction severity, craving, risk behaviors for HIV, and use of other substances. The generalized estimating equation regression analysis showed that, overall, the difference between bupropion and placebo groups in the probability of a non-use week over the 12-week treatment period was not statistically significant (p ¼ 0.09). Mixed model regression was used to allow adjustment for baseline factors in addition to those measured (site, gender, level of baseline use, and level of symptoms of depression). This subgroup analysis showed that bupropion had a significant effect compared to placebo, among male patients who had a lower level of methamphetamine use at baseline (po0.0001). Comorbid depression and attention-deficit/ hyperactivity disorder did not change the outcome. These data suggest that bupropion, in combination with behavioral group therapy, was effective for increasing the number of weeks of abstinence in participants with low-to-moderate methamphetamine dependence, mainly male patients, regardless of their comorbid condition.

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Section: Introductionmentioning

confidence: 99%

Bupropion for the Treatment of Methamphetamine Dependence

Elkashef

Rawson

Anderson

et al. 2007

Neuropsychopharmacol

197

188

View full text Add to dashboard Cite

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“…Bupropion has relatively few antidepressant-associated side effects, such as sexual dysfunction and sedation (Stahl et al, 2004), has a low abuse potential (Nomikos et al, 1989), and is not fatal when taken in large doses (Shepherd et al, 2004). While bupropion's precise mechanism of action is not known, bupropion binds to DAT and has been shown to increase DA transmission in both the nucleus accumbens and the prefrontal cortex (Rau et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

Shoptaw

Heinzerling

Rotheram-Fuller

et al. 2008

Drug and Alcohol Dependence

136

129

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Objective-To compare bupropion to placebo for reducing methamphetamine (MA) use, increasing retention, and reducing the severity of depressive symptoms and MA cravings. A secondary objective compared bupropion to placebo for reducing cigarette smoking among MA dependent participants.Methods-Following a 2-week, non-medication baseline screening period, 73 treatment-seeking MA dependent participants were randomly assigned to bupropion sustained release (150 mg twice daily; N=36) or placebo (twice daily; N=37) for 12-weeks under double blind conditions. Participants attended clinic thrice weekly to provide urine samples analyzed for MA-metabolite, to complete research measures and assessments, and to receive contingency management and weekly cognitive behavioral therapy sessions.Results-There were no statistically significant effects for bupropion relative to placebo on MA use verified by urine drug screens, for reducing the severity of depressive symptoms or MA cravings, or on study retention. In a post hoc analysis, there was a statistically significant effect of bupropion treatment on MA use among participants with lighter (0-2 MA-positive urines), but not heavier (3-6 MA-positive urines) MA use during baseline (OR=2.81, 95% CI=1.61-4.93, p<0.001 for MA-free week with bupropion among light users). Bupropion treatment was also associated with significantly reduced cigarette smoking, by almost 5 cigarettes per day (p=0.0002).Conclusion-Bupropion was no more effective than placebo in reducing MA use in planned analyses, though bupropion did reduce cigarette smoking. Post hoc findings of an effect for bupropion among baseline light, but not heavy, MA users suggests further evaluation of bupropion for light MA users is warranted.

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“…Bupropion is an antidepressant with stimulant properties (Stahl et al, 2004) that is effective for the treatment of nicotine dependence (Richmond and Zwar, 2003). In a clinical trial of bupropion for cocaine dependence (Margolin et al, 1995), an exploratory analysis suggested that patients with greater levels of depression may have benefited the most.…”

Section: Introductionmentioning

confidence: 99%

Bupropion Reduces Methamphetamine-Induced Subjective Effects and Cue-Induced Craving

Newton

Roache

Garza

et al. 2005

Neuropsychopharmacol

141

126

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Bupropion is an antidepressant with stimulant properties, which inhibits the reuptake of dopamine (DA) and norepinepherine, and is purported to enhance DA neurotransmission. Bupropion is considered an appealing candidate medication for the treatment of methamphetamine dependence. The current laboratory study was set forth to assess the impact of bupropion treatment on the subjective effects produced by methamphetamine in the laboratory. We also assessed the effects of bupropion treatment on craving elicited by exposure to videotaped methamphetamine cues. A total of 26 participants were enrolled and 20 completed the entire study (n ¼ 10 placebo and n ¼ 10 bupropion, parallel groups design). Bupropion treatment was associated with reduced ratings of 'any drug effect' (po0.02), and 'high' (po0.02) following methamphetamine administration. There was also a significant bupropion-by-cue exposure interaction on General Craving Scale total score (po0.002), and on the Behavioral Intention subscale (po0.001). Overall, the data reveal that bupropion reduced acute methamphetamine-induced subjective effects and reduced cue-induced craving. Importantly, these data provide a rationale for the evaluation of bupropion in the treatment of methamphetamine dependence.

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A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor

Cited by 409 publications

References 73 publications

Bupropion for the Treatment of Methamphetamine Dependence

Bupropion for the Treatment of Methamphetamine Dependence

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

Bupropion Reduces Methamphetamine-Induced Subjective Effects and Cue-Induced Craving

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