Bupropion Mediated Effects on Depression, Attention Deficit Hyperactivity Disorder, and Smoking Cessation

Abstract

Bupropion had been in use since the late 1980s as an unconventional treatment for depression. Unlike other antidepressants, bupropion has no serotonergic activity and inhibits the reuptake of norepinephrine and dopamine. The drug has been used to treat depression, Attention Deficit Hyperactivity Disorder (ADHD), and smoking cessation. This investigation reviews the pharmacokinetic and pharmacodynamic effects of bupropion and its mechanisms of action and interactions with other drugs. We evaluated the efficacy of major on and off-label uses of bupropion, focusing on the indications, benefits, and adverse effects. Our review demonstrates that bupropion is superior to placebo and non-inferior to SSRIs such as escitalopram in treating major depressive disorder. More research is needed to determine positive patient-centered outcomes such as increases in quality of life. In the case of ADHD, the evidence for efficacy is mixed with poorly conducted randomized clinical trials, small sample sizes, and a lack of long-term assessments. The same is true in the case of bipolar disorder in which there is still limited and controversial data available on bupropion’s safety and efficacy. In the case of smoking cessation, bupropion is found to be an effective anti-smoking drug with synergistic benefits when used as a combination therapy. We conclude that bupropion has the potential to provide benefit for a subset of patients who do not tolerate other typical antidepressants or anti-smoking therapies or for those whose treatment goals align with bupropion’s unique side effect profile, such as smokers who wish to quit and lose weight. Additional research is needed to determine the drug’s full clinical potential, particularly in the areas of adolescent depression and combination therapy with varenicline or dextromethorphan. Clinicians should use this review to understand the varied uses of the drug and identify the situations and patient populations in which bupropion can lend its greatest benefit.

Management Strategies for Borderline Personality Disorder and Bipolar Disorder Comorbidities in Adults with ADHD: A Narrative Review

“…While atomoxetine, bupropion, and lisdexamfetamine are all supported by evidence of similar quality, because of limited data to support atomoxetine in the adult population as well as the risk of hypomanic induction, bupropion remains the preferred first-line agent for managing ADHD symptoms in the BD population. This is supported by recent literature that has demonstrated the clinically significant improvement in disease severity that bupropion has in patients with bipolar disorder, in addition to its dopaminergic properties that render it an effective choice for ADHD treatment [56]. There was a 2017 Cochrane review of a small number of studies that generally concluded that bupropion may lead to a small improvement in ADHD and may decrease ADHD symptoms [57].…”

“…There was a 2017 Cochrane review of a small number of studies that generally concluded that bupropion may lead to a small improvement in ADHD and may decrease ADHD symptoms [57]. Of importance, it is also considered not to pose a greater risk for phase switching (induction of hypomania or mania) when compared to any of the other antidepressants studied, including other SNRIs and SSRIs [56].…”

A Literature Review of Movement Disorder Associated with Medications and Systemic Diseases

“…Bupropion is an antidepressant medication that is also used for smoking cessation [50]. While bupropion is generally well-tolerated, movement disorders are not commonly associated with its use.…”

Unlocking the Potential of High-Quality Dopamine Transporter Pharmacological Data: Advancing Robust Machine Learning-Based QSAR Modeling

“…S1 ). In particular, bupropion functions as a dual DAT and NET inhibitor and is used for the treatment of ADHD, depression, and smoking cessation 130 . Tamoxifen functions as both a DAT inhibitor with some atypical property without psychostimulant effect and a selective estrogen receptor modulator, which is typically prescribed for the treatment of estrogen related breast cancer 131 .…”