Bupropion mimics a transient ischemic attack

To report the development of symptoms suggesting transient ischemic attacks during bupropion treatment for smoking cessation.

A 67-year-old white man experienced paresthesia, dizziness, tinnitus, confusion, and gait impairment shortly after starting bupropion as an aid to smoking cessation. Bupropion was discontinued on hospital admission, and testing for vertebral basilar artery disease was negative. His symptoms resolved, and he remained asymptomatic until restarting bupropion two days after hospital discharge.

Although separate case reports have reported sensory disturbances, tinnitus, and balance impairement associated with bupropion use, the combination of symptoms occurring in this patient has not been previously published.

The temporal relationship between bupropion exposure and symptomatology suggests that bupropion caused symptoms mimicking transient ischemic attacks in this patient.