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Bupropion-induced serum sickness-like reaction.
R A McCollom1, D H Elbe, A H Ritchie
1Department of Pharmacy, The Richmond Hospital, British Columbia, Canada. robert_mccollom@rhss.bc.ca
The Annals of Pharmacotherapy
|April 20, 2000
Summary
Serum sickness-like reactions (SSLRs) are rare but possible side effects of bupropion. This report details three cases, suggesting the reaction may be underrecognized in clinical practice.
Area of Science:
- Pharmacovigilance
- Clinical Toxicology
Background:
- Bupropion is a widely prescribed antidepressant.
- Serum sickness-like reactions (SSLRs) are hypersensitivity reactions typically presenting with rash, arthralgia, and fever.
Observation:
- Three patients presented with symptoms of SSLR, including rash and arthralgias, within weeks of initiating bupropion.
- Bupropion was the only common factor identified in all three cases.
Findings:
- This series represents the second published report of SSLRs linked to bupropion.
- While bupropion-induced rash and urticaria are common (1-4%), arthralgia and arthropathy are less frequently reported.
- SSLR onset typically occurs 6-21 days post-exposure and is usually self-limiting.
Implications:
- The findings suggest that SSLRs associated with bupropion, though rare, may be underreported.
- Clinicians should maintain a high index of suspicion for SSLR in patients presenting with compatible symptoms after bupropion initiation.
- Further pharmacovigilance is warranted to better understand the incidence and clinical spectrum of bupropion-associated SSLRs.