Neuropsychiatric adverse events of bupropion treatment: a brief update

The clinical use of bupropion as an aid for smoking cessation has raised some concern in clinicians and public opinion. Clinical and post-marketing surveillance studies indicate a favourable side effect profile, but spontaneous reports of suspected adverse reactions to medical authorities indicate adverse neuropsychiatric events to be more frequent than previously thought. Except for the risk of seizures, adverse neuropsychiatric events have not been examined systematically. Insomnia has been reported quite frequently. In the placebo-controlled trials, depression scores were unaffected by bupropion treatment. Suspected adverse events reported to medical authorities in the UK or Germany indicate depression to be the most common psychiatric disorder associated with bupropion treatment. Switch to mania or hypomania is very rare, as are psychosis or organic mental disorders. Suicide attempts associated with bupropion use have been reported as possible adverse events. This topic warrants further attention.