New-Onset Tic Disorder Associated With Bupropion XL: A Rare Case

Tics are sudden, rapid, non-rhythmic movements or vocalizations. Bupropion XL, a norepinephrine-dopamine reuptake inhibitor (NDRI), is approved for depression and smoking cessation. While tics are a known adverse effect of stimulants and have been rarely reported with selective serotonin reuptake inhibitors (SSRIs), they are exceptionally uncommon with bupropion. We present the case of a 27-year-old male patient with no prior history of tic disorder who developed motor (clapping) and vocal (whistling, laughing) tics following the initiation of bupropion XL for depressive symptoms. The tics subsided completely upon discontinuation of bupropion and initiation of low-dose risperidone. This case highlights a rare but clinically significant adverse effect of bupropion, underscoring the need for clinical vigilance when prescribing this agent.