Obsessive-Compulsive Symptoms Associated With Bupropion Treatment: A Case Series

Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) and nicotinic antagonist. It belongs to the class of aminoketones and is commonly used to treat major depressive disorder (MDD) and to aid in smoking cessation. There is scarce literature on the sudden appearance of obsessive-compulsive symptoms (OCSs) in depressed patients that could be related to bupropion treatment.

We present four cases of bupropion associated with OCSs in patients with affective disorders. Patients reported no previous history of obsessive ideation or compulsion. Symptoms appeared after the start of bupropion treatment with a progressive increase in intensity. Upon discontinuation of the drug, there was a notable reduction in symptoms with a complete remission over time. Evaluation of obsessive and compulsive symptoms and evolution were assessed using the Yale-Brown obsessive-compulsive scale (YBOCS) and clinical global impression-severity (CGI-S) scale.

The neurobiological basis for the development of OCSs associated with bupropion treatment is not yet fully understood; clinicians need to take these symptoms into account when prescribing bupropion. Further studies with a larger sample of patients with depression who are undergoing bupropion treatment are required to confirm this phenomenon.