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Old 07-19-2011
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Drug Contraindication of Bupropion

Which one of the following is a contraindication for Buproppion?

A) ADHD
B) Narcolepsy
C) Smoking cessation
D) Anorexia Nervosa
E) Bipolar disorder
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Old 07-19-2011
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This can help
Bupropion Indications and Contraindications Mnemonic!
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Old 07-19-2011
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D) Anorexia Nervosa
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Old 07-19-2011
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I am thinking between C ...and ...D...I will go with d
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Old 07-19-2011
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I think D) A.N is the answer even i read somewhere that Bipolar disorder is a CI too.

Medical uses:

Depression: Placebo-controlled double-blind clinical studies have confirmed the efficacy of bupropion for clinical depression.

Anxiety
Bupropion has shown some success in treating social phobia] and anxiety comorbid with depression, but not panic disorderwith agoraphobia.

Smoking cessation
Bupropion reduces the severity of nicotine cravings and withdrawal symptoms. After a seven-week treatment, 27% of subjects who received bupropion reported that an urge to smoke was a problem, versus 56% of those who received placebo. In the same study, 21% of the bupropion group reported mood swings, versus 32% of the placebo group.

Sexual dysfunction
Bupropion is one of few antidepressants that does not cause sexual dysfunction. According to a survey of psychiatrists, it is the drug of choice for the treatment of SSRI-induced sexual dysfunction, although this is not an indication approved by the U.S. Food and Drug Administration (FDA).

Obesity
A recent meta-analysis of anti-obesity medications pooled the results of three double-blind, placebo-controlled trials of bupropion. It confirmed the efficacy of bupropion given at 400 mg per day for treating obesity. Over a period of 6 to 12 months, weight loss in the bupropion group (4.4 kg) was significantly greater than in the placebo group (1.7 kg).

Attention-deficit hyperactivity disorder
Although ADHD is not an approved indication, bupropion was found to be effective for adult ADHD.There have been many positive case studies and other uncontrolled clinical studies of bupropion for ADHD in minors. However, in the largest to date double-blind study, which was conducted by GlaxoSmithKline, the results were inconclusive. Aggression and hyperactivity as rated by the children's teachers were significantly improved in comparison to placebo; in contrast, parents and clinicians could not distinguish between the effects of bupropion and placebo.

Other uses
Bupropion was approved by the U.S. Food and Drug Administration (FDA)[ for the prevention of seasonal affective disorder. According to several case studies and a pilot study, bupropion lowers the level of an inflammatory mediator TNF-alpha and may be useful in autoinflammatory conditions such as Crohn's disease and psoriasis.

No properly controlled double-blind studies of bupropion for Parkinson' disease have been conducted. A small 1984 study funded by bupropion's manufacturer found that addition of bupropion to carbidopa or levodopa improved Parkinson's symptoms in ten out of twenty patients; however, the side effects, particularly nausea and vomiting, were frequent.The American Psychiatric Association notes that, "there is no evidence favoring any particular antidepressant medication from the standpoint of therapeutic efficacy in patients with Parkinson's disease complicated by major depressive disorder".
There is considerable disagreement regarding whether it is useful to add an antidepressant, including bupropion, to a mood stabilizer in patients with bipolar depression.
Bupropion, similarly to other antidepressants, is not efficacious in chronic low back pain. However, it has been found to have surprisingly high efficacy in the treatment of neuropathic pain.
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Old 07-19-2011
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Contraindications

Seizures: Bupropion should not be prescribed to individuals with epilepsy or other conditions that lower the seizure threshold, such as alcohol or benzodiazepine withdrawal, anorexia nervosa, bulimia, or active brain tumors. Seizure is the most controversial side effect of bupropion, and was responsible for its initial withdrawal from the market. The risk of seizure is highly dose-dependent: 0.1% at 100–300 mg of bupropion, 0.4% at 300–450 mg, and 2% at 600 mg.

MAOIs: It should be avoided in individuals who are also taking monoamine oxidase inhibitors (MAOIs). When switching from MAOIs to bupropion, it is important to include a washout period of about two weeks between the medications.

Others: The prescribing information approved by the FDA recommends that caution should be exercised when treating patients with liver damage, severe kidney disease, and severe hypertension, as well as in pediatric patients, adolescents and young adults due to the increased risk of suicidal ideation.

According to a retrospective case series published in 1993, bupropion treatment may exacerbate tics in children with co-occurring ADHD and Tourette syndrome.No further research of this side effect has been conducted.
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Old 07-19-2011
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Bupropion: Contraindications/Precautions
  • abrupt discontinuation
  • anorexia nervosa
  • breast-feeding
  • bulimia nervosa
  • seizure disorder
  • seizures
  • acute myocardial infarction
  • alcoholism
  • biliary cirrhosis
  • bipolar disorder
  • cardiac disease
  • children
  • diabetes mellitus
  • driving or operating machinery
  • elderly
  • ethanol intoxication
  • head trauma
  • heart failure
  • hepatic disease
  • hypertension
  • intracranial mass
  • mania
  • myocardial infarction
  • neonates
  • obesity treatment
  • pregnancy
  • psychosis
  • renal failure
  • renal impairment
  • substance abuse
  • suicidal ideation
  • tics
  • tobacco smoking
  • Tourette’s syndrome
I think Bipolar disorder can be more a Precaution rather than a true CI.
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Old 07-19-2011
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Quote:
Originally Posted by drmuh View Post
Bupropion: Contraindications/Precautions
  • abrupt discontinuation
  • anorexia nervosa
  • breast-feeding
  • bulimia nervosa
  • seizure disorder
  • seizures
  • acute myocardial infarction
  • alcoholism
  • biliary cirrhosis
  • bipolar disorder
  • cardiac disease
  • children
  • diabet
  • driving or operating machinery
  • elderly
  • ethanol intoxication
  • head trauma
  • heart failure
  • hepatic disease
  • hypertension
  • intracranial mass
  • mania
  • myocardial infarction
  • neonates
  • obesity treatment
  • pregnancy
  • psychosis
  • renal failure
  • renal impairment
  • substance abuse
  • suicidal ideation
  • tics
  • tobacco smoking
  • Tourette’s syndrome
I think Bipolar disorder can be more a Precaution rather than a true CI.


In medical uses u mentioned smoking then again in contraindication smoking...i read some where as contraindication ....so smoking is contraindication right?
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Old 07-20-2011
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One of the most common uses of bupropion asked about in the exams is smoking cessation. Though it should be used under close observation for the emergence of any neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide. There is also concerns about Patients taking bupropion and continiung smoking.

One more information good about bupropion that u should start using it 1 week before quitting smoking as it takes 1 week to start its action then u ask the patient to quit smoking in the second week of using it.
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