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Serious neuropsychiatric events, including but not limited to depression, suicidal ideation, suicide attempt, and completed suicide have been reported in patients taking bupropion for smoking cessation. MANAGEMENT: Although sedatives may be prescribed to treat agitation, anxiety, and insomnia associated with bupropion use, patients should be alerted to the possibility of an increased risk of seizures during excessive exposure to these drugs. The amount of bupropion you take may have to be adjusted to meet the needs of your condition and to help avoid unwanted effects. Bupropion can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication. When symptoms were reported, most were during treatment with bupropion, but some were following discontinuation of treatment with bupropion. However, some of these symptoms have occurred in patients taking bupropion who continued to smoke. Bupropion has been demonstrated to increase the likelihood of abstinence from smoking for as long as 6 months compared to treatment with placebo. You will probably need to keep taking bupropion for several months to help prevent the return of your depression. Do not take an MAO inhibitor within 14 days of taking bupropion. If you are already taking medicine for mental depression or to help you stop smoking, discuss this with your doctor before taking bupropion. These symptoms, as well as worsening of pre-existing psychiatric illness and completed suicide have been reported in some patients attempting to quit smoking while taking bupropion in the postmarketing experience. Anyone considering the use of bupropion or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. In many postmarketing cases, resolution of symptoms after discontinuation of bupropion was reported, although in some cases the symptoms persisted; therefore, ongoing monitoring and supportive care should be provided until symptoms resolve. Bupropion passes into breast milk and could be harmful to a nursing baby. Bupropion can cause agitation, anxiety, and insomnia and has been shown to decrease the sedative effect of diazepam in healthy volunteers given single doses of the drugs. It is very important that you receive only one prescription for bupropion at a time. You should not take bupropion if you have seizures, an eating disorder, if you are using a second form of bupropion, or if you have suddenly stopped using alcohol or sedatives. Conversely, bupropion may antagonize the central pharmacologic effects of sedatives. Do not take bupropion without telling your doctor if you are breast-feeding a baby. The patient should stop taking bupropion and contact a healthcare provider immediately if any neuropsychiatric behavior that is not typical for the patient is observed, or if the patient develops suicidal ideation or suicidal behavior. You may have a higher risk of seizures if you use certain medications together with bupropion. After 3 weeks though, I had a severe allergic reation to the Wellbutrin (bupropion) and had to go to the ER twice in a week. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving bupropion. Before taking bupropion, tell your doctor if you are pregnant or plan to become pregnant during treatment. Bupropion hydrochloride powder is white, crystalline, and highly soluble in water. Patients with serious psychiatric illness such as schizophrenia, bipolar disorder, and major depressive disorder did not participate in the premarketing studies of bupropion. At least one brand of bupropion (Zyban) is used to help people stop smoking by reducing cravings and other withdrawal effects.

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