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Bupropion is a medication primarily used to treat depression, mood disorders, and aid in smoking cessation. While it offers significant benefits, it's essential to be aware of potential risks and necessary precautions. Below are important safety considerations and warnings associated with bupropion use:

• Suicidal Thoughts and Behavioral Changes: Bupropion may increase the risk of suicidal thoughts or behavior, particularly in individuals under 24. Alcohol use can exacerbate these effects. Monitor for mood or behavior changes, especially at the start of treatment or if the dosage is altered. If symptoms such as worsening depression, agitation, or hostility occur, stop the medication and contact your healthcare provider immediately. This is crucial for individuals with a history of depression or mental health conditions, and those consuming alcohol.

• Mental Health Changes: Those using bupropion for smoking cessation may experience severe mental health side effects, including depression, hallucinations, psychosis, paranoia, delusions, aggression, or suicidal thoughts. It’s important for patients and those around them to monitor for these changes. Discontinue use and seek medical advice if such symptoms arise. Individuals with a history of mental health issues are at greater risk.

• Seizures: There is an increased risk of seizures, particularly if the recommended dose is exceeded. Patients with a history of seizures, head trauma, eating disorders, or those who have recently stopped using alcohol or certain medications should avoid bupropion. If a seizure occurs, discontinue use and consult a healthcare provider. Use caution if taking other medications that lower the seizure threshold.

• High Blood Pressure: Bupropion can elevate blood pressure, especially in those predisposed to hypertension. Regularly monitor blood pressure and inform your provider of any significant changes. This is particularly critical for those taking other medications that affect blood pressure.

• Mania: Individuals with bipolar disorder may experience manic episodes when taking bupropion without other bipolar disorder medications. Symptoms include extreme energy, difficulty sleeping, and irritability. If you have a personal or family history of bipolar disorder, report any unusual behavioral changes to your healthcare provider.

• Contraindications: Bupropion should not be used by individuals with a history of seizures or eating disorders, or those who have recently stopped using alcohol, benzodiazepines, barbiturates, or antiepileptic medications. Avoid if using or having recently used MAOIs within the past 14 days, or if undergoing treatment with linezolid or intravenous methylene blue.

If you experience any severe reactions or suspect an overdose, seek emergency medical assistance promptly. Always discuss potential risks and benefits with your healthcare provider before starting bupropion.

Common side effects:

• Headache
• Dry mouth
• Nausea
• Trouble sleeping
• Dizziness
• Sore throat
• Constipation
• Restlessness

Less common but important to monitor:

• Stomach pain
• Anxiety
• Confusion
• Tremor
• Fast heartbeat
• Increased sweating
• Ringing in the ears
• Blurred vision
• Muscle pain
• Loss of appetite
• Urinary frequency
• Rash

Serious side effects:

• Suicidal thoughts
• Significant changes in mood or behavior
• Seizures
• Manic episodes
• Vision problems
• Severe allergic reactions
• Severe skin reactions

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (isocarboxazid, Linezolid, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, Tranylcypromine)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Codeine
• Pimozide
• Tamoxifen
• Thioridazine