Falling backward in two elderly patients taking bupropion.
BACKGROUND
Bupropion, a novel antidepressant, has been reported to produce fewer adverse effects than the tricyclic antidepressants. It has relatively weak effects on norepinephrine and serotonin reuptake but possesses significant dopamine agonist and reuptake blocking effects.


METHODS
The case histories of two geriatric patients treated with bupropion for major depression are presented.


RESULTS
Both patients experienced a previously unreported side effect--falling backward--associated with bupropion use. Orthostatic hypotension and vertigo are not consistent with the patients' histories. Both patients manifested other symptoms consistent with parkinsonian syndrome.


CONCLUSIONS
This side effect, apparently unique to bupropion among antidepressants, may be mediated through dopaminergic effects in the basal ganglia. Clinicians should be alert to these potential problems in the geriatric population.
Szuba
M P
MP
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of Medicine.
Leuchter
A F
AF
D000367:Age Factors; D000368:Aged; D001480:Basal Ganglia Diseases / Q000139:chemically induced; D016642:Bupropion / Q000009:adverse effects*; D003866:Depressive Disorder / Q000188:drug therapy*; D004409:Dyskinesia, Drug-Induced / Q000209:etiology*; D005260:Female; D006801:Humans; D010302:Parkinson Disease, Secondary / Q000150:complications; D011187:Posture
D016642:Bupropion