Review: Bupropion and SSRI-induced side effects.
Selective serotonin reuptake inhibitors (SSRIs) are a first line treatment option for millions of patients, due to the positive balance between efficacy and tolerability. However, some side effects associated with their use, can impair quality of life and compliance with treatment. This paper reviews the prevalence of sexual dysfunction, weight gain and emotional detachment during SSRI treatment, the profile of bupropion for each of these events and the ability of bupropion to reverse them. Double-blind trials, open-label trials and anecdotical reports derived from Medline were included. First, there is robust evidence that SSRIs can induce sexual side effects and that bupropion causes less sexual dysfunction than SSRIs. There is limited, mainly open-label evidence that bupropion can reverse SSRI-induced sexual side effects. Second, there is good evidence that long-term treatment with some SSRIs can result in weight gain and that long-term treatment with bupropion can result in a small weight loss. There is only anecdotical evidence that bupropion can reverse SSRI-induced weight gain. Third, treatment with SSRIs has been associated with ;emotional detachment', although controversy exists about this concept. No data are available on the profile of bupropion for ;emotional detachment' or for the reversal of SSRI-induced ;emotional detachment' by bupropion-addition.
Demyttenaere
K
K
University Psychiatric Center KuLeuven, Campus Gasthuisberg, B-3000 Leuven, Belgium. koen.demyttenaere@med.kuleuven.be
Jaspers
L
L
D000342:Affective Symptoms / Q000139:chemically induced / Q000523:psychology; D016642:Bupropion / Q000009:adverse effects* / Q000627:therapeutic use; D003863:Depression / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced; D015430:Weight Gain / Q000187:drug effects
D016642:Bupropion; D018765:Dopamine Uptake Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors