title: Two acute psychotic episodes after administration of bupropion: a case of involuntary rechallenge.
abstract: Bupropion is an antidepressant drug also used as a smoking cessation aid, which inhibits norepinephrine and dopamine re-uptake. Given its pharmacological properties, it has been associated with reports on psychosis and acute delirious episodes. Case We report the case of a patient with schizoaffective disorder who developed two psychotic episodes respectively after a four and a two-day administration of sustained-release (SR) bupropion at a dose of 150 mg/day. To our knowledge, this is the first reported case of involuntary rechallenge with bupropion SR during a smoking cessation program. Conclusion There is a serious risk of incorrectly identifying bupropion as only a therapy for nicotine withdrawal without taking the precaution of exploring possible psychiatric co-morbidity with addiction. Our case illustrates the problem.
authors.affiliation: Secteur Pharmacie, Etablissement Public Santé Alsace Nord, 67170 Brumath, France. herve.javelot@ch-epsan.fr
authors.forename: Hervé
authors.initials: H
authors.lastname: Javelot
authors.forename: Alexandre
authors.initials: A
authors.lastname: Baratta
authors.forename: Luisa
authors.initials: L
authors.lastname: Weiner
authors.forename: Thierry
authors.initials: T
authors.lastname: Javelot
authors.forename: Cathy
authors.initials: C
authors.lastname: Nonnenmacher
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Westphal
authors.forename: Michaël
authors.initials: M
authors.lastname: Messaoudi
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D016642:Bupropion / Q000009:adverse effects* / Q000627:therapeutic use; D003693:Delirium / Q000139:chemically induced*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D011618:Psychotic Disorders / Q000150:complications*; D014029:Tobacco Use Disorder / Q000150:complications / Q000188:drug therapy*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion