Clinical Medicine Reviews in Therapeutics

Bupropion is an antidepressant of the aminoketone class that is chemically unrelated to any other known antidepressant agent. In the treatment of major depressive disorder (MDD), bupropion has shown comparable therapeutic efficacy to selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). Bupropion effectiveness in treating co-morbid fatigue, hypersomnia, anhedonia, and mild to moderate anxiety symptoms (contrary to common clinician beliefs) associated with MDD is well documented. It is generally well tolerated with minimal undesirable side effects associated with antidepressants, such as sexual dysfunction and weight gain. Bupropion has shown effectiveness in augmentation as well as in switching strategies of antidepressant medications. Due to its favorable side-effect profile, bupropion has been used in the treatment of geriatric depression with good therapeutic efficacy and health outcome measurements. Bupropion has also shown usefulness as a smoking cessation agent and in treating depression in patients with medical co-morbidities such as asthma and HIV. Limitations of use include individuals at risk for seizures and patients with eating disorders.