Evidence suggests that the efficacy of bupropion for depression is similar to that of other antidepressants. Unpublished trials are more likely to be negative in findings, and other meta-analyses have included unpublished trials. However, there were methodological limitations with this meta-analysis, including using a subset of only five trials for the effect size calculation, substantial variability in effect sizes between the selected trials-which led the authors to state that their findings in this area should be interpreted with "extreme caution"-and general lack of inclusion of unpublished trials in the meta-analysis. On the other hand, one meta-analysis reported a large effect size. Most meta-analyses report that bupropion has an at-most small effect size for depression. The evidence overall supports the efficacy of bupropion over placebo for the treatment of depression. It is on the World Health Organization's List of Essential Medicines. In 2020, it was the eighteenth most commonly prescribed medication in the United States, with more than 28 million prescriptions. Bupropion was originally called by the generic name amfebutamone, before being renamed in 2000. It was first approved for medical use in the United States in 1985. īupropion was invented by Nariman Mehta, who worked at Burroughs Wellcome, in 1969. Chemically, bupropion is an aminoketone that belongs to the class of substituted cathinones and more generally that of substituted amphetamines and substituted phenethylamines. However, its effects on dopamine are weak. īupropion acts as a norepinephrine–dopamine reuptake inhibitor and a nicotinic receptor antagonist. Bupropion use during pregnancy may be associated with increased odds of congenital heart defects. Rare but serious side effects include seizure, liver toxicity, psychosis, and risk of overdose. Bupropion does, however, carry a much higher risk of seizure than many other antidepressants and extreme caution must be taken in patients with a history of seizure disorder.Ĭommon adverse effects of bupropion with the greatest difference from placebo are dry mouth, nausea, constipation, insomnia, anxiety, tremor, and excessive sweating. Bupropion has several features that distinguish it from other antidepressants: it does not usually cause sexual dysfunction it is not associated with weight gain and sleepiness, and it is more effective than SSRIs at improving symptoms of hypersomnia and fatigue. It is also popular as an add-on medication in the cases of "incomplete response" to the first-line selective serotonin reuptake inhibitor (SSRI) antidepressant. Bupropion, sold under the brand names Wellbutrin and Zyban among others, is an atypical antidepressant primarily used to treat major depressive disorder and to support smoking cessation.
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