15 Years of Clinical Experience With Bupropion HCl: From Bupropion to Bupropion SR to Bupropion XL
Prim Care Companion J Clin Psychiatry 2005;7(3):106-113
© Copyright 2016 Physicians Postgraduate Press, Inc.
Background: Bupropion has been available
in the United States since 1989. Initially a thrice-daily
immediate-release formulation, a twice-daily sustained-release
formulation followed in 1996, and, in August 2003, a once-daily
extended-release formulation was introduced. On the 15th
anniversary of its introduction, we undertook a review of the
background/history, mechanism of action, formulations, and
clinical profile of bupropion.
Data Sources: Major efficacy trials and
other reports were obtained and reviewed from MEDLINE searches,
review of abstracts from professional meetings, and the bupropion
SR manufacturer's databases. Searches of English-language
articles were conducted from June 2003 through August 2004. No
time limit was specified in the searches, which were conducted
using the search terms bupropion, bupropion SR, and bupropion 40 .
Data Synthesis: Bupropion inhibits the
reuptake of norepinephrine and dopamine neurotransmission without
any significant direct effects on serotonin neurotransmission.
Bupropion is an effective antidepressant with efficacy comparable
to selective serotonin reuptake inhibitors and other
antidepressants. It is well tolerated in short- and longer-term
treatment. Headache, dry mouth, nausea, insomnia, constipation,
and dizziness are the most common adverse events. Seizure and
allergic reactions are medically important adverse events
associated with bupropion and are reported rarely. Among all the
newer antidepressants in the United States, bupropion appears to
have among the lowest incidence of sexual dysfunction, weight
gain, and somnolence. Although not U.S. Food and Drug
Administration approved for these indications, bupropion has also
been used as an adjunctive treatment to reverse
antidepressant-induced sexual dysfunction and to augment
antidepressant efficacy in partial responders and nonresponders
to other agents.
Conclusion: Bupropion has played and will
continue to play an important role as a treatment for major
depressive disorder in adults, as well as for other related