Bupropion: Mechanism of Action & Drug Interactions

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

Bupropion is an antidepressant medication that prevents the reuptake of specific neurotransmitters in the brain. This lesson will discuss the mechanism of action and drug interactions of bupropion.

Medication for Depression and Smoking Cessation

Janice is a forty-year-old woman with a history of depression. She has also been a smoker for twenty-five years. Janice is meeting with her doctor to discuss changing her antidepressant medication to bupropion because she heard it can also help with smoking cessation. Janice wants to know how it will work and if it will interact with any other medications she is already taking.

Bupropion: Mechanism of Action

Bupropion is known as an antidepressant, but it can also be used to help people quit smoking. Bupropion prevents the reuptake of three neurotransmitters called dopamine, serotonin, and norepinephrine.

Neurotransmitters moving through the synapse
Neurotransmitters moving through the synapse

Dopamine helps control the pleasure centers in the brain while also regulating movement and emotional responses. Serotonin in the brain helps with cognitive function such as memory and learning, but can also regulate mood, sleep, and appetite. Norepinephrine is known for the fight-or-flight response during stressful situations. However, it also is responsible for increasing arousal and alertness, memory retrieval, focused attention, and restlessness.

Therefore, in depression, there is often a decrease in dopamine, serotonin, and norepinephrine. Medication such as bupropion helps to regulate the amount of neurotransmitters active in the brain.

Bupropion as a smoking cessation medication is also thought to be related to the regulation of serotonin, dopamine, and norepinephrine. However, it also involved in combating nicotine receptors. It is not entirely known what is responsible for the smoking cessation relationship, but bupropion may help reduce the withdrawal symptoms of nicotine.

Janice is intrigued about using bupropion for both her depression management and smoking cessation. However, due to the unclear relationship that bupropion has with smoking cessation, it is not recommended that she take it to combat both of her issues. Janice's doctor is willing to work with her as she wants to take bupropion for smoking cessation, but still stay on her usual antidepressant. She will have to be closely followed, because bupropion can increase thoughts of suicide when first starting to take it. Janice talks with her doctor about any interactions she may see with the selective serotonin reuptake inhibitor (SSRI), fluoxetine, which she is taking for depression.

Feelings when depressed
Feelings when depressed

Bupropion: Drug Interactions

As Janice's doctor has already told her, it is not recommended to take bupropion for depression (medication prescribed as Wellbutrin) and smoking cessation (medication prescribed as Zyban) at the same time. Other contraindications to taking bupropion include:

  • Seizure disorders or other medical issues that increase the risk of seizures
  • Having an eating disorder
  • Having an alcohol problem

Medications that May Cause Interactions with Bupropion

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