Citation

Barman R, Kumar S, Pagadala B, Detweiler MB. J. Clin. Psychopharmacol. 2017; 37(4): 459-463.

Affiliation

From the *Psychiatry Residency Program, Virginia Tech-Carilion, Roanoke; †Geriatric Research Group, Salem Veterans Affairs Medical Center, Salem, VA; ‡Department of Psychiatry, University of Toronto; §Centre for Addiction and Mental Health, Toronto, Ontario, Canada; ∥Department of Psychiatry, Salem Veterans Affairs Medical Center, Salem; ¶Department of Psychiatry and Behavioral Medicine, Virginia Tech-Carilion School of Medicine, Roanoke; and #Department of Psychiatry, Edward Via College of Osteopathic Medicine, Blacksburg, VA.

Copyright

(Copyright © 2017, Lippincott Williams and Wilkins)

DOI

10.1097/JCP.0000000000000729

PMID

28590371

Abstract

BACKGROUND AND OBJECTIVE: Bupropion is generally considered safe and is widely used both as a monotherapy and as an augmentation agent for the treatment of major depression. Concerns have been raised about bupropion's propensity to precipitate new psychosis and worsen existing psychotic symptoms, although the mechanism is poorly understood. Three cases are reported in which bupropion use was associated with psychosis. The aim of the study was to explore the risk factors and possible mechanisms of psychosis in each case. CASE REPORTS: Case 1 describes the interaction of cocaine abuse sensitization in a patient who developed psychosis with a lower dosage of bupropion. Cases 2 and 3 discuss the role of traumatic brain injury and structural brain lesions in increasing the risk of psychosis when using bupropion.

CONCLUSIONS: Cocaine abuse, traumatic brain injury, and preexisting brain lesions appear to be risk factors for developing psychosis in persons taking bupropion. In such cases, clinicians should carefully assess the risks and benefits and closely monitor patients for symptoms of psychosis.

Language: en