Two studies on drug abusers indicated that the subjective effects of bupropion are markedly different from those of amphetamine. They also reported feeling alert, vigorous, elated and energetic, reflecting the general stimulating properties of bupropion.
In contrast to amphetamine and methylphenidate , there was no feeling of "liking the drug " and no desire to take it again. A comparison of bupropion SR mg and caffeine mg indicated that caffeine may have higher abuse liability since it resulted in more reports of pleasant feelings and a "high" than bupropion.
There have been four reports of bupropion abuse in the literature. Three cases described teenagers crushing and insufflating snorting the drug , two of them resulting in seizures. An additional case was reported where a teenager ingested bupropion believing the drug to be a stimulant. An article on medication abuse in prisons mentions bupropion as one of the psychotropic medications commonly abused by inmates. Mechanism of action Bupropion is a dopamine and norepinephrine reuptake inhibitor.
Bupropion does not inhibit monoamine oxidase or serotonin reuptake. However, it has been shown to indirectly enhance the firing of serotonergic neurons, via activation of downstream norepinephrine flow. The drug is supplied as a racemic mixture, and no studies have been published on the activities of the individual enantiomers. In the SAD trials, 2 patients treated with bupropion discontinued from the study because they developed hypertension.
None of the placebo group discontinued because of hypertension. The mean increase in systolic blood pressure was 1. The mean increase in diastolic blood pressure was 0. The mean daily dose was mg per day. The mean duration of bupropion exposure was days. There are no controlled studies assessing the safety of bupropion in patients with a recent history of myocardial infarction or unstable cardiac disease.
The risk appears to be increased in patients with bipolar disorder or who have risk factors for bipolar disorder. Psychosis And Other Neuropsychiatric Reactions Depressed patients treated with bupropion have had a variety of neuropsychiatric signs and symptoms, including delusions, hallucinations, psychosis, concentration disturbance, paranoia, and confusion.
Some of these patients had a diagnosis of bipolar disorder. Reactions have been characterized by pruritus , urticaria , angioedema , and dyspnea , requiring medical treatment.
In addition, there have been rare, spontaneous postmarketing reports of erythema multiforme , Stevens-Johnson syndrome , and anaphylactic shock associated with bupropion. There are reports of arthralgia , myalgia , fever with rash and other symptoms of serum sickness suggestive of delayed hypersensitivity.
Instruct patients, their families, and their caregivers to read the Medication Guide and assist them in understanding its contents. Patients should be given the opportunity to discuss the contents of the Medication Guide and to obtain answers to any questions they may have. The complete text of the Medication Guide is reprinted at the end of this document.
Advise families and caregivers of patients to observe for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt. Such symptoms should be reported to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Symptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medication.
Advise patients, families and caregivers that quitting smoking, with or without ZYBAN, may trigger nicotine withdrawal symptoms e. Depression, rarely including suicidal ideation, has been reported in smokers undergoing a smoking cessation attempt without medication. However, some of these symptoms have occurred in patients taking bupropion who continued to smoke.
All patients being treated with bupropion for smoking cessation treatment should be observed for neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide. These symptoms, as well as worsening of pre-existing psychiatric illness and completed suicide have been reported in some patients attempting to quit smoking while taking ZYBAN in the postmarketing experience.
These events have occurred in patients with and without pre-existing psychiatric disease; some have experienced worsening of their psychiatric illnesses. Patients with serious psychiatric illness such as schizophrenia, bipolar disorder, and major depressive disorder did not participate in the premarketing studies of ZYBAN. Advise patients and caregivers that the patient using bupropion for smoking cessation should stop taking bupropion and contact a healthcare provider immediately if agitation, hostility, depressed mood, or changes in thinking or behavior that are not typical for the patient are observed, or if the patient develops suicidal ideation or suicidal behavior.
In many postmarketing cases, resolution of symptoms after discontinuation of ZYBAN was reported, although in some cases the symptoms persisted; therefore, ongoing monitoring and supportive care should be provided until symptoms resolve. The risks of using bupropion for smoking cessation should be weighed against the benefits of its use.
ZYBAN has been demonstrated to increase the likelihood of abstinence from smoking for as long as 6 months compared to treatment with placebo. The health benefits of quitting smoking are immediate and substantial. Its structure closely resembles that of diethylpropion; it is related to phenylethylamines. The molecular weight is Bupropion hydrochloride powder is white, crystalline, and highly soluble in water. It has a bitter taste and produces the sensation of local anesthesia on the oral mucosa.
The structural formula is: Each tablet contains the labeled amount of bupropion hydrochloride and the inactive ingredients: Bupropion is a relatively weak inhibitor of the neuronal uptake of norepinephrine and dopamine, and does not inhibit monoamine oxidase or the re-uptake of serotonin. Bupropion is a racemic mixture. Xanax is not a good choice for me since I need a medication that is designed for long-term use and is gentle for my liver to metabolize.
Read More Hi, have you heard of an extended release xanax? I know FLaddict said something about a longer lasting benzo. I have never tried it, but I saw it on a website. You really only have to take it once a day.
Its called xanax xr. You can google it and find out more about it.
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