Bupropion anxiety with

Occasional Confusion amnesia disinhibition paradoxical excitement depression dizziness witiidrawal symptoms, including convulsions, on abrupt discontinuance (witiidrawal may be especially difficult with alprazolam) rebound insomnia or excitement Rare Hypotension blood dyscrasias jaundice allergic reactions paradoxical rage reactions stuttering with alprazolam BUPROPION, Anxiety agitation insomnia tremor anorexia BUSPIRONE, Dizziness headache nausea paresthesias diarrhea CHLORDIAZEPOXIDE, see Benzodiazepines CHLORPROMAZINE, see Phenothiazines, aliphatic CHLORPROTHIXENE, similar to Phenothiazines CLOMIPRAMINE, see Tricyclic antidepressants CLORAZEPATE, see Benzodiazepines CLOZAPINE... 

Adverse reactions with administration of bupropion include citation, dry mouth, insomnia, headache, nausea, constipation, anorexia, weight loss, and seizures. Fluoxetine administration may result in headache, activation of mania or hypomania, insomnia, anxiety, nervousness, nausea, vomiting, and sexual dysfunction. Trazodone administration may cause the following adverse reactions drowsiness, skin disorders, anger, hostility, anemia, priapism, nausea, and vomiting. Additional... 

Bupropion causes insomnia, nightmares, decreased appetite, anxiety, and tremors, but the most concerning adverse effect is seizures. Because of the risk for seizures, patients who should not receive the drug include those with a CNS lesion or those with a history of seizures, head trauma, or bulimia. The daily dose of bupropion should not exceed 450 mg/day, and any single dose of the immediate-release formulation should not exceed 150 mg/day Occurrences of insomnia and/or nightmares often respond to moving the last daily dose from bedtime to late afternoon.7,9,22,23... 

The tricyclic antidepressants (TCAs), such as imipramine, can alleviate symptoms of ADHD. Like bupropion, TCAs likely will improve symptoms associated with comorbid anxiety and depression. The mechanism of action of TCAs is in blocking norepinephrine transporters, thus increasing norepinephrine concentrations in the synapse the increase in norepinephrine is believed to alleviate the symptoms of ADHD. TCAs have been demonstrated to be an effective non-stimulant option for ADHD but less effective than stimulants. However, their use in ADHD has declined owing to case reports of sudden death and anticholinergic side effects6,13 (Table 39-3). Further, TCAs may lower seizure threshold and increase the risk of car-diotoxicity, (e.g., arrythmias). Patients starting on TCAs should have a baseline and routine electrocardiograms. 

Inattentiveness, impulsivity, hyperactivity 50% will continue to manifest the disorder into adulthood Stimulants (70% response for uncomplicated ADHD caution in patients with tic disorders) TCAs (70% response, first line for patients with comorbid MD or anxiety disorders, and for patients with ADHD + tics) requires serum levels and cardiovascular monitoring Bupropion Clonidine, guan-facine (first line for patients with ADHD + tics) MAOIs Combined pharmacotherapy for treatment-resistant cases... 

At present, SSRIs are the most commonly prescribed first-line agents in the treatment of both MDD and anxiety disorders. Their popularity comes from their ease of use, tolerability, and safety in overdose. The starting dose of the SSRIs is usually the same as the therapeutic dose for most patients, and so titration may not be required. In addition, most SSRIs are now generically available and inexpensive. Other agents, including the SNRIs, bupropion, and mirtazapine, are also reasonable first-line agents for the treatment of MDD. Bupropion, mirtazapine, and nefazodone are the antidepressants with the least association with sexual side effects and are often prescribed for this reason. However, bupropion is not thought to be effective in the treatment of the anxiety disorders and may be poorly tolerated in anxious patients. The... 

Bupropion (100 mg p.o. b.i.d.) is indicated in the treatment of depression. It is reserved for patients who cannot tolerate or have not responded to other medications. Bupropion does not alter the uptake of serotonin, has an equivocal effect on the uptake of norepinephrine, but blocks the uptake of dopamine. Bupropion has no affinity for alpha-1 and alpha-2-adrenergic receptors, H,-histamine receptors, muscarinic cholinergic receptors, or D2-dopaminergic receptors. It does not cause sedation or orthostatic hypotension. However, because it is structurally related to amphetamine, it may cause insomnia, agitation, and anxiety shortly after initiation of therapy. Bupropion lowers the seizure threshold and hence is contraindicated in patients with a history of seizure disorder (see also Tables 5 through 7). 

A. Central nervous system. The usual presentation after overdose includes ataxia, sedation, and coma. Respiratory depression may occur, especially with co-ingestion of alcohol or other drugs. These agents, particularly bupropion, can cause restlessness, anxiety, and agitation. Tremor and seizures are common with bupropion but occur occasionally after overdose with an SSRI. 

The day after stopping fluoxetine 60 mg daily, a 41-year-old man was started taking 75 mg and later 100 mg of bupropion three times daily. After 10 days he became edgy and anxious and after 12 days he developed myoclonus. After 14 days he became severely agitated and psychotic, with delirium and hallucinations. His behaviour returned to normal 6 days after the bupropion was stopped. Another patient taking lithium carbonate for bipolar disorder developed anxiety, panic and eventually mania a little over a week after stopping fluoxetine and starting bupropion. ... 

Weinttaub D. Nortriptyline toxicity secondary to interaction with bupropion sustained-release. Depress Anxiety (2001) 13, 50-2. 

In a 6-week-randomised, double-blind study, 44 patients diagnosed with ADHD were randomly assigned to receive bupropion 100-150 mg/day or methylphenidate (20-30 mg/day) treatment. No serious events were observed in the study in any of the patients. The most commonly reported adverse events were abdominal pain (30%), anxiety (25%), decreased appetite (55%), agitation (20%), insomnia (50%), dizziness (5%), dry mouth (15%), nervousness (25%), tachycardia (5%), headache (50%) and vomiting (15%) [18 ]. In a randomised, double-blind. 

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