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Page: Side Effects
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Common side effects include dry mouth, tremors, anxiety, loss of appetite, agitation, dizziness, hypertension, headache, excessive sweating such as night sweats, increased risk of seizure (its most controversial side effect, found in 4/1000 during trials), aggressiveness, tinnitus, and both initial and terminal insomnia. Activation of mania and psychosis have both been encountered. The side effect profile is consistent with that observed in mixed dopamine and norepinephrine reuptake inhibition. Some patients may also require less than the normal dosing which usually starts at around 75 mg for the first few weeks and is then switched to the normal 150–300 mg dosage; these patients may be kept on the 150 mg regimen however, some patients are experimentally placed on doses as high and sometimes exceeding, 600 mg/day. Dosage is strictly on a patient to patient basis and can vary greatly.
Although with the recommended dosing incidence of seizures is comparable to, and in some cases lower than, that of other antidepressants, patients using Bupropion should still be screened for pre-disposing factors that could contribute to and/or indicate a low seizure threshold. A prescriber may also review all other medications/substances the patient might be using and make dosing decisions based on the results.
Taking antidepressants may increase suicidal thoughts and actions in about 1 out of 50 people 18 years or younger. Although bupropion is prescribed for children, FDA has not approved bupropion for use in children.
Scattered abnormalities of liver function tests are noted, without evidence of hepatotoxicity. Cases of significant liver damage with or without jaundice (icterus) have been seen rarely. In a German database covering side effects, five cases of pancreatitis with elevations of serum-amylase and lipase as well as clinical symptoms (e.g. abdominal pain, anorexia), reversible after termination of bupropion, have been reported. Currently, it is unclear whether preexisting alcohol abuse or dependence might predispose patients to develop pancreatitis.
Infrequently, dose-dependent hypertension is noted. Single cases of myocardial infarction (heart attack) have been noted, but the causal association to the use of bupropion is currently unknown.
The development of mild to moderate skin rashes associated with sensitivity to dye components within the pill coating. This can often be alleviated by simply prescribing a different color pill and consequently, changing the dosage.
A single case of clitoral priapism was reported in the literature.
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