Bupropion: uses and side effects of this drug

Tobacco is one of the substances with psychoactive effects that has been most legally consumed since its discovery. Even though smoking is currently prohibited in establishments and closed public spaces and its The price has increased due to taxes, millions of people continue to smoke.

But many of these people, at some point, need to stop doing it. Although it is possible to do it at will, in some cases they may require psychological and even pharmacological help. In the latter case, one of the existing drugs used in smoking cessation is bupropion, a drug originated as an antidepressant.

• Related article: "Types of psychoactive drugs: uses and side effects"

What is bupropion?

Bupropion is a well-known antidepressant-type drug, although more than in its application for depression it is more common and distinctive for its efficacy in the treatment of tobacco addiction. In this sense, it is a treatment that does not include nicotine and that is recommended together with some type of therapy or psychological treatment. This shows that psychotropic drugs are not designed following a plan from scratch, but that there is a certain process in their development. of trial and error, and that sometimes benefits arise for the drug that at first had not even been considered. account.

Bupropion is a specific inhibitor of the reuptake of dopamine and norepinephrine, or DNRI, which works by increasing the levels of these neurotransmitters in the brain. Compared to other drugs in the antidepressant group, bupropion has the advantage of not causing dysfunction. sexual, although on the other hand its effectiveness by itself seems lower compared to other drugs present in the market.

Thus, bupropion is an example of molecules related to other substances used for a certain kind of disorder may be more useful in different health conditions, however difficult their structure may be. similar.

• You may be interested in: "Types of antidepressants: characteristics and effects"

Mechanism of action

The functioning of bupropion and its mechanism of action is based on its role as a selective inhibitor of the reuptake of dopamine and norepinephrine. This implies that bupropion acts by preventing these two transmitters (associated with gratification and energy) from being reuptaked by the presynaptic neuron, such that they are available to postsynaptic neurons for longer time. Furthermore, it seems to stimulate the secretion of these neurotransmitters. Thus, the levels of dopamine and norepinephrine and their transport increase at the level of the brain, something that can alter mood.

Likewise, it has also been observed that it has an effect at the level of acetylcholine, binding to nicotinic receptors and exerting a non-competitive antagonist effect. Although there is no total certainty for this, this element is one of the possible explanations for its role in smoking cessation.

However, it must be taken into account that the exact way in which the mechanism of action of bupropion and psychoactive drugs in general works is still unknown. Its use does not guarantee that it will work to alleviate the symptoms of the disorder to be treated, and in fact its effectiveness is only slightly better than that of placebo. This does not mean that in many cases it is very useful, simply that the percentage of patients who try this treatment and do not obtain any benefit is relatively high.

Indications: uses in disorders

Bupropion is a drug that throughout its history has had various uses. Although it was born as an antidepressant and today it is still used to treat this condition both as monotherapy (single therapy) and as therapy. combined (more common, to boost some specific antidepressants when first-line drugs are not effective), the truth is that by itself generally considered less effective than other antidepressants.

Where this drug stands out the most and has the greatest use is in smoking cessation, being effective in reducing the consumption habit and the desire to smoke. In this sense, its mechanism of action seems to help stop the craving (possibly due on the one hand to its antagonism of nicotinic receptors and its interaction with brain dopamine, although the exact mechanism is not fully known). Another disorder in which it is used is seasonal affective disorder, in which depressive episodes appear associated with certain times of the year.

In addition to the above it has sometimes been used in the treatment of bipolar disorder, especially during depressive episodes that can occur in this disorder (although this use requires caution as there is a risk of turning the disorder into a manic crisis). Also in ADHD. But in any case, more research is required in this regard and the existence of possible risks must be taken into account.

Side effects

Bupropion is a drug that is very useful in smoking cessation and is used in cases of depression, but as with other drugs its clinical utility is not free of risks and possible side effects.

This occurs because the active substance in bupropion affects many areas of the body, not just the areas that could produce improvement in relation to the symptoms. This undesired interaction generates a chain reaction of unpredictable consequences to a certain extent, which can lead to further health problems (although these usually disappear as the substance leaves the organism). Therefore, its use should always be supervised and indicated by doctors.

In this sense, among the main side effects of bupropion we can find the cause of insomnia (being one of the most common), dry mouth and dizziness, headache, nausea, constipation, rapid heartbeat, tremors, rashes, agitation and nervousness. It can also cause a decrease in appetite.

In more serious cases it can cause seizures. (this being one of the most well-known serious risks), arrhythmias, hallucinations, panic or difficulties breathing or eating or inflammations, making it necessary to see a doctor. In some cases it can cause irritability, hostility, depression, suicidal thoughts.

contraindications

In addition to these side effects,this drug is totally contraindicated in some segments of the population. People who are allergic to it or to any of its components (something obvious on the other hand), those people who consume certain medications (especially MAOIs), dependence on substances other than tobacco (such as alcohol, drugs, and pharmaceuticals) and those with epilepsy, tumors cerebral and anorexia nervosa or bulimia (since it reduces appetite).

It is not recommended either, although it can sometimes be used if the benefits are estimated to outweigh the risks, in cases of people with renal or hepatic insufficiency, head trauma, insomnia or consumption of other medications that may interact with the bupropion.

Diabetics, alcoholics, hypertensives or people with psychiatric disorders (since it can contribute to the appearance of mania in bipolar patients or psychotic crises in schizophrenia, among others) they also have it contraindicated (or at least the treatment should be done with a high level of control of the patient's condition and the doses administered) due to the risk of seizures and other effects secondary. Finally, it is also not recommended for pregnant and lactating women.

Price

The price of bupropion, for a box of 30 tablets of 150 milligrams, is about 26 euros in Spain and 1400 Mexican pesos in Mexico, approximately. In any case, it must be taken into account that it must be consumed under medical indication, since its effects are too powerful to be taken without the supervision of specialists.