Additional Evidence of the Abuse Potential of Bupropion

Reeves, Roy R.; Ladner, Mark E.

doi:10.1097/jcp.0b013e318295fe2f

Cited by 29 publications

(44 citation statements)

References 8 publications

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“…In the last decade, the most commonly cited misused antidepressant is bupropion. Our literature search of bupropion abuse and misuse yielded a total of 13 articles, two review articles,38,39 and a number of case reports 40–50…”

Section: Scope Of Antidepressant Misuse and Pharmacologymentioning

confidence: 99%

“…Bupropion is approved by the US Food and Drug Administration (FDA) for treatment of major depressive disorder, seasonal affective disorder, and nicotine addiction, and is often used “off label” for attention deficit/hyperactivity disorder, bipolar depression, sexual dysfunction, and obesity 55,56. While bupropion is generally considered to be a drug of low abuse potential,51 there is evidence that bupropion is abused, particularly in correctional facilities 38–40. According to Hiliard et al, the decreased availability of stimulants and benzodiazepines in correctional facilities has led inmates to seek alternative replacements, and bupropion has become a replacement for some 39,46.…”

Section: Bupropionmentioning

confidence: 99%

“…Case reports describe stimulant and cocaine-like, euphoric effects, or a sensation of feeling “high” by those abusing bupropion 40–44. There are also anecdotal reports of antidepressants, including bupropion, being used by athletes in an attempt to stimulate their motivation and obtain a euphoric effect 57.…”

Section: Bupropionmentioning

confidence: 99%

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Abuse and misuse of antidepressants

Evans

Sullivan

2014

SAR

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BackgroundRates of prescription drug abuse have reached epidemic proportions. Large-scale epidemiologic surveys of this under-recognized clinical problem have not included antidepressants despite their contribution to morbidity and mortality. The purpose of this review is to look specifically at the misuse of antidepressants and how this behavior may fit into the growing crisis of nonmedical use of prescription drugs.MethodsWe conducted a comprehensive search on PubMed, Medline, and PsycINFO using the search terms “antidepressant”, “abuse”, “misuse”, “nonmedical use”, “dependence”, and “addiction”, as well as individual antidepressant classes (eg, “SSRI”) and individual antidepressants (eg, “fluoxetine”) in various combinations, to identify articles of antidepressant misuse and abuse.ResultsA small but growing literature on the misuse and abuse of antidepressants consists largely of case reports. Most cases of antidepressant abuse have occurred in individuals with comorbid substance use and mood disorders. The most commonly reported motivation for abuse is to achieve a psychostimulant-like effect. Antidepressants are abused at high doses and via a variety of routes of administration (eg, intranasal, intravenous). Negative consequences vary based upon antidepressant class and pharmacology, but these have included seizures, confusion, and psychotic-like symptoms.ConclusionThe majority of individuals prescribed antidepressants do not misuse the medication. However, certain classes of antidepressants do carry abuse potential. Vulnerable patient populations include those with a history of substance abuse and those in controlled environments. Warning signs include the presence of aberrant behaviors. Physicians should include antidepressants when screening for risky prescription medication use. When antidepressant misuse is detected, a thoughtful treatment plan, including referral to an addiction specialist, should be developed and implemented.

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Section: Scope Of Antidepressant Misuse and Pharmacologymentioning

confidence: 99%

Section: Bupropionmentioning

confidence: 99%

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Abuse and misuse of antidepressants

Evans

Sullivan

2014

SAR

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“…We conducted a population-based study of all publicly funded prescriptions for bupropion, citalopram, and sertraline dispensed between April 1, 2000, 1,5,7 Muhammad M. Mamdani, PharmD, MPH 1,[4][5][6]8 David N. Juurlink MD, PhD 1,5,9,10 for and March 31, 2013. We used the Ontario Public Drug Benefit Program database, which contains prescription information for patients receiving social assistance at the time their prescriptions were filled.…”

Section: Methodsmentioning

confidence: 99%

“…Bupropion can be misused by ingestion, nasal insufflation, or intravenous injection, although the latter often produces extensive local tissue necrosis. [4][5][6][7][8][9] Reports of seizures following bupropion misuse have also been documented. 10,11 In May 2013, the Chief Coroner for Ontario issued a public health alert following 6 deaths involving bupropion insufflation or injection.…”

mentioning

confidence: 99%

Rates of Anomalous Bupropion Prescriptions in Ontario, Canada

Steele

Macdonald

Gomes

et al. 2015

The Annals of Family Medicine

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PURPOSE Reports of bupropion misuse have increased since it was first reported in 2002. The purpose of this study was to explore trends in bupropion prescribing suggestive of misuse or diversion in Ontario, Canada. METHODSA serial cross-sectional study was conducted of Ontarians aged younger than 65 years who received prescriptions under Ontario's public drug program from April 1, 2000, to March 31, 2013. We determined the number of potentially inappropriate prescriptions in each quarter, defined as early refills dispensed within 50% of the duration of the preceding prescription, as well as potentially duplicitous prescriptions, defined as similarly early refills originating from a different prescriber and different pharmacy. We replicated these analyses for citalopram and sertraline, antidepressants not known to be prone to abuse. RESULTSWe identified 1,780,802 prescriptions for bupropion, 3,402,462 for citalopram, and 1,775,285 for sertraline. Rates of early refills for bupropion declined during the study from 4.8% to 3.1%. In the final quarter, rates of early refills for bupropion were more common than for citalopram (3.1% vs 2.2%) (P <.001) but not for sertraline (3.1% vs 2.9%) (P = .16). Potentially duplicitous prescriptions for bupropion increased dramatically, from <0.05% of all prescriptions in early 2000 to 0.47% in early 2013 and by the final quarter were more common than both citalopram (0.11%) and sertraline (0.12%) (P <.001).CONCLUSIONS Although no marked differences were seen for early refills of bupropion relative to its comparators, potentially duplicitous prescriptions have increased dramatically in Ontario, suggesting growing misuse of the drug. 2015;13:343-346. doi: 10.1370/afm.1818. Ann Fam Med INTRODUCTION Bupropion is a drug widely prescribed for the treatment of depression and as an adjunct for smoking cessation. It is thought to work by inhibiting neuronal reuptake of dopamine and norepinephrine in the central nervous system. Although the drug was initially thought to confer no risk of addiction, 1,2 reports of bupropion misuse have grown since the phenomenon was first reported in 2002. 3People who misuse bupropion sometimes characterize its effects as a cocaine-like high. Bupropion can be misused by ingestion, nasal insufflation, or intravenous injection, although the latter often produces extensive local tissue necrosis.4-9 Reports of seizures following bupropion misuse have also been documented. 10,11 In May 2013, the Chief Coroner for Ontario issued a public health alert following 6 deaths involving bupropion insufflation or injection. 12There are no large-scale data on the prevalence of bupropion misuse in the general population. In light of increasing reports of bupropion misuse, we explored prescribing trends of bupropion in Ontario, Canada. METHODSWe conducted a population-based study of all publicly funded prescriptions for bupropion, citalopram, and sertraline dispensed between April 1, 2000, 1,5,7 Muhammad M. Mamdani, PharmD, MPH 1,[4][5][6]8 David N. Juurlink MD, ...

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Enantiomeric separation of bupropion by liquid chromatography on derivatized cyclofructan chiral stationary phase

et al. 2022

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High‐performance liquid chromatography (HPLC) is an ideal tool for enantiomeric separations of different drugs. In this study, the direct enantioseparation of bupropion, an atypical antidepressant structurally related to cathinone, was explored by using five chiral columns, including three based on derivatized cyclofructans, macrocyclic glycopeptide teicoplanin, and an immobilized amylose derivative under multimodal elution conditions. Baseline enantioseparation was obtained on the LarihcShell CF6‐RN column, with derivatized cyclofructan 6, in the polar organic mode. The effects of the mobile‐phase composition, type and content of major components, the nature and the amount of mobile‐phase additives, and the column temperature on the retention, selectivity, and resolution were investigated to optimize enantioseparation. The calibration curve was linear in the range of 10–125 μg/ml for each enantiomer. The limits of detection and quantification were 0.1 and 0.3 μg/ml for both enantiomers of bupropion. The chiral recognition was controlled especially by H bonds, π–π, dipole–dipole interactions, and steric effects. Finally, the developed method was applied to the determination of bupropion in the commercially available drug.

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Additional Evidence of the Abuse Potential of Bupropion

Cited by 29 publications

References 8 publications

Abuse and misuse of antidepressants

Abuse and misuse of antidepressants

Rates of Anomalous Bupropion Prescriptions in Ontario, Canada

Enantiomeric separation of bupropion by liquid chromatography on derivatized cyclofructan chiral stationary phase

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