Bupropion-induced psychosis: folklore or a fact? A systematic review of the literature
General Hospital Psychiatry, 08/31/2011
Clinical Article
Kumar S et al. – The literature is incomplete and in some cases contradictory. In selected cases, bupropion appears to be associated with the induction of psychotic symptoms in addition to the precipitation or worsening of an existing psychotic syndrome. Further research including controlled studies is required to clarify the risk of bupropion precipitating a psychotic illness in vulnerable populations.
Methods- Medline database search limited to human and English-language studies was conducted using the keywords “bupropion” and “psychosis”
- A total of 23 articles were selected based on the relevance of the articles and their references
- Data from these articles were collated
- Collated data show that there is some evidence to suggest that bupropion may cause or worsen psychosis in selected subpopulations
- Higher doses of bupropion appear more likely to be associated with the outcome severity
- Preexisting psychotic symptoms, substance abuse and drug interactions also seem to increase risk
- Concurrent use of antipsychotics at adequate doses appears to be protective
