The DOI matches its Crossref record.
A Prospective Safety Surveillance Study for Bupropion Sustained-Release in the Treatment of Depression
Abstract
BACKGROUND: This prospective 105-site study was conducted to determine the rate of seizures and other serious adverse experiences associated with the therapeutic use of the sustained-release formulation of bupropion (bupropion SR). METHOD: 3100 patients with a DSM-III-R diagnosis of depression without a current or past diagnosis of an eating disorder and with no personal or family history of seizure disorders were treated for up to 8 weeks with bupropion SR in an open-label study. Dosing was initiated at 50 mg b.i.d. and increased to a maximum of 150 mg b.i.d. unless not tolerated. Patients had the option to continue treatment with bupropion SR (50 mg b.i.d. to 150 mg b.i.d.) in a continuation phase lasting up to 1 year. During the acute and continuation phases, patients were evaluated for the occurrence of seizures and other serious adverse experiences. Clinical response to and tolerability of bupropion SR were also evaluated. RESULTS: Three patients each experienced a seizure associated with the therapeutic use of bupropion SR during the acute and continuation phases combined. The observed seizure rate during the 8-week acute phase was 2 seizures in 3094 evaluable patients, or 0.06%. The observed seizure rate for the acute and continuation phases combined was 3 seizures in 3094 patients, or 0.10%. Survival analysis yielded a cumulative seizure rate of 0.08% for the acute phase and 0.15% for both phases combined. Two patients who intentionally overdosed with bupropion SR also experienced seizures; however, these events were not included in calculations of the overall seizure rate. Therapeutic doses of bupropion SR were well tolerated and clinically efficacious. CONCLUSION: The therapeutic use of bupropion SR at total daily doses up to 300 mg/day in depressed patients without predisposition to seizures is associated with a seizure rate that is well within the range observed with other marketed antidepressants.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“However, with the development of bupropion sustained release (SR), the incidence of seizure was decreased to 0.1% in a study containing 3,094 patients (50–300 mg).51”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [51]
Citations
Cited by
Sorted by citations
Items 101–179 of 179
Gao, L., Liu, F.-Q., Yang, L. P., Cheng, L. Z., Dai, H.-Y., Tao, R., Cao, S.-P., Wang, D., & Tang, J. (2016) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-016-2095-0 · Cited by 12
Bupropion-associated movement disorders: A systematic review
Rissardo, J. P., & Caprara, A. L. F. (2020) · Annals of Movement Disorders · doi:10.4103/aomd.aomd_35_19 · Cited by 12
Antidepressants: Indications, Contraindications, Interactions, and Side Effects
Corponi, F., Fabbri, C., & Serretti, A. (2020) · Springer eBooks · doi:10.1007/978-3-319-56015-1_29-1 · Cited by 13
Present and future pharmacotherapeutic options for adult attention deficit/hyperactivity disorder
Horrigan, J. P. (2001) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2.4.573 · Cited by 11
“relative to the slow-release (XR) form [64].”
Monoaminergic‐based Pharmacotherapy for Depression
Papakostas, G. I., & D, M. F. M. (2005) · Wiley eBooks · doi:10.1002/9783527619672.ch6 · Cited by 11
Current Treatment Options in Smoking Cessation
Crain, D., & Bhat, A. (2010) · Hospital Practice · doi:10.3810/hp.2010.02.279 · Cited by 11
Li, D., Tseng, P., Chen, Y., Wu, C.-K., & Lin, P. (2016) · Medicine · doi:10.1097/md.0000000000003165 · Cited by 10
Epileptic seizures, coma and EEG burst‐suppression from suicidal bupropion intoxication
Noda, A. H., Schu, U., Maier, T., Knake, S., & Rosenow, F. (2017) · Epileptic Disorders · doi:10.1684/epd.2017.0896 · Cited by 10
Methodological considerations for the development of new treatments for bipolar disorder
Potter, W. Z., & Ozcan, M. E. (1999) · Australian & New Zealand Journal of Psychiatry · doi:10.1111/j.1440-1614.1999.00671.x · Cited by 9
Médicaments d’aide au sevrage tabagique
Mansourati, J., Borel, M. L., Munier, S., & Guevel-Jointret, A. L. (2005) · La Presse Médicale · doi:10.1016/s0755-4982(05)84182-x · Cited by 9
Uzark, K. C., Webb, C. L., Vetter, V. L., Elia, J., Erickson, C., Berger, S., & Blum, N. J. (2011) · Cited by 9
Algorithms for the Pharmacotherapy of Acute Depression in Patients With Bipolar Disorder
Dantzler, A., & Osser, D. N. (1999) · Psychiatric Annals · doi:10.3928/0048-5713-19990501-09 · Cited by 9
Niburski, K., & Niburski, O. (2023) · Journal of Consumer Health on the Internet · doi:10.1080/15398285.2022.2133832 · Cited by 8
Antidepressants and Their Impact on Sleep
Dhuna, N. A., & Malkani, R. G. (2020) · Current Sleep Medicine Reports · doi:10.1007/s40675-020-00189-5 · Cited by 8
Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression
Gartlehner, G., Hansen, R. A., Morgan, L. C., Thaler, K. J., Lux, L. J., Noord, M. V., Mager, U., Gaynes, B. N., Thieda, P., Strobelberger, M., et al. (2011) · Cited by 8
Treating tobacco use and dependence in clinical practice
Cornuz, J. (2006) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.7.6.783 · Cited by 8
“A much larger, open, uncontrolled, observational safety surveillance study conducted by the manufacturers [29] examined 3100 adult patients using SR bupropion for 8 weeks for the treatment of depression (not for smoking cessation).”
BackgroundGeneralized Seizure in Three Adolescents with Bupropion Overdose
Boora, K., Cummings, M. R., & Marshall, D. R. (2010) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2009.0016 · Cited by 8
“The risk of seizure with bupropion sustained release (SR) with a daily dose of 150 mg twice daily (bid) is 0.1% (Dunner et al. 1998).”
InfluentialBhattacharya, C. S., Kirby, D., Stipdonk, M. J. V., et al. (2018) · European Journal of Drug Metabolism and Pharmacokinetics · doi:10.1007/s13318-018-0516-4 · Cited by 8
“Despite proven efficacy, bupropion therapy is associated with wide inter-subject variability in clinical response [11, 18, 21, 55].”
BackgroundTreatment of Temporomandibular Pain With the Selective Serotonin Reuptake Inhibitor Paroxetine
Inagaki, T., Miyaoka, T., Shinno, H., et al. (2007) · The Primary Care Companion to The Journal of Clinical Psychiatry · doi:10.4088/pcc.v09n0114b · Cited by 7
The use of psychotropics in the medically ill
Robinson, M. J., & Levenson, J. L. (2000) · Current Psychiatry Reports · doi:10.1007/s11920-996-0018-y · Cited by 7
Fábregas, B. C., Moura, A. S., Marciano, R. C., Carmo, R. A., & Teixeira, A. L. (2009) · The Brazilian Journal of Infectious Diseases · doi:10.1590/s1413-86702009000500015 · Cited by 7
“Both clomipramine [31] and bupropion [32,33] have the ability to decrease seizure threshold with higher doses being more epileptogenic.”
Background▼Bupropion to aid smoking cessation
BMJ Publishing Group Ltd (2000) · Drug and Therapeutics Bulletin · doi:10.1136/dtb.2000.381073 · Cited by 7
Monsalve, B. C. (2013) · Revista de Neurología · doi:10.33588/rn.5703.2013192 · Cited by 6
Silverstone, P., Henshall, D. C., Durmuller, et al. (2009) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s4714 · Cited by 6
“Bupropion hydrochloride (HCl), a widely used antidepressant, is associated with a dose-dependent risk of seizures when given at therapeutic doses or following over-dose in humans, 1–6 and in animals.”
InfluentialA Case of Prolonged Seizure Activity After Combined Use of Bupropion and Clomipramine
Shin, Y., Erm, T., Choi, E. J., et al. (2004) · Clinical Neuropharmacology · doi:10.1097/01.wnf.0000135479.78529.60 · Cited by 6
“Another observation was reported by Dunner et al.(3) that the incidence of seizure was 0.”
InfluentialSilverstone, P. H., Williams, R., McMahon, L. M., et al. (2008) · Annals of General Psychiatry · doi:10.1186/1744-859x-7-27 · Cited by 6
Uzark, K. C., Webb, C. L., Vetter, V. L., Elia, J., Erickson, C., Berger, S., & Blum, N. J. (2008) · Cited by 6
Cytochrome P450 enzymes— in vitro , in vivo , and in silico studies
Turpeinen, M. (2006) · Cited by 6
Testino, G., & Adriani, A. (2021) · Minerva Gastroenterologica e Dietologica · doi:10.23736/s1121-421x.20.02749-x · Cited by 5
Neuropsychiatric adverse events of bupropion treatment: a brief update
Soyka, M. (2004) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651500410005630 · Cited by 6
“In a study in depressive patients, the risk for seizures was not higher for bupropion compared to other antidepressants.(30) Clinical trials data suggest the incidence of seizures to be 0.”
Catching the Seizure Culprit: Drugs on the Differential
Nestor, M. A., Ryan, M. A., & Cook, A. M. (2010) · Orthopedics · doi:10.3928/01477447-20100722-16 · Cited by 5
Three clinical pearls in the treatment of patients with seizures and comorbid psychiatric disorders
Tallian, K. B. (2017) · Mental Health Clinician · doi:10.9740/mhc.2017.11.235 · Cited by 5
“either long-acting product within the therapeutic dose is comparable to the general population.(46,49) Nevertheless,”
BackgroundCase Studies in Drug Discovery
Blass, B. E. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-411508-8.00013-x · Cited by 8
Psychiatric illness and psychotropic medication use in epilepsy
Perr, J. V., & Ettinger, A. B. (2011) · Cambridge University Press eBooks · doi:10.1017/cbo9780511977145.016 · Cited by 5
Drug Class Review on Second Generation Antidepressants: Final Report
Gartlehner, G., Hansen, R. A., Kahwati, L. C., Lohr, K. N., Gaynes, B. N., & Carey, T. (2006) · Cited by 5
New-Onset Seizure in Patient Medicated With Bupropion for Smoking Cessation: A Case Report
Saffaei, D., Lovett, S., & Rech, M. A. (2020) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2019.12.020 · Cited by 4
Re-considering the use of bupropion in schizophrenia: A case report and review of literature
Ng, Q. X., Chong, J. W. X., Yong, C. S. K., & Sivalingam, V. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113636 · Cited by 4
Pharmacological Treatment of Major Depressive Disorder: A Review
Papakostas, G. I., Bech, P., & D, M. F. M. (2009) · Wiley eBooks · doi:10.1002/9780470745892.ch2 · Cited by 4
New Onset of Seizures and Psychosis in a Patient Who Is Coprescribed Atomoxetine and Bupropion
Ju, V., Walkerly, A., VandenBerg, A., & Shobassy, A. (2022) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001614 · Cited by 3
Psychopharmacology of smoking cessation medications: focus on patients with mental health disorders
Castaldelli-Maia, J. M., de Oliveira, V. C., Irber, F. M., Blaas, I. K., Angerville, B., Martins-da-Silva, A. S., Gimenes, G. K., Campos, M. W., Torales, J. C., Ventriglio, A., et al. (2023) · International Review of Psychiatry · doi:10.1080/09540261.2023.2249084 · Cited by 3
“Because bupropion lowers the seizure threshold, it must be cautiously used with other medications that also lower the threshold (Dunner et al., 1998), like antipsychotics and other anti-depressants (Delanty et al., 1998; Gardner et al., 2000; Jefferson et al., 2005).”
BackgroundKeenan, M., Alabi, P., Alsakha, A., et al. (2024) · Clinical Toxicology · doi:10.1080/15563650.2024.2439019 · Cited by 3
“When the dose is kept at 300 mg/day, the risk of seizures with the sustained release formulations is only 0.1% [2,11]. the exact incidence of seizures with the extended release formulation has not been evaluated but is assumed to be comparable to the immediate release and sustained release…”
InfluentialDo Antidepressants Improve or Worsen Seizures in Patients with Epilepsy?
Alper, K. (2008) · Elsevier eBooks · doi:10.1016/b978-0-12-374006-9.00017-5 · Cited by 3
Épidémiologie du tabagisme. Aide à l’arrêt du tabac
Lebargy, F., Becquart, L.-A., & Picavet, B. (2004) · EMC - Médecine · doi:10.1016/j.emcmed.2004.10.005 · Cited by 3
D, M. F. M., & Papakostas, G. I. (2008) · Elsevier eBooks · doi:10.1016/b978-0-323-04743-2.50045-7 · Cited by 2
Which Xenobiotic(s) Could be Responsible for the Radiologic Findings Below?
Stellpflug, S. J., & Roberts, D. J. (2010) · Journal of Medical Toxicology · doi:10.1007/s13181-010-0043-4 · Cited by 2
“Even in therapeutic dosing, they have been shown to lower the seizure threshold [1–3].”
BackgroundPaiement, N., Noonan, P. K., Ángel-González, M., et al. (2012) · International Journal of Clinical Pharmacology & Toxicology · doi:10.19070/2167-910x-120005 · Cited by 2
“It was later developed into a twice a day tablet (Wellbutrin SR®) followed by a once-daily tablet (Wellbutrin XL®) (3-4).”
MethodBergmann, L., Warncke, W., & Herschel, M. (2004) · Pneumologie · doi:10.1055/s-2004-818377 · Cited by 2
Bupropión: un tratamiento no nicotínico para dejar de fumar
Martín-Cantera, C., & Moret, S. F. (2001) · FMC - Formación Médica Continuada en Atención Primaria · doi:10.1016/s1134-2072(01)75420-5 · Cited by 2
Bupropion for attentiondeficit hyperactivity and comorbid disorders
Daviss, W. B., Pan, R. J., & Perel, J. M. (2003) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.3.1.9 · Cited by 2
Safety profile of bupropion for chronic obstructive pulmonary disease
Cox, A. R., & Anton, C. (2001) · The Lancet · doi:10.1016/s0140-6736(01)06130-x · Cited by 2
Épidémiologie du tabagisme. Aide à l’arrêt du tabac
Lebargy, F., Becquart, L.-A., & Picavet, B. (2005) · EMC - Traité de médecine AKOS · doi:10.1016/s1634-6939(05)34195-0 · Cited by 1
Chapter 20. Psychopharmacology
Mulsant, B. H., & Pollock, B. G. (2022) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375196.ds20 · Cited by 1
Simon, M. W., Brent, J. A., Brandehoff, N., et al. (2025) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2025.03.013 · Cited by 1
Zou, D., Hu, Q., Yu, L., et al. (2025) · Clinics · doi:10.1016/j.clinsp.2025.100727 · Cited by 1
Epidemiología del tabaquismo. Ayudas para interrumpir el consumo de tabaco
Lebargy, F., Becquart, L.-A., & Picavet, B. (2005) · EMC - Tratado de Medicina · doi:10.1016/s1636-5410(05)70344-5 · Cited by 1
Case studies in drug discovery
Blass, B. E. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-817214-8.00014-2 · Cited by 2
Nicotine Dependence and Cardiovascular Diseases: Biobehavioral and Psychosocial Correlates
Al’Absi, M., Nakajima, M., Green, P. A., Petersen, K. L., & Wittmers, L. E. (2022) · Springer eBooks · doi:10.1007/978-0-387-85960-6_12 · Cited by 1
Bupropion: Does Its Efficacy Outweigh Potential Morbidity and Lethality?
Al-Namnakani, B., & Zell‐Kanter, M. (2023) · Pediatric Annals · doi:10.3928/19382359-20230307-01 · Cited by 1
Mayo, J. L., Cahill, G. M., & Lott, R. S. (2005) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.25.4.520.61030 · Cited by 1
“Concurrent conditions Eating disorder 0 (0) Alcohol abuse (current or in remission) 14 (14)”
BackgroundSeizure Related to the Split Extended-Release Bupropion Tablets in a Young Female Patient
Chou, H.-Y., Chang, H., Mao, W., et al. (2019) · American Journal of Therapeutics · doi:10.1097/mjt.0000000000000950 · Cited by 1
Bilden, E. F. (2010) · Elsevier eBooks · doi:10.1016/b978-0-323-05472-0.00149-3 · Cited by 1
State of the Art Reviews: Smoking Cessation
Sullivan, K. M., Seed, S. M., & DeBellis, R. J. (2007) · American Journal of Lifestyle Medicine · doi:10.1177/1559827606298725 · Cited by 1
“Nicotine (all NRT products are pregnancy category D, except the gum, which is category C) may be harmful to the fetus,(55) and bupropion SR (pregnancy category B) may induce seizures in 1 out of 1000 patients.(56) If NRT is to be used in a pregnant smoker, it is recommended that a dose be chosen on the lower end of th…”
BackgroundAlleviation of Hot Flashes With Increase in Venlafaxine Dose
Padala, P. R., Rapuri, S. B., & Padala, K. P. (2007) · The Primary Care Companion to The Journal of Clinical Psychiatry · doi:10.4088/pcc.v09n0114c · Cited by 1
Tabakabhängigkeit und Möglichkeiten der medikamentösen Behandlung
Haustein, K.-O. (2001) · Suchttherapie · doi:10.1055/s-2001-19379 · Cited by 1
Bupropion w leczeniu depresji - skuteczność, objawy uboczne i bezpieczeństwo leku
Urban‐Kowalczyk, M. (2008) · Psychiatria i Psychologia Kliniczna
Terapia farmacológica para el abandono del tabaquismo
Becerra, N., Cañón, M., & Vivas, J. M. (2010) · Universitas Médica · doi:10.11144/javeriana.umed51-2.tfpa
Treatment of nicotine dependency with bupropion
Tønnesen, P. (2000) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(00)80016-4
Psychopharmacohazardology: Major hazards of treating depression and anxiety
Zetin, M. (2004) · Comprehensive Therapy · doi:10.1007/s12019-004-0020-4
Catching the Seizure Culprit: Drugs on the
Ryan, M. A., & Cook, A. M. (2010)
Smoking Cessation: A Review of Treatment Considerations
Sullivan, K. M., Seed, S. M., & DeBellis, R. J. (2007)
Sustained- Release Bupropion as a Pharmacological Aid to Smoking Cessation
Hays, J. T., & Ebbert, J. O. (2006) · CRC Press eBooks · doi:10.1201/9781420005431.ch5
Prokhorov, A. V., Ford, K. H., & Hudmon, K. S. (2008) · Lung Cancer · doi:10.1002/9780470696330.ch1
Psychopharmacotherapy: Side Effects
Shetty, N., & Gunduz‐Bruce, H. (2015) · Elsevier eBooks · doi:10.1016/b978-0-08-097086-8.27065-7
Pharmacotherapy of Nicotine Dependence
Haustein, K.-O. (2003) · Springer eBooks · doi:10.1007/978-3-662-05256-3_11
Medikamentöse Behandlung des Rauchers
Haustein, K.-O. (2008) · Springer eBooks · doi:10.1007/978-3-540-73309-6_13
Antidepressants: Indications, Contraindications, Interactions, and Side Effects
Corponi, F., Fabbri, C., & Serretti, A. (2022) · Springer eBooks · doi:10.1007/978-3-030-62059-2_29
Stevenson, K. A., Hamilton, D. V., & Clayton, A. H. (2024) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375523.as18
Falk, J. (2014) · eDiss (Georg-August-Universität Göttingen) · doi:10.53846/goediss-4689
Estratégias para a cessação do tabagismo : uma revisão das alternativas terapêuticas
Fagundes, M. L. (2010) · Lume (Universidade Federal do Rio Grande do Sul)
Metadata
- Authors
- Dunner, D. L., Zisook, S., Billow, A. A., Batey, S. R., Johnston, J. A., & Ascher, J. A.
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 1998-07-15
- Volume
- 59
- Issue
- 7
- Pages
- 366-373
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2080593090
- Cited by
- 180
- References
- 0
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 3 · 2014: 2 · 2013: 6 · 2012: 2
- FWCI
- 3.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- bupropion sustained release, depression, seizures, adverse drug reactions, drug safety, antidepressant efficacy, drug tolerability, drug overdose, seizure risk
- MeSH terms
- Adolescent, Adult, Aged, Delayed-Action Preparations, Depressive Disorder, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Patient Compliance, Product Surveillance, Postmarketing, Prospective Studies, Psychiatric Status Rating Scales, Seizures, Severity of Illness Index, Incidence, Survival Analysis, Bupropion, Treatment Outcome, Adverse Drug Reaction Reporting Systems, Antidepressive Agents, Second-Generation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review