Buproban and Seizure disorders

The use of bupropion is contraindicated in patients with a seizure disorder. Bupropion may trigger seizures in a dose-dependent manner up to a frequency of 0.4% at 450 mg/day, the maximum recommended dosage. The incidence of seizures increases dramatically at higher dosages (almost 10-fold at 600 mg/day). Because of the wide variability in individual capacity to metabolize drugs and the disproportionate increase in seizure incidence with dosage escalation, bupropion should not be used in patients with underlying seizure disorders. The use of bupropion is also contraindicated in patients with a current or prior diagnosis of bulimia or anorexia because of a higher reported incidence of seizures in such patients treated with the drug. Therapy with bupropion should be administered extremely cautiously in patients with other predisposing factors for seizures, including underlying neurologic abnormalities such as head trauma, brain damage or CNS tumor; excessive use of or abrupt withdrawal from alcohol; addiction to opiates, cocaine, or stimulants; diabetes treated with oral hypoglycemic agents or insulin; and concomitant use of medications that lower seizure threshold. A more gradual titration may be appropriate.