What could be a significant risk when prescribing Bupropion to certain patients?

Bupropion is an atypical antidepressant primarily used to treat major depressive disorder and as a smoking cessation aid. One significant risk associated with prescribing bupropion is its potential to lower the seizure threshold, particularly in certain populations. This is particularly relevant in patients with a history of eating disorders such as bulimia, as well as individuals who have a history of substance use disorders, especially alcohol dependence. In these cases, the risk of seizures increases due to the neurochemical changes influenced by both the disorder and substance withdrawal.

Patients who have bulimia may experience electrolyte imbalances and other physiological changes that can predispose them to seizures. Similarly, alcoholics may have withdrawal seizures which can be exacerbated by bupropion. Thus, careful screening and consideration of medical and psychiatric history are crucial when determining the appropriateness of bupropion for these individuals, making the recognition of this risk an important aspect of treatment planning.