Bupropion discontinuation symptoms
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Bupropion Discontinuation Symptoms: Overview and Reported Cases
Bupropion is an antidepressant commonly used for depression and smoking cessation. While withdrawal symptoms are well-documented for many antidepressants, the evidence for bupropion is mixed and less clear.
Reported Withdrawal and Discontinuation Symptoms
Some case reports have described withdrawal symptoms after abruptly stopping bupropion. These symptoms can include irritable mood, anxiety, sleeplessness, headache, and generalized aches and pains. In rare cases, more severe symptoms like acute dystonia (involuntary muscle contractions causing abnormal movements or postures) have been reported, with symptoms such as dysphagia (difficulty swallowing), trismus (jaw muscle spasm), and torticollis (twisted neck). These symptoms resolved after restarting bupropion or with specific treatment for dystonia 12.
Evidence from Clinical Trials and Large-Scale Data
However, large clinical trials and post-marketing surveillance involving over 10,000 patients have not found evidence of a consistent withdrawal syndrome with bupropion. In these studies, patients were monitored for adverse events after stopping bupropion, and withdrawal symptoms were not observed. Reviews of millions of patient cases have found very few reports of withdrawal symptoms, and a direct causal link to bupropion could not be established. Based on this data, some experts do not recommend a general need to taper bupropion before stopping it 34.
Recommendations for Discontinuation
Despite the lack of strong evidence for a withdrawal syndrome, some clinicians recommend tapering bupropion slowly and monitoring for symptoms, especially since rare cases of withdrawal-like symptoms have been reported. Patient education about the possibility of symptoms and the importance of medication compliance is also advised .
Other Symptoms After Discontinuation
Some side effects, such as severe constipation, pancytopenia (low blood cell counts), drug-induced rash, and chest pain, have been reported to resolve after stopping bupropion. However, these are not considered classic withdrawal symptoms but rather adverse effects that improve when the drug is discontinued 5678.
Conclusion
Most people do not experience withdrawal symptoms when stopping bupropion, according to large studies and post-marketing data. However, rare cases of withdrawal-like symptoms, including mood changes and even acute dystonia, have been reported. Tapering may be considered in some cases, and patients should be monitored for any unusual symptoms after discontinuation.
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