Bupropion: A Case Study

Bupropion works by inhibiting the neuronal uptake of both dopamine and norepinephrine (Stall, Godwin, & Juurlink, 2014). Bupropion is also an antagonist for acetylcholine (Stall et al., 2014). Bupropion is considered a second generation antidepressant (Moreira, 2011). Compared to other antidepressants, bupropion acts as a dopamine and norepinephrine reuptake inhibitor (Moreira, 2011). Bupropion can be taken in a once daily extended release tablet or an immediate release tablet that is taken three times a day (Moreira, 2011). For Barbara, I would prescribe an extended release tablet. I chose the extended release because it appears Barbara is otherwise in good health and there is no indication she is taking other medications. Taking three …show more content…
Unlike bupropion, fluoxetine works only as a serotonin inhibitor. The medication works to increase the amount of serotonin. Fluoxetine has been used to treat smoking cessation, but is not as successful as bupropion is. SSRIs, including fluoxetine, have known sexual dysfunction effects. Bupropion does not have such a strong effect on sexual function. While both medications treat depression, Barbara was on an SSRI initially and did not see adequate results. This puts bupropion as a better choice for her.
Venlafaxine: Venlafaxine is a serotonin norepinephrine reuptake inhibitor. Venlafaxine works to increase serotonin and norepinephrine. Both venlafaxine and bupropion work to inhibit norepinephrine. Venlafaxine can cause weight gain and sexual dysfunction. This is the opposite with bupropion. Venlafaxine does not address Barbara’s smoking like bupropion does. I would also be hesitant to use this medication since she did not respond well to an SSRI. Part of this medication is acting on serotonin reuptake …show more content…
Nortriptyline is a known active metabolite of amitriptyline (Jeon et al., 2011). Nortriptyline is metabolized by different cytochrome P450s but more specifically by CYP2D6 (Smith & Curry, 2011). Nortriptyline works by inhibiting the reuptake of both norepinephrine and serotonin and also blocks histamine and acetylcholine. Both nortriptyline and bupropion inhibit norepinephrine. They both also block acetylcholine. Like the other medications listed weight gain is a possible side effect of this medication whereas it is not a high concern with bupropion. Like bupropion, nortriptyline also has a secondary use. Nortriptyline is also used for pain management. Nortriptyline also has an effect on sexual function unlike