Bupropion
Bupropion is an antidepressant with a unique mechanism — it inhibits the reuptake of dopamine and norepinephrine (NDRI), without significant action on serotonin. This sets it apart from SSRIs and SNRIs and explains its particular side-effect and benefit profile.
Unlike SSRIs, bupropion: does not cause sexual dysfunction (and may improve libido in some people), is activating (useful for depression with fatigue and hypersomnia), and is approved for smoking cessation (as Zyban) in addition to depression. Its specific side effects include insomnia (take it early in the day), headache, and — at high doses or in predisposed individuals — an increased risk of seizures (it is contraindicated in seizure disorders and in people with a history of anorexia/bulimia).
Common brand names include Wellbutrin (extended-release formulation, taken once daily) and Zyban (for smoking cessation).
Practical example
Felipe switched from fluoxetine to bupropion for two reasons: the sexual dysfunction caused by the SSRI was affecting his relationship, and he smoked and wanted to quit. His psychiatrist proposed bupropion — which treats depression AND helps with smoking cessation. Within three months, Felipe was smoke-free and had a better antidepressant response than he'd had on fluoxetine.
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