Barman et al identified risk factors for psychosis occurring in a patient being treated with bupropion for depression. These patients may benefit from an alternative management strategy. The authors are from Virginia Tech-Carilion, Salem Veterans Affairs Medical Center, University of Toronto, and Edward Via College of Osteopathic Medicine in Blacksburg.
Patient selection: depression treated with bupropion
Outcome: psychosis
Risk factors for psychosis in a patient treated with bupropion:
(1) cocaine abuse
(2) traumatic brain injury
(3) pre-existing brain lesions
It may be difficult to determine how much of the risk is due to the bupropion and how much is due to the underlying condition.
If psychosis disappears on lowering the bupropion dose or bupropion discontinuation, then this would support a causal relationship.
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