Australia - Bupropion (Zyban SR®) was first marketed in late 2000 as a short-term aid to smoking cessation and has been used by high numbers of patients. Originally developed as an antidepressant, it is a selective inhibitor of the neuronal re-uptake of catecholamines in the brain but its mechanism to enhance the ability to quite smoking is unknown.

Assessment of reactions to bupropion is difficult because many patients experience nicotine withdrawal symptoms. Since November 2000, the Australian Adverse Drug Reactions Committee has received 780 reports of suspected adverse reactions in connection with the use of bupropion. The profile of the drug is dominated by hypersensitivity reactions and neurological and psychiatric effects. The majority of hypersensitivity reactions involve relatively minor skin reactions although cases have been described of facial oedema or angioedema and serum sickness-like reactions.

Bupropion can cause seizures and is contraindicated in patients with epilepsy. It should be used with great caution in those with a predisposition to seizures including those abusing alcohol or taking another medication that can lower the seizure threshold. This includes most antidepressant and antipsychotic drugs, insulin, oral hypoglycaemic drugs and anorectic products.

Reference: Australian Adverse Drug Reactions Bulletin, Volume 20, Number 2, 2001. Also at: http://www.health.gove.au/tga/docs/html/zyban.htm