Christina asked
Can I take bupropion if I have been diagnosed with long QT?
Answer
While not an absolute contraindication, Wellbutrin (bupropion) needs to be used cautiously in those with pre-existing cardiac disease or arrhythmia.
Bupropion has been associated in clinical trials with causing a fast or irregular heart beat as well as increases in blood pressure. In addition, studies suggest that left ventricular dysfunction can result in decreased metabolism of bupropion, theoretically increasing the chance of side effects.
Cardiac Side Effects Of Wellbutrin (Bupropion)
According to the prescribing information for bupropion, the drug is associated with the following cardiac adverse reactions (incidence in parenthesis):
- Hypertension (1-4.3%)
- Unspecified cardiac arrhythmias (5.3% )
- Hypotension (2.5%)
- Palpitations (2-6%)
- Sinus tachycardia (10.8%)
- Chest pain (1-4%)
In addition, ECG abnormalities (e.g. nonspecific ST-T changes, sinus tachycardia, QRS prolongation) have been reported rarely in individuals. It appears these effects may be dose related as they have been specifically noted after an overdose of bupropion.
Before starting on bupropion, it would be prudent to make all of your doctors aware of the potential therapy, especially your cardiologist. As stated above, a cardiac problem is not an absolute contraindication, be must be considered before starting the medication.
Wellbutrin (Bupropion) Information
Wellbutrin (bupropion) is an antidepressant medication that is also used for the treatment of depression, smoking cessation and for ADHD (although this is an off-label use).
Unlike the most commonly used SSRI antidepressants, Wellbutrin does not affect serotonin and is thought to work mainly on dopamine, and to a weaker extent, norepinephrine.
Wellbutrin is thought to be associated with less sexual side effects than SSRI medications. Like most antidepressants, it can take a few weeks of continuous dosing to realize the full effects of the drug.
Common side effects of Wellbutrin include:
- Nausea
- Headache
- Dizziness
- Insomnia
- Nervousness
- Weight Loss
- Cardiac abnormalities
Also bupropion is associated with an increased risk of seizures, especially at high doses.
Summary
- Cardiac arrhythmias are not a contraindication to bupropion therapy, but must be considered before the medication is started.
