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Severe bupropion XR abuse in a patient with long‐standing bulimia nervosa and complex PTSD
Author(s) -
Dagan Yael,
Yager Joel
Publication year - 2018
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.22948
Subject(s) - bupropion , bulimia nervosa , psychiatry , anorexia nervosa , eating disorders , psychology , euphoriant , context (archaeology) , substance abuse , abstinence , anxiety , medicine , smoking cessation , paleontology , pathology , biology
Objective Although abuse of bupropion to achieve euphoria or a stimulant‐like effect has been described in the literature, to our knowledge abuse of bupropion XR to control binge eating and reduce appetite by a patient with eating disorder has not been previously reported. Method We report the case of a 22‐year‐old woman with bulimia nervosa and complex PTSD who abused bupropion XR to doses that at peak reached 3,000–4,500 mg/day. She suffered from adverse effects including headaches, tachycardia, anxiety, insomnia, and, finally, grand mal seizures. Results Unable to control the abuse on her own, she sought inpatient treatment, following which she remained off bupropion XR for a year. However, she subsequently relapsed. Discussion The stimulant, euphoriant, and anorexic effects of bupropion XR contribute to its potential for abuse, particularly among patients with eating disorders. Clinicians are reminded to screen for anorexia nervosa and bulimia nervosa histories prior to prescribing this medication, and to consider its abuse among eating disorder patients presenting with seizures. For patients abusing this medication, motivational interviewing in the context of a strong, ongoing therapeutic relationship might help to achieve sustained periods of abstinence.