Bupropion-induced epileptic seizures

Introduction. Bupropion hydrochloride (Zyban(R)) is prescribed for smoking cessation. It is contraindicated in patients with seizure disorders. We report three patients with generalized tonic-clonic seizure that occurred a few days after the intake of this drug. Observations. The first two patients had no personal or family seizure history. They had generalized tonic-clonic seizure after taking bupropion (300 mg per day) for a few days. Acute symptomatic seizures were diagnosed in both cases. The third patient suffered from myoclonic jerks during adolescence, had a history of seizure after high dose codeine treatment and a family seizure history. She had generalized tonic-clonic seizure after taking bupropion 300 mg per day. EEG showed paroxystic generalized activity and photosensitivity, consistent with the diagnosis of juvenile myoclonic epilepsy. Discussion. Bupropion can lower seizure threshold. The incidence of seizure at 300 mg per day is 1/1000 patients treated. Conclusion. Many commonly prescribed drugs can trigger epileptic seizure, bupropion is one of them. When prescribing this drug, this adverse effect must be acknowledged and health practitioners should be aware of this risk.