Tobacco is one of the substances with psychoactive effects that has been consumed the most legally since its discovery. Even though smoking is now prohibited in establishments and closed public spaces and its price has become more expensive due to taxes, millions of people still have the habit of smoking.
But many of these people, at some point, need to stop doing it. Although it is possible to do it voluntarily, in some cases they may require psychological and even pharmacological help. In the latter case, one of the existing drugs used to quit smoking is bupropion, a drug originated as an antidepressant
Bupropion is a well-known antidepressant-type drug, although it is more common and distinctive in its use for depression. its effectiveness in the treatment of tobacco addiction In this sense, it is a treatment that does not include nicotine and is recommended along with some type of therapy or psychological treatment. This shows that psychotropic drugs are not designed following a plan from scratch, but that in their development there is a certain process of trial and error, and that sometimes uses arise for the medication that had not even been taken into account at the beginning.
Bupropion is a specific dopamine and norepinephrine reuptake inhibitor, or NDRI , which works by increasing the levels of these neurotransmitters in the brain. Compared to other drugs in the antidepressant group, bupropion has the advantage of not generating sexual dysfunctions, although on the other hand its effectiveness alone seems lower compared to other drugs on the market.
Thus, bupropion is an example that molecules related to other substances used for a certain type of disorder can be more useful in different health disorders, even if their structure is similar.
Mechanism of action
The functioning of bupropion and its mechanism of action is based on its role as a selective inhibitor of the reuptake of dopamine and norepinephrine. This implies that bupropion acts by preventing these two transmitters (associated with reward and energy) from being recaptured by the presynaptic neuron, in such a way that they are available to the postsynaptic neurons for a longer time. Additionally, it appears to stimulate the secretion of these neurotransmitters. Thus, the levels of dopamine and norepinephrine and their transport increase at the brain level, something that can alter mood
Likewise, it has also been observed to present an effect at the level of acetylcholine, binding to nicotinic receptors and exerting a non-competitive antagonist effect. Although there is no complete certainty for this, this element is one of the possible explanations for its role in smoking cessation.
However, it must be taken into account that the exact way in which the mechanism of action of bupropion and psychotropic drugs in general works is still unknown. Its use does not guarantee that it will work by alleviating the symptoms of the disorder to be treated, and in fact its effectiveness is only slightly better than that of the placebo. That does not mean that in many cases it is very useful, simply that the percentage of patients who try this treatment and do not obtain any benefit is relatively high.
Indications: uses in disorders
Bupropion is a drug that throughout its history has had various uses. Although it was born as an antidepressant and today it is sometimes still used to treat this condition both as monotherapy (single therapy) and combined therapy (more common, to enhance some specific antidepressants when first-choice drugs are not effective), the truth is is that by itself It is generally considered less effective than other antidepressants
Where this drug stands out the most and has the greatest use is in smoking cessation, being effective in reducing the consumption habit and the desire to smoke. In this sense, its mechanism of action seems to help stop craving (possibly due on the one hand to its antagonism of nicotinic receptors and its interaction with brain dopamine, although the exact mechanism is not fully known). Another disorder in which it is used is seasonal affective disorder, in which depressive episodes appear associated with certain times of the year.
In addition to the above It has sometimes been used in the treatment of bipolar disorder , especially during the depressive episodes that can occur in this disorder (although this use requires caution since there is a risk of turning the disorder into a manic crisis). Also in ADHD. But in any case, more research is required in this regard and the existence of possible risks must be taken into account.
Side effects
Bupropion is a drug that is very useful in smoking cessation and is used in cases of depression, but as with the rest of the drugs Its clinical usefulness is not free of risks and possible side effects
This occurs because the active ingredient in bupropion affects many areas of the body, not just the areas that could produce an improvement in symptoms. This unwanted interaction generates a chain reaction of somewhat unpredictable consequences, which can lead to new health alterations (although they usually disappear as the substance leaves the body). Therefore, its use should always be supervised and indicated by doctors.
In this sense, among the main side effects of bupropion we can find the causation of insomnia (being one of the most frequent), dry mouth and dizziness, headaches, nausea, constipation, tachycardia, tremors, skin rashes, agitation and nervousness. It can also cause a decrease in appetite.
In more severe cases it can cause seizures (this being one of the best-known serious risks), arrhythmias, hallucinations, panic or difficulties breathing or feeding or inflammation, making it necessary to go to the doctor. In some cases it can cause irritability, hostility, depression, thoughts of suicide.
In addition to these side effects,This drug is totally contraindicated in some segments of the population This drug should not be used by people who are allergic to it or any of its components (something that is otherwise obvious), those who consume certain medications (especially MAOIs), are dependent on substances other than tobacco (such as alcohol, drugs and pharmaceuticals) and those who suffer from epilepsy, brain tumors and anorexia nervosa or bulimia (as it reduces appetite).
It is also not recommended, although it can sometimes be used if the advantages are considered greater than the risks, in cases of people with kidney or liver failure, head trauma, insomnia or consumption of other medications that may interact with bupropion.
Diabetics, alcoholics, hypertension or people with psychiatric disorders (since it can contribute to the appearance of mania in bipolar patients or psychotic crises in schizophrenia, among others) it is also contraindicated (or at least the treatment must be done with a high level of control of the patient’s condition and the doses administered ) due to the risk of seizures and other side effects. Finally, it is not recommended for pregnant and lactating women.
Price
The price of bupropion, for a box of 30 150 milligram tablets , is about 26 euros in Spain and 1,400 Mexican pesos in Mexico, approximately. In any case, it must be taken into account that it must be consumed under medical indication, since its effects are too powerful to be taken without specialist supervision.
