Bupropion is approved for major depressive disorder and smoking cessation. Its antidepressant mechanism is DISTINCT from SSRIs and SNRIs because it acts primarily as:

• A Norepinephrine and dopamine reuptake inhibitor (NDRI) without significant serotonergic activity ✓
• B Selective serotonin reuptake inhibitor with secondary norepinephrine effects
• C Monoamine oxidase-A inhibitor reducing serotonin and norepinephrine catabolism
• D Alpha-2 autoreceptor antagonist enhancing norepinephrine and serotonin release

Explanation

Bupropion is a norepinephrine and dopamine reuptake inhibitor (NDRI) with no clinically significant serotonergic activity, which is why it lacks the sexual side effects and weight gain commonly seen with SSRIs/SNRIs. Its dopaminergic activity also underlies its efficacy in smoking cessation (attenuating craving and withdrawal symptoms). It is not an MAO inhibitor; that would describe phenelzine or selegiline. Mirtazapine is the alpha-2 autoreceptor antagonist. Bupropion lowers the seizure threshold and is contraindicated in anorexia nervosa and bulimia due to electrolyte imbalances predisposing to seizures.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.