Bupropion is used for depression and smoking cessation. Its pharmacological mechanism is:

• A Noradrenaline and dopamine reuptake inhibition without significant serotonin effects ✓
• B Selective serotonin reuptake inhibition via allosteric binding to SERT
• C Antagonism of postsynaptic 5-HT2 receptors with mild serotonin reuptake inhibition
• D α2-adrenoceptor antagonism increasing noradrenaline and serotonin release

Explanation

Bupropion inhibits the reuptake transporters for noradrenaline (NET) and dopamine (DAT) without meaningful serotonin (SERT) inhibition. This monoamine action also contributes to reducing craving and reward in nicotine dependence. Unlike SSRIs, bupropion does not cause sexual dysfunction or weight gain and can be used in patients for whom these side effects are problematic. Mirtazapine is an α2-adrenoceptor antagonist; trazodone has 5-HT2 antagonism with mild SERT inhibition.

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

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