Bupropion is prescribed as an antidepressant. Its primary mechanism of action is:

• A Selective serotonin reuptake inhibition with potent 5-HT1A partial agonism
• B Non-selective monoamine oxidase inhibition
• C Inhibition of neuronal reuptake of norepinephrine and dopamine without significant serotonin reuptake inhibition ✓
• D Blockade of presynaptic α2-adrenoreceptors and 5-HT2/5-HT3 receptors (NaSSA mechanism)

Explanation

Bupropion (an aminoketone) is a norepinephrine-dopamine reuptake inhibitor (NDRI) that does not significantly inhibit serotonin reuptake. This distinguishes it from SSRIs and SNRIs and accounts for its additional uses in smoking cessation (dopaminergic) and ADHD. Because it lacks serotonergic activity, it is less likely to cause sexual dysfunction and is often preferred when this is a concern. Vortioxetine combines SRI with 5-HT1A partial agonism. MAO inhibition describes phenelzine/tranylcypromine. The NaSSA profile belongs to mirtazapine.

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

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