Bupropion is contraindicated in which of the following patients?
- A A 40-year-old man with hypertension controlled on amlodipine who wants to stop smoking
- B A 35-year-old woman on sertraline with residual depressive symptoms
- C A 22-year-old woman with bulimia nervosa and a history of one unprovoked seizure ✓
- D A 55-year-old man with type 2 diabetes on metformin starting bupropion for depression
Correct answer: C. A 22-year-old woman with bulimia nervosa and a history of one unprovoked seizure
Explanation
Bupropion is dose-dependently epileptogenic, and the risk is markedly amplified in eating disorders such as bulimia and anorexia nervosa due to associated electrolyte disturbances and vomiting, and in any patient with a seizure history. These are formal contraindications. Hypertension, diabetes, and combination with SSRIs (used deliberately for augmentation, though seizures must be considered) do not contraindicate its use.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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