A 19-year-old woman with bulimia nervosa is being considered for pharmacotherapy of comorbid depression. Which antidepressant is contraindicated in her?
- A Sertraline
- B Bupropion ✓
- C Mirtazapine
- D Escitalopram
Correct answer: B. Bupropion
Explanation
Bupropion lowers the seizure threshold in a dose-dependent manner and is absolutely contraindicated in eating disorders involving purging, because electrolyte disturbances and vomiting further increase seizure risk. Fluoxetine is actually approved for bulimia itself. Mirtazapine and escitalopram are not proconvulsant and are acceptable alternatives. This seizure liability also underlies bupropion's contraindication in withdrawal states and head injury.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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