Which antidepressant lowers the seizure threshold in a dose-dependent fashion and is therefore contraindicated in patients with an active eating disorder or a prior seizure history?
- A Mirtazapine
- B Bupropion ✓
- C Vilazodone
- D Trazodone
Correct answer: B. Bupropion
Explanation
Bupropion inhibits neuronal reuptake of dopamine and noradrenaline and is associated with dose-related seizure risk, particularly with the immediate-release formulation and doses above 450 mg/day. It is formally contraindicated in bulimia nervosa and anorexia nervosa, where electrolyte disturbance further lowers seizure threshold. Mirtazapine, trazodone, and vilazodone carry minimal seizure risk and are acceptable alternatives in such patients.
Reference: Katzung Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.