Which antidepressant is most likely to LOWER the seizure threshold and is CONTRAINDICATED in eating disorders (particularly bulimia nervosa and anorexia nervosa) due to increased seizure risk?
- A Venlafaxine
- B Mirtazapine
- C Bupropion ✓
- D Escitalopram
Correct answer: C. Bupropion
Explanation
Bupropion (norepinephrine-dopamine reuptake inhibitor) dose-dependently lowers the seizure threshold and is contraindicated in eating disorders (bulimia nervosa and anorexia nervosa) and in patients with a history of seizures. Electrolyte disturbances (hypokalaemia, hyponatraemia) common in purging eating disorders further increase seizure susceptibility. Bupropion is also contraindicated in patients withdrawing from alcohol/benzodiazepines. Its seizure risk is why it is not typically first-line, despite efficacy in depression and as an aid to smoking cessation.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.