Carilion Clinic Virginia Tech-Carilion School of Medicine, Psychiatry Residency Program, Roanoke, VA, USA.
Gen Hosp Psychiatry. 2011 Nov-Dec;33(6):612-7. doi: 10.1016/j.genhosppsych.2011.07.001. Epub 2011 Aug 26.
Bupropion is a substituted phenyl-ethylamine that is extensively utilized for the treatment of major depressive disorder and for smoking cessation. It is a reuptake inhibitor of dopamine and norepinephrine, and it also has some nicotinic antagonism. There are concerns that it may increase the risk of psychosis due to its dopaminergic effects. Our objective is to review the literature and analyze the risk of bupropion precipitating a psychotic illness in the general population as well as in the populations with a history of psychotic symptoms.
A Medline database search limited to human and English-language studies was conducted using the keywords "bupropion" and "psychosis." A total of 23 articles were selected based on the relevance of the articles and their references. The data from these articles were collated.
Collated data show that there is some evidence to suggest that bupropion may cause or worsen psychosis in selected subpopulations. Higher doses of bupropion appear more likely to be associated with the outcome severity. Preexisting psychotic symptoms, substance abuse and drug interactions also seem to increase the risk. Concurrent use of antipsychotics at adequate doses appears to be protective.
The literature is incomplete and in some cases contradictory. In selected cases, bupropion appears to be associated with the induction of psychotic symptoms in addition to the precipitation or worsening of an existing psychotic syndrome. Further research including controlled studies is required to clarify the risk of bupropion precipitating a psychotic illness in vulnerable populations.
安非他酮是一种广泛用于治疗重度抑郁症和戒烟的取代苯乙胺。它是多巴胺和去甲肾上腺素的再摄取抑制剂，也具有一定的烟碱拮抗作用。由于其多巴胺能作用，人们担心它可能会增加精神病的风险。我们的目的是回顾文献，并分析安非他酮在普通人群以及有精神病症状史的人群中引发精神病的风险。
使用关键词“安非他酮”和“精神病”，对人类和英语文献的 Medline 数据库进行了限制。根据文章的相关性及其参考文献，共选择了 23 篇文章。对这些文章的数据进行了整理。
整理的数据表明，有一些证据表明，安非他酮可能会导致或加重某些亚人群的精神病。较高剂量的安非他酮似乎更有可能与结果严重程度相关。先前存在的精神病症状、物质滥用和药物相互作用似乎也会增加风险。同时使用足够剂量的抗精神病药物似乎具有保护作用。
文献不完整，在某些情况下存在矛盾。在某些情况下，安非他酮似乎除了引发或加重现有的精神病综合征外，还与精神病症状的诱导有关。需要进一步包括对照研究在内的研究来阐明安非他酮在易受影响人群中引发精神病的风险。
