Ormoz Psychiatric Hospital, Ormoz, Slovenia, E-mail:
Psychiatr Hung. 2022;37(3):246-249.
Bupropion (BUP) is a norepinephrine-dopamine reuptake inhibitor frequently used in prisons. Although its positive effects on depression treatment are often presented, there are many questions about its approved use in prisons and similar facilities. In this context, this article aims to present two case reports of BUP XL unapproved use and a review of the mechanism of action, formulations, and the clinical profile of BUP.
Two case reports. The patients' data for the case reports were obtained from their medical records. A PubMed search was conducted using the terms BUP, inmates, and efficacy to identify randomized and non-randomized controlled trials and case reports to evaluate the possible effects of BUP in prison settings. Only approved medications were included.
The positive effects of BUP XL on major depressive disorder treatment are well-reported, but few reports are on the pharmacokinetics of BUP XL in prisons. The exact mechanism of its effect on the central nervous system is predominantly connected with its unique pharmacokinetics.
This paper shows that BUP XL will continue to play an essential role in treating a major depressive disorder in adults in prisons and other related disorders, although a different treatment strategy should be preferred in patients with high addictive potential. Because of a similar mechanism of action, the most appropriate alternatives for BUP XL could be mirtazapine, agomelatine, aripiprazole, and quetiapine, although clinical trials are needed to confirm these alternatives.
安非他酮（BUP）是一种经常在监狱中使用的去甲肾上腺素-多巴胺再摄取抑制剂。尽管其在治疗抑郁症方面的积极作用经常被提及，但关于其在监狱和类似设施中获准使用的问题仍有很多。在这种情况下，本文旨在报告两例 BUP XL 未批准使用的病例，并对 BUP 的作用机制、制剂和临床概况进行综述。
两项病例报告。病例报告中患者的数据是从他们的病历中获得的。使用 BUP、囚犯和疗效等术语在 PubMed 上进行了检索，以确定随机和非随机对照试验和病例报告，以评估 BUP 在监狱环境中的可能效果。只包括已批准的药物。
BUP XL 对治疗重性抑郁症的积极作用已有充分报道，但关于 BUP XL 在监狱中的药代动力学的报道很少。其对中枢神经系统影响的确切机制主要与其独特的药代动力学有关。
本文表明，尽管对于有高成瘾性风险的患者应首选不同的治疗策略，但 BUP XL 将继续在监狱和其他相关疾病中治疗成年人大重性抑郁症中发挥重要作用。由于作用机制相似，BUP XL 的最合适替代品可能是米氮平、阿戈美拉汀、阿立哌唑和喹硫平，但需要临床试验来证实这些替代品。
