Elali Faisal R, Grant Arthur C
College of Medicine, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn 11203, New York, USA.
Department of Neurology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue., Brooklyn 11203, New York, USA.
Case Rep Psychiatry. 2024 Oct 23;2024:6638911. doi: 10.1155/2024/6638911. eCollection 2024.
Bupropion is an atypical antidepressant indicated for the treatment of major depressive disorder (MDD), seasonal affective disorder (SAD), and smoking cessation. It is also used off-label for attention deficit hyperactivity disorder (ADHD). Its mechanism of action includes the selective norepinephrine and dopamine reuptake inhibitor (NDRI). The drug is available in immediate-release (IR), sustained-release (SR), and extended-release (XL) formulations. Common side effects are typically mild and include anxiety, insomnia, headache, dizziness, constipation, and nausea. Rarely, cutaneous hypersensitivity reactions may occur. We describe a 23-year-old man who developed severe and diffuse urticaria and angioedema 4 weeks after initiation of bupropion XL for MDD and ADHD. The bupropion was stopped, and he was treated with levocetirizine, diphenhydramine (oral and topical), and methylprednisolone with complete resolution of his symptoms within 2 weeks. Due to a good initial therapeutic response to the medication, a trial of bupropion SR was initiated. The patient again had a favorable therapeutic response without any dermatologic side effects.
安非他酮是一种非典型抗抑郁药，用于治疗重度抑郁症（MDD）、季节性情感障碍（SAD）和戒烟。它也被用于注意缺陷多动障碍（ADHD）的非适应证治疗。其作用机制包括选择性去甲肾上腺素和多巴胺再摄取抑制剂（NDRI）。该药物有速释（IR）、缓释（SR）和长效释放（XL）制剂。常见副作用通常较轻，包括焦虑、失眠、头痛、头晕、便秘和恶心。罕见情况下，可能会出现皮肤过敏反应。我们描述了一名23岁男性，在开始使用安非他酮XL治疗MDD和ADHD 4周后出现严重弥漫性荨麻疹和血管性水肿。停用安非他酮后，他接受了左西替利嗪、苯海拉明（口服和外用）和甲泼尼龙治疗，症状在2周内完全缓解。由于最初对该药物有良好的治疗反应，开始试用安非他酮SR。患者再次获得良好的治疗反应，且无任何皮肤副作用。
