Ans:
B
Explanation: Adverse events commonly encountered with bupropion include agitation, insomnia, and anxiety. For a patient with pre-existing GAD, bupropion can exacerbate these symptoms,.
• Context: Bupropion is generally considered activating, whereas other antidepressants like Mirtazapine are more sedating
:Bupropion is an atypical antidepressant that primarily affects norepinephrine and dopamine reuptake. While it is generally well-tolerated, one of the more significant side effects to monitor for, especially in patients with a history of anxiety, is agitation. Bupropion can cause an increase in anxiety and agitation, particularly when first starting the medication or when the dose is increased. This is crucial to monitor because exacerbation of anxiety symptoms could worsen the patient’s overall condition. Other side effects like nausea, lethargy, and weight gain are less concerning in this context, and sundowning is not typically associated with bupropion use. Therefore, monitoring for agitation is the most critical in this scenario.
Bupropion warning and precaution
Potential Association with Behavioural and Emotional Changes, Including Self-Harm
Adults and Pediatrics: Additional Data
There are clinical trial and post-marketing reports with SSRIs and other newer antidepressants, in both pediatrics and adults, of severe agitation-type adverse events coupled with self-harm or harm to others. The agitation-type events include: akathisia, agitation, disinhibition, emotional lability, hostility, aggression, depersonalization. In some cases, the events occurred within several weeks of starting treatment.
Rigorous clinical monitoring for suicidal ideation or other indicators of potential for suicidal behaviour is advised in patients of all ages given an antidepressant drug. This includes monitoring for agitation-type emotional and behavioural changes.
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