Falling backward in two elderly patients taking bupropion

• Published in: The journal of clinical psychiatry Vol. 53; no. 5; pp. 157 - 159
• Main Authors: SZUBA, M. P, LEUCHTER, A. F
• Format: Journal Article
• Language: English
• Published: Memphis, TN Physicians Postgraduate Press 01-05-1992
• Subjects: Age Factors; Aged; Basal Ganglia Diseases - chemically induced; Biological and medical sciences; Bupropion - adverse effects; Depressive Disorder - drug therapy; Drug toxicity and drugs side effects treatment; Dyskinesia, Drug-Induced - etiology; Female; Humans; Medical sciences; Parkinson Disease, Secondary - complications; Pharmacology. Drug treatments; Posture; Toxicity: nervous system and muscle; Human; Case study; Dopaminergic transmission; Nervous system diseases; Pathophysiology; Psychotropic; Toxicity; Antidepressant agent; Fall; Basal ganglion; Elderly; Brain (vertebrata)
• ISSN: 0160-6689; 1555-2101

Bupropion, a novel antidepressant, has been reported to produce fewer adverse effects than the tricyclic antidepressants. It has relatively weak effects on norepinephrine and serotonin reuptake but possesses significant dopamine agonist and reuptake blocking effects.
The case histories of two geriatric patients treated with bupropion for major depression are presented.
Both patients experienced a previously unreported side effect--falling backward--associated with bupropion use. Orthostatic hypotension and vertigo are not consistent with the patients' histories. Both patients manifested other symptoms consistent with parkinsonian syndrome.
This side effect, apparently unique to bupropion among antidepressants, may be mediated through dopaminergic effects in the basal ganglia. Clinicians should be alert to these potential problems in the geriatric population.