RT Journal
A1 Peloso PM, Baillie C
T1 BIological warfare
JF JAMA
JO JAMA
YR 1999
FD November 17
VO 282
IS 19
SP 1817
OP 1817
DO 10-1001/pubs.JAMA-ISSN-0098-7484-282-19-jbk1117
UL http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-282-19-jbk1117
AB 
To the Editor: Bupropion hydrochloride, an
atypical antidepressant that has both dopaminergic and adrenergic actions,
is effective for smoking cessation, being more effective than placebo1 and more effective than the nicotine patch alone.2 Bupropion enhances the response rate of the nicotine
patch. Recent guidelines on smoking cessation3
recommend bupropion for smokers who fail treatment with or who do not wish
to use nicotine replacement therapy. It is the second-line therapy in part
due to adverse effects.4 Principally, these
include agitation, dizziness, insomnia, tremor, reduced seizure threshold,
dry mouth, nausea, and abdominal pain. A study by Settle4
found that these adverse effects are dose related. Compared with placebo,
which had a 4% discontinuation rate, buproprion had a discontinuation rate
of 9% at the 300 mg/d dosage and 11% at 450 mg/d dosage. We describe herein
a serum sickness–like reaction in a man taking bupropion.