• E J Wagena, L de Graaf, N H Chavannes, A C van Grootheest, and C P van Schayck.
• Universiteit Maastricht, capaciteitsgroep Huisartsgeneeskunde, Postbus 616, 6200 MD Maastricht. edwin.wagena@hag.unimaas.nl
• Ned Tijdschr Geneeskd. 2001 Aug 4; 145 (31): 1489-92.

AbstractA report in a national newspaper on Thursday 26 April 2001, linked the anti-smoking drug bupropion to 41 deaths. From the reports of suspected adverse reactions received by the Netherlands Pharmacovigilance Foundation, it appears that more than half the cases concerned patients at risk of developing smoking-related diseases. In 15 cases, the simultaneous use of bupropion and another antidepressant (10 patients), theophylline (1 patient) or insulin (4 patients) was reported, even though these combinations may lead to an increase in the risk of seizures. Furthermore, 2 patients were reported to have been taking anti-epileptics, despite the fact that use of bupropion is contra-indicated in patients with a seizure disorder. The results seem to illustrate that the guidelines described in the product information are not being adhered to in all cases. Provided that bupropion is used according to the guidelines in the product information, this new aid in smoking cessation is considered an effective and safe drug. It is highly unlikely that bupropion has contributed to any deaths. If prescribed appropriately and in combination with counselling (e.g. minimal intervention strategy), bupropion is as yet the most effective aid in helping people stop smoking.

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