Key result
Stable bupropion use is linked to abnormal asymptomatic EEGs in ~20% of adults, particularly females.
Why the study?
The risk of dose-dependent seizures with bupropion hydrochloride necessitates evaluation of specific EEG waveforms in patients taking the medication.
What is the incidence of abnormal, asymptomatic electroencephalographic findings in adult patients taking stable doses of bupropion?
Cohort (n=210)
No
What is the incidence of abnormal, asymptomatic electroencephalographic findings in adult patients taking stable doses of bupropion?
Nearly 20% of patients on stable doses of bupropion exhibit abnormal, asymptomatic EEG findings, which may represent a risk factor for seizures, particularly in females.
May warrant EEG caution during bupropion titration; leaves open whether findings predict clinical seizures.
The risk of dose-dependent seizures is a safety issue with bupropion hydrochloride. To evaluate the presence of specific electroencephalographic (EEG) waveforms, 210 adult subjects taking stable doses of bupropion hydrochloride were recruited to undergo 2 EEGs in a prospective, single-center cohort study. The occurrence of spike waves, sharp waves, and focal slowing was recorded and assessed with a continuation ratio logit model for polytomous responses. This model showed that there was a relationship between sex and the incidence of these waveforms, such that the odds of female subjects having sharp waves was increased by a factor of 2.53 (P = 0.05) when compared with male subjects and controlled for both age and dose. Similarly, female subjects were 2.45 (P = 0.09) times more likely than males to have focal slowing on EEG. Overall, 19.8% (39/197) of this representative population was found to have abnormal, asymptomatic EEG findings. The presence of these waveforms in individuals taking a medication known to lower the seizure threshold may be a risk factor for developing seizures.
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Macaluso et al. (2010) conducted a cohort in Patients taking bupropion hydrochloride (n=210). Bupropion hydrochloride was evaluated on Abnormal, asymptomatic EEG findings (spike waves, sharp waves, and focal slowing). Among adults taking stable doses of bupropion hydrochloride, 19.8% had abnormal, asymptomatic EEG findings, with females having 2.53 times higher odds of sharp waves than males (P=0.05).
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