From the Research
Withdrawal from bupropion can potentially cause hypertension in some individuals, and it is generally recommended to taper off the medication gradually under medical supervision to minimize this risk. When a person stops taking bupropion, especially if they discontinue it abruptly after regular use, they may experience various withdrawal symptoms including elevated blood pressure. Bupropion works by affecting certain neurotransmitters in the brain, particularly norepinephrine and dopamine. When the medication is suddenly withdrawn, there can be a rebound effect in these neurotransmitter systems, which may lead to increased sympathetic nervous system activity and consequently elevated blood pressure.
This is more likely to occur in patients who have been taking higher doses (such as 300-450 mg daily) or have been on the medication for extended periods. According to a study published in the Journal of clinical psychopharmacology 1, bupropion can cause a rise in supine blood pressure, and another study published in Frontiers in cardiovascular medicine 2 suggests that the dopamine-norepinephrine reuptake inhibitor bupropion can lead to blood pressure increases, usually at high doses.
To minimize the risk of hypertension during bupropion withdrawal, the following steps can be taken:
- Taper off bupropion gradually under medical supervision rather than stopping abruptly
- Individualize the tapering schedule based on the current dose, duration of treatment, and patient-specific factors
- Monitor blood pressure closely during the withdrawal process, especially in patients with pre-existing hypertension or cardiovascular conditions
- Contact a healthcare provider promptly if significant blood pressure elevation is noticed during bupropion withdrawal.
It's also important to note that bupropion misuse can occur, particularly in patients with a history of substance use disorder, and can lead to various adverse effects, including tachycardia, seizures, and cardiovascular complications, as reported in a systematic review published in the Journal of clinical psychopharmacology 3. However, the primary concern with bupropion withdrawal is the potential for rebound effects on the sympathetic nervous system, which can lead to elevated blood pressure.