Talk:Bupropion

The following is an archived discussion of a featured article nomination. Please do not modify it. Subsequent comments should be made on the article's talk page or in Wikipedia talk:Featured article candidates. No further edits should be made to this page.

The article was promoted 21:28, 30 August 2007.

[edit] Bupropion

I think this is what you would call a "Featured Article Status", I am thus nominating it, so that it becomes official. Anyways research wise I like this chemical a lot, so if it is not at "FA level" yet, I will improve it based on the comments received I have done like just 4 edits after the FA review started. I am sorry. --Savedthat 03:17, 14 August 2007 (UTC)

• Comments. Nice start. Pls see WP:MOSBOLD, WP:DASH, WP:UNITS, WP:LEAD and WP:MEDMOS. Did you consider peer review or good article? SandyGeorgia (Talk) 03:24, 14 August 2007 (UTC)

I have seen those rules you mentioned, but I cannot connect the dots, what exactly is this article not following? I have decided to go straight to FA candidate because it has a more stringent review system. Thus, I can start doing additional research immediately on this substance if it does not meet criteria.--Savedthat 04:23, 14 August 2007 (UTC)

The article is head and shoulders above most pharm articles, but ... Bolding is used where it shouldn't be, the lead could be expanded to a compelling, stand-alone summary of the entire article, there is incorrect use of hyphens where endashes are needed, all numbers and units of measurement need non-breaking hardspaces, there's a citation in a section heading, you should explain your use of trade names (see the footnote at Tourette syndrome), and section headings don't conform with WP:MEDMOS. Each citation that is not to a journal-published source should be scrutinized to see if it can be replaced with refereed sources. External links can probably be pruned per WP:EL, WP:RS, WP:NOT; is there anything there that can't be found in the DMOZ link or in the article and its sources? If so, the article may not be comprehensive. Fvasconcellos (talk · contribs) is familiar with pharm articles and FAC; he might be willing to help out. (Speaking of comprehensive, I don't find the words tic or Tourette syndrome in the article.) SandyGeorgia (Talk) 04:18, 14 August 2007 (UTC)

I've been looking for a sample article to guide you, but I'm afraid you're blazing new territory. Antioxidant is the most recent FA, but it's not a class pharmaceutical, so isn't really comparable. Neither is caffeine. Paracetamol is a very old FA, probably doesn't meet current standards, and needs review. So, there isn't really a pharm FA to compare to, but TimVickers (talk · contribs) could help you prepare for WP:GAC. SandyGeorgia (Talk) 04:29, 14 August 2007 (UTC)

Oppose. Poorly written and MOS breaches.

• MOS breachs—hyphens/dashes; why are simple years linked? Read MOS on linking.
• compared with for contrasts.
• "have confirmed efficacy of bupropion"—"the" is missing

And tons more. Tony 10:14, 14 August 2007 (UTC)

• Comment You may want to contact Paul gene (talk · contribs), the article's main contributor. BTW, anyone consider dropping WP:PHARM a line? What are we, chopped liver? :) I jest, I jest. Fvasconcellos (t·c) 14:59, 14 August 2007 (UTC)

Anyway, here we go:

• The "History" section is excellent, way above average for pharm articles. It is asking for references, though; they shouldn't be too hard to find.
• The article is quite heavy on stats; this is not a bad thing, but more prose would make it more readable. There are a lot of parenthetical statements throughout. It would be nice to rewrite some of these; get crazy with em dashes.
• "Pharmacokinetics" is quite technical. I've no problem with it but it is probably above the lay reader. It also took me a couple of seconds to get acquainted with the metabolites table; its syntax could perhaps be improved to make it... prettier? :)
• "Availability in the UK" should be expanded to "Availability" with country-specific subsections as needed; I hate to toot my own horn, but Orlistat does a good job of this. The list of trade names could go in as a subsection of "Availability" as well; making it two- or three-column, if possible, would help readability.
• "only if you are able to get a letter from a smoking cessation clinic to your GP"... Second-person writing is a no-no.
• IMHO there's nothing in "Additional information" which couldn't be rearranged within the rest of the article. "Overdosage" doesn't fit in with "Availability"; it could be a stand-alone section or go with Adverse effects.

There's more to come, but I'm off to lunch now :) Will see what else I can do later. Best, Fvasconcellos (t·c) 15:35, 14 August 2007 (UTC)

Comments:

• The smoking cessation paragraph under indications should be improved using the later cited cochrane review on antidepressants for smoking cessation.
• Should a study showing equal effectiveness as placebo be included in the article?
• The number of prescriptions in one specific year in one specific country does not belong to the lead section I think.
• History: withdrawal from market, was this in the U.S. only or worldwide?
• The suicide risk section should start with objective information about the suicide risk, not with "the FDA requires...".

--WS 18:34, 14 August 2007 (UTC)

Comments - go for it - this one is doable. Main thing is that WP is an encyclopedia not a pharmaceutical info pamphlet- so the prose should be richer. I am happy to help with copyediting. Only thing of substance I can't see so far is that it has a reputation for benig psychotogenic (at least in Australia) so evidnce refuting or supporting that would be importand.cheers, Casliber (talk · contribs) 04:55, 16 August 2007 (UTC)

Comments Overall, I think this is one of the best drug articles I've seen on Wikipedia yet! I think it covers the topic quite well, is well-referenced, and interesting to read. I've made a couple of minor changes to the article. A couple of things still remain. Here's my detailed comments:

I am reviewing this version of the article.

The lead is a bit short. It should be a concise summary of the article. As a summary, it should ideally not contain any references (inline citations would be placed on the material later in the article that is being cited). WP:LEAD can help in this regard.

I like the indications section, as it is written out in reasonably good prose and not just a list, like a lot of other drug articles. This provides an excellent example for others to follow.

The metabolism image in the pharmacokinetics section seems a bit odd, with the drug on the right and the metabolites pointing back to the left. I would think that it should be the other way around. Also, the quality of some of the lines in the sketch seems a bit choppy. What chemical software was used to create it?

The pharmacokinetics section seems a bit crowded with the image and the table right next to each other. Perhaps the table could be moved to the bottom of the section, after all the text?

References are only indicated for one of the three bullet points under 'dosage'. With specific dosage information provided, a reference should be there.

While the colorful table in the 'availability in the UK' section looks nice and all; (a) it is unreferenced and (b) I am uncertain exactly what it is contributing to the article? It seems to go a bit beyond the purpose of an encyclopedia to provide a listing and descriptions of each of the different pills of the drug; you can look up — perhaps a far more accurate version — on the manufacturer's official website. Plus, is the table specific to the UK? Where's the US version? I would recommend removing this section, and possibily moving the text at the beginning to another section of the article, and finding a reference for it.

"Recently, addition of bupropion to a mood-stabilizer in patients with bipolar depressions was shown to have the same effectiveness as placebo." -- This statement should probably be integrated with a different section. It seems out of place in its own brief subsection under 'additional information'. Once it's removed, I'd recommend renaming the main section to 'trade names' and removing the identically-named subsection.

Dr. Cash 06:07, 16 August 2007 (UTC)

• I believe the bolding problem has been fixed. [1] & [2]. Y Done --Savedthat 05:03, 17 August 2007 (UTC)

• The Trade Name section has been made as a subsection of Additional Information. [3]. Y Done --Savedthat 05:03, 17 August 2007 (UTC)

• Copy-editing has been done here [4], thank you Wouterstomp; and here [5], thank you Axl; and here [6] & [7], thank you Fvasconcellos; and here [8], [9], [10], [11], [12], [13],

[14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], & [32], thank you Derek.cashman; and here [33] & [34], thank you Outriggr --Savedthat 05:10, 17 August 2007 (UTC)

• Dash fixes have been done here [35] & [36] & [37], thank you Fvasconcellos; and here [38] & [39], thank you SandyGeorgia; and here [40], thank you Brighterorange Y Done --Savedthat 05:10, 17 August 2007 (UTC)

• Reference Scrutinizing has been done here [41] & [42], thank you Fvasconcellos. Y Done --Savedthat 05:13, 17 August 2007 (UTC)

• Manual of Style (dates and numbers) has been done here [43], thank you SandyGeorgia. Y Done --Savedthat 05:16, 17 August 2007 (UTC)

• WP:RS, WP:EL, WP:NOT pruning has been done here [44], thank you SandyGeorgia. Y Done --Savedthat 05:21, 17 August 2007 (UTC)

• "The lead... should ideally not contain any references" — Dr. Cash (Derek Cashman)

With respect, I don't think that this is correct. Look at Wikipedia:Lead section#Citations in the lead section. This indicates that references in this section are less important (because appropriate references should be present later in the article); "there is not, however, a citation exception specific to leads". Axl 20:34, 17 August 2007 (UTC)

The lead must conform to verifiability and other policies. In particular, material likely to be challenged and quotations should be cited in the lead. --Savedthat 21:19, 17 August 2007 (UTC)

Thanks for correcting me on that. I often think of the lead section in wikipedia as similar to a scientific abstract, which should not contain references. Wiki does take a stand similar to this, but does not explicitly prohibit references in the lead. Dr. Cash 00:01, 18 August 2007 (UTC)

• Savedthat, thank you for noting my contribution above. However, copyediting is not "done"—the article needs quite a bit of work in this area, and I've done maybe half of it so far. I am willing to continue if there are others also engaged in improving this to FA status. –Outriggr § 07:27, 18 August 2007 (UTC)

FYI, I've finished my contribution to the copyediting of this article... there is always room for improvement, but I feel it's in much better shape than it was, with the efforts of a number of us. –Outriggr § 08:53, 19 August 2007 (UTC)

• Round 2 of copy editing has been done here [45], [46], & [47] thank you Outriggr; and here [48], [49],

[50], [51], [52], [53], [54], [55], [56], [57], [58], [59], [60], & [61], thank you Derek.cashman; and here [62], [63], [64], [65], [66], [67], [68], [69], & [70], thank you Fvasconcellos; and here [71], [72], & [73], thank you Casliber --Savedthat 11:50, 18 August 2007 (UTC)

• Note on Comprehensiveness - before this can pass, some work needs to be done on comprehensiveness. Rather than clog the page here I am leaving items on the talk page - they are a deal-breaker for me anyway so m vote is currently Oppose for the record but we are really nearly there (nice rhyme ain't it?) and I am close to supporting. The end is in sight.cheers, Casliber (talk · contribs) 23:03, 18 August 2007 (UTC)

• I'm close to Supporting. The article has improved a lot, particularly with regard to referencing and thanks to copy editing efforts. There are still a few minor (dashes and WP:MOSNUM) and not so minor (a few under-referenced paragraphs) obstacles, but I think this is a strong candidate. Fvasconcellos (t·c) 01:14, 19 August 2007 (UTC)

• Support. The article has come a long way, and, as Casliber says below, I think we're "over the line". Any remaining concerns of mine are minor, and don't stand in the way of an FA pass. Fvasconcellos (t·c) 03:22, 22 August 2007 (UTC)

• Weak Support: the content is impressive, but there seems to be something missing. Perhaps it is the structure of the content. I'm not greatly troubled by the quality of the prose as others are; it's really a matter of susbtance for me. Maybe it's the nature of the subject matter but the content doesn't seem to interlink between sections 100%. But all said I'm still voting support because it's very comprehensive and well-researched. Manderiko 08:38, 19 August 2007 (UTC)
  • Note The sections have since been rearranged. You may want to have another look and see whether or not it was an improvement. Fvasconcellos (t·c) 21:20, 19 August 2007 (UTC)

• Support - I think we're over the line; in terms of sources I think the best has been done from what reliable sources are available and the prose has much improved. cheers, Casliber (talk · contribs) 04:58, 20 August 2007 (UTC)

• Support - I really like the direction this article has gone over the past couple of days, it has improved a lot. While I may not be as reliable on the copyediting and manual of style perspective as far as FA status goes (I'll defer to other reviewers there), from a scientific standpoint, I think the article is very complete, well referenced, and well written. Dr. Cash 07:11, 20 August 2007 (UTC)

• Comments regarding Neutral Point of View:
  • I'm not a physician or pharmacologist, but I'll comment on what I can. I honestly don't see how this pertains to NPOV. Fvasconcellos (t·c) 01:58, 23 August 2007 (UTC)

• "Bupropion is an atypical antidepressant that acts as a norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist."

If it is nicotinic antagonist it will make people smoke more to get the same effect. I read some journal article that states when Bupropion is taken in higher doses it makes people smoke more.

Actually, it is postulated that nicotinic antagonists, such as mecamylamine (and to a lesser extent bupropion), reduce the urge to smoke by preventing nicotine from doing its thing. I can't find any such article; do you mean this small study, which used acute, therapeutic doses? Fvasconcellos (t·c) 01:58, 23 August 2007 (UTC)

Yes thats the study I was referring to...It makes no sense: increasing the dose of Bupropion has an opposite effect in regards with smoking cessation? --1ws1 02:03, 23 August 2007 (UTC)

Fvasconcellos pretty much has it right. To be specific, bupropion is a competitive antagonist of the [acetylcholinergic] nicotinic receptor. What this means is that it binds at the same active site as nicotine and prevents nicotine from interacting there. So in other words, smoking cigarettes or obtaining nicotine in other ways prevents it from having any effect at its normal site, so it effectively neutralizes it. Dr. Cash 05:49, 23 August 2007 (UTC)

Bupropion is a non-competitive antagonist of nicotinic receptors. See the article. Still prevents nicotine from acting, though.Paul gene 03:48, 25 August 2007 (UTC)

• "Bupropion improved ratings of "energy", which had decreased under the influence of the SSRI; also noted were improvements of mood and motivation" & "Bupropion is more effective than SSRIs at improving symptoms of hypersomnia and fatigue in depressed patients."

I have the opposite reaction when I take Bupropion. I sleep for hours straight. Aren't there any studies that say Bupropion makes people drowsy?

Agitation is far more common than drowsiness with bupropion. In clinical studies, there was no difference in the incidence of drowsiness between bupropion and placebo. Fvasconcellos (t·c) 01:58, 23 August 2007 (UTC)

Bupropion shouldn't cause drowsiness in patients; it's properties as a dopamine reuptake inhibitor should give it an effect similar to other stimulating drugs, such as cocaine, methamphetamine, ritalin, etc. If bupropion is making you "sleep for hours straight" and makes you drowsy, I would think that you might be experiencing an interaction with another drug, or bupropion may just not work with you (drugs do have different effects on different people -- see pharmacogenomics). Anyway, it almost sounds more like you're seeking medical advice than responding to the article, so if you're still having drowsiness issues, I would suggest that you consult your physician. Dr. Cash 06:03, 23 August 2007 (UTC)

• Olanzapine (Zyprexa) a dopamine & serotonin antagonist is sometimes prescribed for bipolar depression. Now I am really confused.

If increasing the levels of dopamine & serotonin in the brain via Bupropion & Citalopram (Celexa) can cure depression, reducing the levels of dopamine & serotonin via Zyprexa can cure bipolar depression?

It's not that simple, particularly regarding the word "cure" :) Long story short, olanzapine is prescribed to treat the manic part of bipolar disorder, usually in conjunction with an antidepressant. Fvasconcellos (t·c) 01:58, 23 August 2007 (UTC)

If they take anti-depressants along with anti-psychotics the levels of the dopamine & serotonin will remain the same as before as the medicines are now contradicting themselves! --1ws1 10:08, 24 August 2007 (UTC)

• Bupropion being a dopamine reuptake inhibitor increases the level of dopamine in the brain right? So are there studies for Bupropion to treat Parkinson's disease which is caused by low levels of dopamine?

A single 1984 study found bupropion to be mildly effective in Parkinson's, though side effects limited its utility. I don't have access to the full text, so I don't know whether or not it's even worth a mention. (Good study design, relevance etc.) Fvasconcellos (t·c) 02:02, 23 August 2007 (UTC)

Very poor study, claims to be double-blind but no protocol is described. Very poorly written, almost incomprehensible. I relegated it to a footnote in the article.Paul gene 04:34, 25 August 2007 (UTC)

• Studies on the drug Modafinil (Alertec) have shown it to inhibit the reuptake of dopamine and, more potently, norepinephrine. While the co-administration of a dopamine antagonist is known to decrease the stimulant effect of amphetamine, it does not negate the wakefulness-promoting actions of modafinil.

What was my question again....I forgot... I probably have ADHD....lol--1ws1 01:08, 23 August 2007 (UTC)

I'm not sure this is relevant to the bupropion article, but I believe antipsychotics like Zyprexa are prescribed to treat the manic part of bipolar disorder. A lot of bipolar patients also take an antidepressant.

A friend of mine also reported sedation with bupropion. Can't find anything about it, but I'm not very good at searching for journal articles. --Galaxiaad 01:45, 23 August 2007 (UTC)

There are bound to be idiosyncratic reactions to any drug. I know of a person who gets very irritable and anxious from benzodiazepines.Paul gene 03:48, 25 August 2007 (UTC)

• Support - conforms to wikipedia standards. --1ws1 03:47, 24 August 2007 (UTC)

• Oppose, not there yet, not comprehensive, not necessarily neutral, although it can certainly make it with a bit more attention. Wikipedia has to take care not to be an advertisement for smoking cessation or for GlaxoSmithKline. It doesn't appear that PMID 17685748 has been factored into the article at all. Causality and comorbidy of smoking with psychiatric disorders have to be sorted out relative to claims that the medication aids in smoking cessation. Whether the bupropion is actually treating underlying psychiatric disorders (ADHD, dpression) that lead to increased smoking, and reduces smoking indirectly via treating other underlying disorders, has not been addressed here. There are also case reports of tic exacerbation in patients on bupropion, which has not been mentioned. We shouldn't downplay side effects of medications or overplay their efficacy. Better attention to wikilinking or definitions is also needed; example only—it appears that Wiki has no article defining "placebo-controlled", so things like that need to be defined for laypersons who may not understand the significance (alternately, an article on placebo-controlled studies needs to be created). Please run through again and make sure all technical terms, not familiar to a layperson, are linked or defined. SandyGeorgia (Talk) 12:45, 24 August 2007 (UTC)
  • Wow, that's a very recent study. Regarding "Whether the bupropion is actually treating underlying psychiatric disorders...", we need to be very careful not to wander into OR territory, but I don't have to tell you that :) Is PMID 8428875 a good enough analysis of tic exacerbation? It's a case series and quite dated, but seems appropriate. Perhaps someone more adept at analysing the literature (hint, hint) could help out :) Fvasconcellos (t·c) 13:04, 24 August 2007 (UTC)

The article is not an advertisement for bupropion for smoking cessation. Equal efficacy of nicotine patch is pointed out. The fact that the new medication varenicline is more effective is also noted in the article. Paul gene 04:34, 25 August 2007 (UTC)

The article is not an advertisement for GSK. Personally, I hold a very dim view of GSK, but it has nothing to do with the fascinating pharmacology of bupropion. Please give examples to correct.

PMID 17685748 is included now.Paul gene 04:34, 25 August 2007 (UTC)

Bupropion is specific for smoking cessation and does not simply treat a possible underlying depression. Results of trials of other antidepressants such as SSRIs (four trials of fluoxetine, one of sertraline and one of paroxetine), venlafaxine and moclobemide for smoking cessation were all negative. See the Cochrane Database review reference in the article.Paul gene 04:34, 25 August 2007 (UTC)

Tics have been reported only in children treated with bupropion for ADHD. Bupropion should not be used in children according to the recent FDA guidelines. And I do not believe anybody uses it in the USA. So the issue of tics is moot.Paul gene 04:34, 25 August 2007 (UTC)

I've struck my Oppose since both of the items I was concerned about have been added, but the commentary above is surprising. Perhaps I'm misunderstanding since the way you interspersed your comments is confusing, but are you really saying that 1) bupropion isn't used in the US, 2) bupropion isn't used off-label in children, and 3) tic exacerbations are moot in a med used often to treat ADHD, considering the high comorbidity between ADHD and tics? <scratching my head ... as long as the article is accurate ... but these certainly are not moot points. Wiki pharm articles have to be comprehensive, and that means common off-label uses have to be considered.> SandyGeorgia (Talk) 23:00, 26 August 2007 (UTC)

O-ops, stupid mistake. Let me re-write incorporating the answer to your objections. Tics have been reported only in children treated with bupropion for ADHD, not in adults. Bupropion should not be used in children. Since 2004, it is not simply an off-label use, it is the use of the drug in a population where it is contraindicated. While it is possible that a very small number of psychiatrists would still use bupropion in children with depression as a drug of the last resort, it is inconceivable and highly improbable that anyone would use it for ADHD in children, since bupropion’s efficacy in children with ADHD has not been demonstrated. (In the largest double-blind study conducted bupropion was not better than placebo, for the review see PMID: 9554326). Thus, bupropion for ADHD in children is in no way a common off-label use, and it is not necessary to include the tics issue in the article. By the way, do you think I should add to the article that bupropion is not efficacious for ADHD in children?Paul gene 01:28, 27 August 2007 (UTC)

I linked the article to placebo and blind clinical studies. The two latter articles contain explanations sufficient for understanding the concept of double-blind placebo study.Paul gene 04:34, 25 August 2007 (UTC)

• • • Recent, but a well-established phenomenon (something I happen to know because of the issue of self-medication with nicotine in Tourette syndrome); there probably is data to sort that out without getting into OR. If someone does the research and tells me there's no data, I'll strike, but there has been a lot of work on this concept with TS, so I strongly suspect there should be something. If the drug is actually treating underlying depression or attention deficit, it may not actually be acting as an effective smoking cessation med—did the studies showing that it helps with smoking cessation control for comorbid psychiatric disorders? Someone has to dig up the research, or convince me there is none; if they haven't controlled for other disorders, that needs to be sorted out somehow, if there's any literature. Similar on exacerbation of tics; people with TS won't touch the stuff because it has that rap. Is the exacerbation actually due to the natural waxing and waning of tics, and do controlled studies show bupropion increases tics no more than placebo (as in the case of stimulants as discussed at Treatment of Tourette syndrome? I really don't know; I don't follow bupropion studies as closely as I follow the stimulants, because people with TS avoid the stuff. ) SandyGeorgia (Talk) 13:48, 24 August 2007 (UTC)
      • Ps, on the hint hint, I would if I knew where to find these answers or if I had free full access to journal articles—I don't—and I'm up to my eyeballs trying to salvage Asperger syndrome at FAR right now. At least I can point others in the direction to look. SandyGeorgia (Talk) 13:50, 24 August 2007 (UTC)
        • I thought of another idea that might help you track this down: are there trials of smoking cessation comparing bupropion to methylphenidate or other stimulants, or SSRIs? If the bupropion is actually working to control smoking because it's addressing self-medication of underlying psychiatric disorders via nicotine, we'd expect to find success in other medications that treat those conditions and comparisons between the types of medications. I just want us to take care in presenting it as a smoking cessation med without a full investigation of other studies; if it's actually working by treating self-medication of underlying conditions like depression or attention deficit, Prozac or Ritalin is probably cheaper, and we shouldn't become an "advert" for Wellbutrin. SandyGeorgia (Talk) 14:32, 24 August 2007 (UTC)

Bupropion is specific for smoking cessation and does not simply treat a possible underlying depression. Results of trials of other antidepressants such as SSRIs (four trials of fluoxetine, one of sertraline and one of paroxetine), venlafaxine and moclobemide for smoking cessation were all negative. See the Cochrane Database review reference in the article.Paul gene 04:34, 25 August 2007 (UTC)

While I haven't been able to find evidence in the literature that suggests that the smoking cessation mechanism works by treating self-medication of underlying conditions like ADHD or depression, this paper (PMID 12044800), published in 2002, does challenge the earlier research that bupropion is a nicotinic antagonist. The findings indicate that bupropion exhibits a similar overall feeling as nicotine, but works by a different mechanism of action that doesn't involve inhibition of the nicotinic acetylcholine receptor. Dr. Cash 02:54, 25 August 2007 (UTC)

The link does not work, please provide a formal citation or PMID Thank youPaul gene 04:34, 25 August 2007 (UTC). OK. This paper does not present a problem. That study was done on rats. As pointed out in the article, "As bupropion is rapidly converted in the body into several metabolites with differing activity, its action cannot be understood without reference to its metabolism." And "There are significant interspecies differences in the metabolism of bupropion, with guinea pigs' metabolism of the drug being closest to that of humans.[74] Particular caution is needed when extrapolating the results of experiments on rats to humans since hydroxybupropion, the main metabolite of bupropion in humans, is absent in rats.[75]" In mice bupropion does antagonize the behavioral action of nicotine (ref [2] in the article). Later, the authors of the paper you quote (PMID 12044800), found that some metabolites of bupropion antagonize nicotine's action in rats acting through nicotinic receptors, and some partially substitute for it, probably acting through the NE and SER uptake inhibition (see ref 81). Also look at the receptor inhibition data in the Table 1. The bottom line is, if you see a study of bupropion in rats, disregard it - the researchers did not do their homework.Paul gene 12:32, 25 August 2007 (UTC)

Two issues are troubling me. There is a very high rate of comorbid tics in ADHD (and vica-versa as well), so the issue of tic exacerbation when bupropion is used to treat ADHD needs to be addressed. I don't have the full-text of the Spencer study Fvasconcellos mentioned; I've only seen reference to it in other journal reviews. And, the statement in PMID 17685748 that stimulant use affected smoking but bupropion didn't raises the question of what's being treated. If there's no data, there's no data, but I wanted to make sure someone looked into this (and can the new study be incorporated?). Will someone pls ping me when these are resolved so I can strike?? Thanks, SandyGeorgia (Talk) 03:01, 25 August 2007 (UTC)

PMID 17685748 is included now. Drop a note on my user page if you need more detailsPaul gene 04:41, 25 August 2007 (UTC)

• According to my experience, while taking Celexa a SSRI medication was more useful in smoking cessation. (While not taking Wellbutrin) Seriously, have the scientist done studies on this subject? --1ws1 17:53, 24 August 2007 (UTC)

Yes they did. Bupropion is specific for smoking cessation and does not simply treat a possible underlying depression. Results of trials of other antidepressants such as SSRIs (four trials of fluoxetine, one of sertraline and one of paroxetine), venlafaxine and moclobemide for smoking cessation were all negative. See the Cochrane Database review reference in the article.Paul gene 04:41, 25 August 2007 (UTC)

• Also regarding "If bupropion is making you "sleep for hours straight" and makes you drowsy, I would think that you might be experiencing an interaction with another drug, or bupropion may just not work with you (drugs do have different effects on different people -- see pharmacogenomics). Anyway, it almost sounds more like you're seeking medical advice than responding to the article, so if you're still having drowsiness issues, I would suggest that you consult your physician." Perhaps, Fvasconcellos can provide the relevant studies which show that "In clinical studies, there was no difference in the incidence of drowsiness between bupropion and placebo.", please? --1ws1 18:00, 24 August 2007 (UTC)

• One more request to Fvasconcellos, can you provide that study you were talking about regarding Wellbutrin & Parkinson's disease, please? --1ws1 18:03, 24 August 2007 (UTC)

There's a couple of studies regarding bupropion and Parkinson's Disease, most of which are exploring its use to treat depression related to PD, not actual PD itself. This study however, found that it was mildly efficacious in treating PD, due to its dopaminergic agonist (actually, dopamine reuptake inhibitor) properties, but there were significant side effects in treating PD with bupropion. Here is a listing of other scientific publications relating to bupropion and PD, most of which are studies on treating depression related to PD instead of the PD itself. Dr. Cash 18:58, 24 August 2007 (UTC)

Thanks, Derek. Regarding drowsiness, the prescribing information summarizes this in the Adverse effects section. It's linked to from the article, or you can just go here. Again, this issue is best discussed with your physician. Fvasconcellos (t·c) 19:16, 24 August 2007 (UTC)

• Good job Derek in adding the PD section. Fvasconcellos from your link it says that Somnolence was reported in 2% people taking 300mg/day, 3% taking 400mg/day & placebo 2%. So what can be inferred from that? --1ws1 02:00, 25 August 2007 (UTC)

Nothing. The difference is by chance.Paul gene 12:32, 25 August 2007 (UTC)

Yep, that's basically it. Fvasconcellos (t·c) 14:29, 25 August 2007 (UTC)

• Also are there any scientific studies done to explain Why Increasing the dose of Bupropion Has an Opposite Effect in regards with smoking cessation? --1ws1 02:02, 25 August 2007 (UTC)

I've been looking for this at google scholar and pubmed. So far, I haven't found any scientific evidence that supports this assertion. Dr. Cash 02:55, 25 August 2007 (UTC)

• Support - Am I allowed to delete comments made before 20th August because all issues have been addressed right? Looking forward to seeing this article on the main page, so more scientific studies are done on solving treatment resistant depression. I have tried all the anti-depressants prescribed by my psychiatrist, nothing worked, 6 months per anti-depressant. My only alternative choice is Electric Shock Therapy, which I am scared of. I had rather suicide than let them put electricity in my bran. Do scientists read Wikipedia? --9urges 15:51, 27 August 2007 (UTC)

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