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Am Fam Physician. 2004;69(11):2528

to the editor: Although the article1 by Drs. Ables and Baughman in the February 1, 2003, issue of American Family Physician seemed to be a comprehensive review of antidepressant agents, it did not mention bupropion (Wellbutrin). This agent is novel because it is a norepinephrine and dopamine reuptake inhibitor. It has the same efficacy as any selective serotonin reuptake inhibitor (SSRI) for the treatment of depression and has characteristically different side effects. It does not have the sexual dysfunction and gastrointestinal side effects associated with SSRIs. However, it can cause sleeplessness, agitation, and vivid dreams.2 Also, it is not associated with weight gain, while patients receiving SSRIs tend to gain weight. Bupropion (such as Zyban) also is indicated for smoking cessation.3 It is particularly useful for patients who are depressed and attempting to quit smoking.

in reply: I would like to thank Dr. Wax for his comments. Our article1 was not meant to be a comprehensive review. We were asked to provide an update on new agents and/or indications. Bupropion has been on the market since 1985 and, hopefully, physicians are aware of its advantages in the treatment of depression.

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