DOI: https://doi.org/10.36347/sjmcr.2026.v14i07.013

Pages: 1662-1665

Bupropion is an atypical antidepressant that inhibits the reuptake of norepinephrine and dopamine and is approved for the treatment of major depressive disorder and smoking cessation. Its unique pharmacological profile has led to growing interest in other indications, including attention-deficit/hyperactivity disorder (ADHD). However, its dopaminergic activity may also be associated with misuse and dose-related toxicity, particularly in individuals with substance use disorders. We report the case of a 34-year-old man with polysubstance use disorder, ADHD, recurrent depressive disorder, and social anxiety disorder who was admitted for benzodiazepine, pregabalin, and tobacco withdrawal. Treatment with bupropion, venlafaxine, quetiapine, and tapering lorazepam resulted in significant improvement in mood and attentional functioning. Following discharge, however, the patient independently increased his bupropion dosage from 300 mg/day to 600 mg/day and repeatedly requested further dose escalation, raising concerns regarding potential misuse in a context of addictive vulnerability. This case highlights the complex balance between the therapeutic benefits and risks of bupropion in patients with psychiatric and addictive comorbidities. While the drug may improve depressive symptoms, cognitive functioning, and smoking cessation outcomes, its dopaminergic properties may contribute to misuse behaviors in susceptible individuals. Furthermore, doses exceeding recommended therapeutic limits are associated with an increased risk of severe adverse effects, particularly seizures. Careful patient selection, close clinical monitoring, and regular reassessment of the benefit–risk balance are therefore essential when prescribing bupropion to high-risk populations.