Bupropion is a weak, selective inhibitor of neuronal dopamine and noradrenaline uptake. It has a minimal effect on serotonin uptake and does not inhibit monoamine oxidase. Its licensed indications are as an aid to smoking cessation with motivational support for nicotine-dependent patients, and, when in combination with naltrexone, as an aid to weight management in obesity.¹³

Bupropion’s activity in helping patients abstain from smoking and in suppressing appetite are not clear, but is likely to involve moderating noradrenaline and/or dopamine pathways. It is known to trigger a process stimulating the release of β-endorphin, an endogenous agonist of mu-opioid receptors. Co administration of naltrexone will block an inhibitory feedback loop which may enhance and prolong the bupropion effects.