Bupropion Decreases Resting Motor Threshold: A Case Report

• Type of Material: Article
• Authors: Mustafa A. Mufti, Emory University; Paul E. Holtzheimer, Emory University; Charles M Epstein, Emory University; Sinead C. Quinn, Emory University; Nancie Vito, Emory University; William McDonald, Emory University
• Language: English
• Date: 2010-07
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2009 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1016/j.brs.2009.08.001
• Title of Journal or Parent Work: Brain Stimulation
• ISSN: 1935-861X
• Volume: 3
• Issue: 3
• Start Page: 177
• End Page: 180
• Grant/Funding Information: Dr. Epstein receives grant support from GlaxoSmithKline, Inc.; Dr. McDonald has received grant support from Boehinger Ingelheim and Neuronetics; This work was funded through a grant from the NIMH (R01 MH069886).; Dr. Holtzheimer has received grant funding from NARSAD, NIMH and the Greenwall Foundation
• Keywords: Bupropion; Cortical Excitability; Resting Motor Threshold; repetitive Transcranial Magnetic Stimulation
• Research Categories: Psychology, General

Abstract

Background Bupropion is associated with a dose-related increased seizure risk. This effect could correlate with a change in motor cortex excitability. Transcranial magnetic stimulation (TMS) can assess changes in motor cortical excitability by measuring resting motor threshold (RMT). Method RMT was determined before and during two weeks concomitant administration of bupropion at two different doses (150 mg per day and 300 mg per day) in a 41 year old female enrolled in a study of repetitive TMS (rTMS) for the treatment of depression. Results RMT was significantly lower when the patient took 300 mg per day of bupropion compared to no bupropion and 150 mg per day of bupropion. When bupropion was reduced to 150 mg, RMT returned to the pre-medication level. Conclusion Bupropion 300 mg per day increased cortical excitability as demonstrated by decreased RMT. This finding emphasizes the importance of assessing RMT regularly during rTMS treatment – especially in the context of new or changed doses of medications.