Bupropion-induced leukopenia: A case report

Bupropion hydrochloride, a norepinephrine/dopamine reuptake inhibitor, is administered for the treatment of depression and smoking cessation. Common side effects of bupropion are dry mouth, nausea and insomnia, also it may lower the seizure threshold. The normal range of total white blood cell (WBC) count is 4000 -11000/mu l for adults. The values below 4000/ mu l, are defined as leukopenia. A 33-year-old woman admitted to the psychiatry outpatient clinic with the complaints of mild depression, also wanted to quit smoking. Bupropion hydrochloride (extended release-XL) 150 mg/day was initiated to the patient. The leukocyte count of her treatment was 3890/mu l at the third month and 3730/mu l at the fourth month. The leukocyte count was at normal value before initiation of bupropion hydrochloride (7220/mu l) and after stopping the treatment (7290/mu l). She did not have any chronic disease, medication and drug or alcohol abuse. According to this case, it is probable that there was a relationship between bupropion hydrochloride and leukopenia as an adverse event. Many idiosyncratic drug reactions involve blood dyscrasias. Some of the psychotropic drugs have been associated with leukopenia and sometimes agranulocytosis. Although some rare studies and case reports related to leukopenia have been reported with some of the antidepressants but to our knowledge bupropion induced leukopenia is not a common side effect. Therefore, reporting this adverse event due to bupropion is important to make a contribution to literature.