Generalized Tonic-Clonic Seizure Due to the Concomitant Use of Bupropion Extended-Release and Moxifloxacin

Abstract

Bupropion extended-release (XL), an amphetamine-like dual mechanism drug, is used for the treatment of major depressive disorder, and its use is associated with a dose-dependent risk of epileptic seizures. Moxifloxacin is synthetic fluoroquinolone antibiotic agent which has proconvulsant side effects. Although there is no drug-drug interaction between these two drugs, their concomitant use can trigger epilepsy. In this report, we discussed a male patient using bupropion XL, who developed generalized tonic-clonic seizure after treatment with moxifloxacin and had no history of seizures. The association of bupropion XL with catecholamines and the association of both bupropion XL and moxifloxacin with gamma aminobutyric acid were possible accused mechanisms. This case report suggests physicians to pay attention to the potential risk of bupropion XL- and moxifloxacin-induced seizures.