Q: My 26-year-old relative takes anti-depressants. She wants to give up smoking. She has been recommended Bupropion as anti-smoking medicine. Can she take Bupropion and what would be the dosage? Is there any different power of Bupropion, which one should she take?

A:The patient is taking quite a few anti-psychotic, anti-depressant medicines that interact with bupropion. For example fluoxetine (brand names: Platin, Loftil) is known to inhibit the metabolism of bupropion that can lead to toxic levels resulting in severe psychosis and even mania. Similarly the concurrent administration of fluoxetine and bupropion has led to seizures in some cases. In addition risperidone (Rozidal) also interactions adversely with bupropion. It may be added here that one of the known side effects of bupropion is depression and hence it can worsen pre-existing disease. We cannot locate the brand Caberlin on either Indian or international quality brands data bank. May be it contains cabergolin; if so the rationality of its use in the patient is not clear. With respect to bupropion, only Zyban brand of GlaxoSmithKline, the innovator of the medicine, appears on the national list of quality products in India. It is available in 150 mg tablets.