The authors describe the development of acute psychoses in four patients
treated with bupropion, a unicyclic aminoketone antidepressant. In two of
the cases the psychoses seemed to be affected by dose. The mechanism
responsible for the psychotic reactions is unclear, although it may involve
perturbation of dopaminergic systems. On the basis of their experience, the
authors offer recommendations regarding the clinical use of bupropion.