Bupropion

Question:
I have a student who wants to start taking the Stop Smoking Tablets (Zyban) and wants to know if there are any known contra-indications with diving that he needs to be aware of. Your assistance in this matter would be most appreciated.
Zyban is formulated as prolonged release tablets containing 150mg of the active ingredient bupropion hydrochloride. Zyban also contains the following inactive ingredients: microcrystalline cellulose, hypromellose, cysteine hydrochloride monohydrate, magnesium stearate, macrogol 400. titanium dioxide (E171) carnauba wax & iron oxide black (E172).

Answer:
Although diving accidents related to bupropion (Wellbutrin, Zyban) are not, so far, known, it is the opinion of many diving physicians that the drug may have significant contraindications to diving; many physicians, particularly in the USA, actually refuse to certify a diver who is taking the drug.
Here are some guidelines to use in considering the relationships between drugs and diving, in general and with regard to bupropion:
General
- Always consider the condition / illness / disease for which the medication is being given.
- Always consider possible complex relationships between drugs, the individual, other medications, diet and the conditions for which the drugs are taken.
Specific
- Check for any effects of the drug that alter consciousness or cause alteration in decision-making ability. Seizure activity is deadly underwater. Four of every 1,000 persons who receive bupropion (Wellbutrin,Zyban) in doses less than 450 mg/day experience seizures. When doses exceed 450 mg/day, the risk increases tenfold.