Sialorrhea possibly associated with bupropion: a case report and review of potential mechanisms
- 1Department of Psychiatry, The First People’s Hospital of Guiyang , ,
Abstract
Background: Bupropion is typically associated with xerostomia (dry mouth) rather than increased salivation. However, its prescribing information lists “increased salivation” as an infrequent adverse reaction.
Case presentation: We report the case of a 59-year-old female patient with the diagnosis of comorbid anxiety and depressive disorders. The patient experienced no sialorrhea while on a combination of venlafaxine and low-dose quetiapine. However, after switching venlafaxine to bupropion, she developed significant sialorrhea. The sialorrhea was severe: she had to carry tissues and a plastic bag during the day, and at night the pillow was frequently soaked. Gradual discontinuation of quetiapine did not resolve the symptom. The sialorrhea completely remitted only after bupropion was discontinued and replaced with escitalopram. The Naranjo Adverse Drug Reaction Probability Scale score was 6, indicating a “probable” relationship.
Conclusion: This case suggests that bupropion may induce sialorrhea, potentially through a synergistic mechanism involving noradrenergic pathways when combined with quetiapine. Clinicians should be aware of this rare adverse effect when prescribing bupropion, particularly in combination therapies. Therapeutic drug monitoring and clinical pharmacist collaboration may help prevent such adverse events.
Related
- Memantine-Induced Sialorrhea: A Rare Adverse Reaction and Review of Pathophysiological Mechanisms
- Polydeoxyribonucleotide (PDRN) in Osteoarthritis: Immunomodulatory and Matrix-Supportive Potential, A2A Receptor-Associated Mechanisms, and Translational Challenges
- Atrophic tibial shaft nonunion in a young elite skier possibly associated with severe vitamin D deficiency and vitamin K insufficiency successfully treated with graft-free chipping and circular external fixation: a 10-year follow-up case report.
- Extracellular Vesicle Associated MicroRNAs in Vitiligo: A Systematic Review of Mechanisms and Translational Potential
- Staphylococcus epidermidis-associated brain abscess following endovascular treatment of a ruptured intracranial aneurysm: potential immune-inflammatory mechanisms—a case report and literature review
BibTeX
@article{du2026sialorrhea,
title = {{Sialorrhea possibly associated with bupropion: a case report and review of potential mechanisms}},
author = {Huijie Du and Mei Bai and Lu Yang and Shuqin Jia and Yang Yang and Wei Wang and Xiaowei Luo and Jinxuan Wei},
journal = {Frontiers in psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1979464},
url = {https://europepmc.org/article/PMC/PMC13668853},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sialorrhea possibly associated with bupropion: a case report and review of potential mechanisms
AU - Huijie Du
AU - Mei Bai
AU - Lu Yang
AU - Shuqin Jia
AU - Yang Yang
AU - Wei Wang
AU - Xiaowei Luo
AU - Jinxuan Wei
PY - 2026
DA - 2026/10/01
JO - Frontiers in psychiatry
DO - 10.3389/fpsyt.2026.1979464
UR - https://europepmc.org/article/PMC/PMC13668853
AB - Background: Bupropion is typically associated with xerostomia (dry mouth) rather than increased salivation. However, its prescribing information lists “increased salivation” as an infrequent adverse reaction. Case presentation: We report the case of a 59-year-old female patient with the diagnosis of comorbid anxiety and depressive disorders. The patient experienced no sialorrhea while on a combination of venlafaxine and low-dose quetiapine. However, after switching venlafaxine to bupropion, she developed significant sialorrhea. The sialorrhea was severe: she had to carry tissues and a plastic bag during the day, and at night the pillow was frequently soaked. Gradual discontinuation of quetiapine did not resolve the symptom. The sialorrhea completely remitted only after bupropion was discontinued and replaced with escitalopram. The Naranjo Adverse Drug Reaction Probability Scale score was 6, indicating a “probable” relationship. Conclusion: This case suggests that bupropion may induce sialorrhea, potentially through a synergistic mechanism involving noradrenergic pathways when combined with quetiapine. Clinicians should be aware of this rare adverse effect when prescribing bupropion, particularly in combination therapies. Therapeutic drug monitoring and clinical pharmacist collaboration may help prevent such adverse events.
SN - 1664-0640
ER -