A nurse is teaching a client with major depressive disorder about their new prescription for bupropion. Which of the following instructions should the nurse include?

Choice A reason: Bupropion, a norepinephrine-dopamine reuptake inhibitor, is stimulating and can cause insomnia by increasing catecholamine activity in the brain. Taking it at bedtime may disrupt sleep, exacerbating depressive symptoms or causing agitation, making this an inappropriate instruction for effective management of major depressive disorder. Choice B reason: Alcohol interacts with bupropion, increasing seizure risk due to bupropion’s lowering of the seizure threshold via dopamine and norepinephrine modulation. Alcohol’s depressant effects also counteract bupropion’s antidepressant action, worsening mood and cognitive symptoms, making avoidance critical for safety and therapeutic efficacy. Choice C reason: Increasing bupropion’s dose without medical supervision is dangerous, as it risks seizures or toxicity due to its narrow therapeutic index. Dose adjustments require provider oversight to monitor efficacy and side effects, ensuring safe management of depression’s neurochemical imbalances, making this instruction incorrect. Choice D reason: Bupropion’s absorption is not significantly affected by food, and high-fat meals are unnecessary. Unlike some medications requiring dietary considerations, bupropion’s pharmacokinetics remain stable regardless of meal composition, making this instruction irrelevant for ensuring therapeutic efficacy or safety in depression treatment.