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Three metabolites are active: hydroxybupropion, which is formed via hydroxylation of the tert-butyl group of bupropion, and the amino-alcohol isomers threohydrobupropion and erythrohydrobupropion, which are formed via reduction of the carbonyl group

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Other long-term side effects can include the development of bronchitis or pneumonia, disrupted growth and development in teens and adolescents, muscle tissue loss, heart attack, brain damage, deterioration of the spinal cord and seizures