Difference between revisions of "Nortriptyline-bupropion"
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* '''Day 1:''' simultaneously start administration of bupropion in a dosage of 150 mg/day and continue administration of nortriptyline according to the scheme above. | * '''Day 1:''' simultaneously start administration of bupropion in a dosage of 150 mg/day and continue administration of nortriptyline according to the scheme above. | ||
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* Bupropion is a strong inhibitor of CYP2D6, which metabolizes nortriptyline. | * Bupropion is a strong inhibitor of CYP2D6, which metabolizes nortriptyline. | ||
| − | * Caution with this switch is necessary. }} | + | * Caution with this switch is necessary. |
| + | * {{RiskSeizureBupropionTCA}} | ||
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Latest revision as of 16:25, 28 October 2015
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Switch medication from nortriptyline to bupropion.[1] [2]
Stop nortriptyline - Before day 1: gradually reduce dosage of nortriptyline to a maximum of 50 mg/ day, when this dosage is > 50 mg/day.
- Day 1-3: reduce dosage of nortriptyline to 25 mg/day.
- Day 4-7: reduce dosage of nortriptyline to 10 mg/day.
- Day 8: stop administration of nortriptyline.
Start bupropion- Day 1: simultaneously start administration of bupropion in a dosage of 150 mg/day and continue administration of nortriptyline according to the scheme above.
- Day 8: stop administration of nortriptyline and continue administration of bupropion.
More information- Bupropion is a strong inhibitor of CYP2D6, which metabolizes nortriptyline.
- Caution with this switch is necessary.
- The concomitant use of bupropion and tricyclic antidepressants (TCAs) may potentiate the risk of seizures. These agents are all epileptogenic and may have additive effects on the seizure threshold.
- ↑ Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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