Switch medication from clomipramine to bupropion.[1]
[2]
Stop clomipramine
- Before day 1: gradually reduce dosage of clomipramine to a maximum of 75 mg/ day, when this dosage is > 75 mg/day.
- Day 1-3: reduce dosage of clomipramine to 50 mg/day.
- Day 4-7: reduce dosage of clomipramine to 25 mg/day.
- Day 8: stop administration of clomipramine.
Start bupropion
- Day 1: simultaneously start administration of bupropion in a dosage of 150 mg/day and continue administration of clomipramine according to the scheme above.
- Day 8: continue administration of bupropion.
More information
- Bupropion is an inhibitor of CYP2D6, which metabolizes clomipramine.
- 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.
- This switch is currently being reviewed.
- ↑ 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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Stop clomipramine 
Start bupropion
More information