Switch medication from maprotiline to bupropion.
- Before day 1: gradually reduce dosage of maprotiline to a maximum of 75 mg/day.
- Day 1: reduce dosage of maprotiline to 50 mg/day.
- Day 7: reduce dosage of maprotiline to 25 mg/day.
- Day 14: stop dosage of maprotiline.
- Day 7: simultaneously start administration of bupropion in a dosage of 150 mg/day and continue administration of maprotiline according to the scheme above.
- Day 14: stop administration of maprotiline and continue administration of bupropion.
- Bupropion is a strong inhibitor of CYP2D6, which metabolizes maprotiline.
- 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.
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