SSRIs that inhibit CYP2D6 (such as
paroxetine and fluoxetine) may raise
bupropion levels. Concurrent use has lead to psychosis, mania, seizures,
serotonin syndrome and hypersexuality.
The manufacturers of
bupropion recommend caution with
SSRIs (fluoxetine,
paroxetine and sertraline named).
Bupropion should be started at the lower end of the dose range in patients taking an SSRI. Note that, a maximum
bupropion dose of 150 mg daily is recommended if it is given with other drugs that reduce the seizure threshold.