Bupropion may increase the levels of desipramine, imipramine, and nortriptyline.
Adverse effects including confusion, lethargy and unsteadiness have been reported with nortriptyline and
bupropion. Because there is a small risk of seizures (up to 0.4%) in those given
bupropion at doses of up to 450 mg daily, the manufacturers caution other drugs that can lower the convulsive threshold, such as the tricyclic
antidepressants. A seizure occurred in a patient given trimipramine and
bupropion.
It has been recommended that tricyclic doses at the lower end of the range should be used in patients taking
bupropion. If
bupropion is added to existing treatment,
decreased dosages should be considered. However, there appear to be no reports of problems with the concurrent use of any of these drugs. The
clinical significance of
the increased seizure risk is unknown, but it should be considered when prescribing this combination.