Major
Bupropion × Escitalopram
Other antidepressants (NDRI)×Selective serotonin reuptake inhibitors (SSRIs)
Mechanism
Escitalopram is a citalopram enantiomer with the same effects. Additive seizure threshold reduction (bupropion + escitalopram). High-dose escitalopram prolongs QT.
Symptoms
Seizures (especially with prior epilepsy or eating disorders), QT prolongation on ECG, dizziness.
Management
The combination is used for antidepressant augmentation. Cap escitalopram at 10 mg and bupropion at 300 mg/day. Avoid in prior epilepsy or eating disorders.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.