Moderate
Probable
Description
Bupropion, a CYP2D6 inhibitor, significantly increases aripiprazole plasma concentrations, increasing the risk of dose-dependent adverse effects.
Mechanism
Bupropion inhibits CYP2D6 moderately to potently, reducing aripiprazole metabolism and raising its AUC; the active metabolite dehydro-aripiprazole ratio also shifts.
Clinical Significance
Aripiprazole exposure may increase substantially; adverse effects (akathisia, metabolic effects) may become clinically prominent.
Management
Reduce aripiprazole dose when adding bupropion; monitor for adverse effects and adjust dose based on clinical response.