Major
Probable
説明
Bupropion combined with tramadol increases the risk of both serotonin syndrome and seizures, representing a serious dual-hazard drug combination.
機序
Bupropion inhibits dopamine and norepinephrine reuptake and is a CYP2D6 inhibitor that elevates tramadol's serotonergic M1 metabolite; the combination raises CNS serotonin and lowers the seizure threshold.
臨床的意義
Both serotonin syndrome and seizure events have been documented in case reports with this combination.
対処法
Avoid concurrent use; if necessary, use the lowest effective tramadol dose and monitor for neurological symptoms closely.