Major
Probable
描述
Bupropion combined with tramadol increases the risk of both serotonin syndrome and seizures, representing a serious dual-hazard drug combination.
机制
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.
临床意义
Both serotonin syndrome and seizure events have been documented in case reports with this combination.
处理措施
Avoid concurrent use; if necessary, use the lowest effective tramadol dose and monitor for neurological symptoms closely.