Combining Low-Dose Aripiprazole with Bupropion for Treatment-Resistant Depression

Contraindications and Precautions

• The combination of aripiprazole and bupropion is contraindicated in patients with seizure disorders, as bupropion lowers the seizure threshold, and in patients with anorexia nervosa or bulimia nervosa, due to bupropion's contraindication in these conditions 1, 2
• The American Academy of Child and Adolescent Psychiatry recommends avoiding the use of this combination in patients with concurrent MAOI use or within 14 days of discontinuation, and in patients with acute alcohol or benzodiazepine withdrawal, as bupropion increases seizure risk 1

Drug Interactions and Monitoring

• The National Institute of Health suggests monitoring for drug interactions, particularly with drugs metabolized through CYP2D6 pathways, as both aripiprazole and bupropion can affect CYP450 metabolism 3
• The Obesity Society recommends avoiding combining this treatment with other medications that lower seizure threshold, due to the increased risk of seizures 1

Comprehensive Treatment Plan

• The Journal of the American Academy of Child and Adolescent Psychiatry suggests using the combination of aripiprazole and bupropion as part of a comprehensive treatment plan, addressing psychosocial factors contributing to treatment resistance 4

Aripiprazole and Bupropion Combination Therapy

Introduction to Combination Therapy

• The Finnish Current Care Guideline for schizophrenia notes that combining aripiprazole with another antipsychotic may reduce negative symptoms, and this principle extends to its use in augmenting antidepressants, such as bupropion, for treatment-resistant depression 5