bupropionAdjunctive therapyBrands: WELLBUTRIN | MDD; seasonal affective disorder; smoking cessation (SR). View labelExact | XL: start 150 mg qAM for 3–7 days, increase to 300 mg qAM; may increase to 450 mg qAM if needed. | Norepinephrine–dopamine reuptake inhibitor (NDRI). | CYP2B6 | Steady-state mean 21 h | No | — | - Blood pressure at baseline and after dose changes, especially when nicotine replacement is used.
- Seizure risk factors (eating disorder history, alcohol/benzodiazepine withdrawal, electrolyte disturbances) before initiation and at follow-up.
- Sleep and anxiety during early titration; dose timing and titration speed are common levers for tolerability.
- Mood elevation or agitation in bipolar-spectrum illness; coordinate prevention plans via the bipolar disorder hub.
- Medication list review to ensure only one bupropion-containing product is active (to reduce accidental dose escalation across brands).
| No | 2026-02-12 |
|---|
| MDD; OCD; panic disorder; PTSD; social anxiety disorder. View labelExact | Start 50 mg once daily for major depressive disorder (clinical depression) or anxiety; titrate by 25–50 mg increments every ≥1 week to 100–200 mg/day (max 200 mg/day). | Selective serotonin reuptake inhibitor (SSRI). | Multiple CYPs | Steady-state mean 26 h | No | — | - Suicidality and psychiatric activation during initiation and dose changes, especially in younger patients and in bipolar-spectrum illness.
- Sodium in older adults or patients on diuretics if symptoms suggest hyponatremia (confusion, fatigue, falls).
- Bleeding/bruising risk when combined with NSAIDs, antiplatelets, or anticoagulants; reinforce early symptom reporting.
- Medication reconciliation when TCAs, antipsychotics, or other serotonergic agents are co-prescribed; anticipate switching washout needs when regimens change.
| No | 2025-12-28 |
|---|
| Major depressive disorder. View labelExact | Typical adult initiation: 15 mg at bedtime; increase to 30 mg after 1–2 weeks based on response; usual maintenance 15–45 mg nightly. | Central presynaptic alpha-2 antagonist; enhances noradrenergic and serotonergic transmission (NaSSA). | CYP1A2, CYP2D6, CYP3A4 | Single-dose mean 30 h; Single-dose range 20–40 h; Steady-state mean 37 h | No | | - Weight and appetite changes, plus fasting lipids and glucose at baseline and periodically, given weight gain and dyslipidemia risk.
- Daytime sedation and falls risk, especially in older adults and when other sedatives are co-prescribed.
- Infection symptoms (fever, sore throat) given rare neutropenia; prompt evaluation is appropriate when symptoms arise.
- Mood elevation or agitation in bipolar-spectrum illness; coordinate prevention plans via the bipolar disorder hub.
| No | 2025-10-05 |
|---|
| Major depressive disorder. View labelExact | Initiate 10 mg once daily; increase to 20 mg once daily after at least 7 days if tolerated.[label_vortioxetine] | Multimodal antidepressant: SERT inhibition plus 5-HT receptor modulation. | CYP2D6, CYP3A4, CYP2C19 | Single-dose mean 66 h; Steady-state mean 66 h | No | — | - Suicidality and psychiatric activation during initiation and dose changes, especially in younger adults.[label_vortioxetine]
- Nausea and early GI tolerability during the first 1–2 weeks; supportive care and dosing time adjustments can prevent premature discontinuation.
- Sodium in older adults or patients on diuretics if symptoms suggest hyponatremia (confusion, fatigue, falls).[label_vortioxetine]
- Medication reconciliation for CYP2D6 inhibitors/inducers that can shift exposure and tolerability.[label_vortioxetine]
- Mood elevation or mixed features in bipolar-spectrum illness; coordinate monitoring plans via the bipolar disorder hub.
| No | 2026-02-22 |
|---|