SUMMARY

• There are no studies evaluating the efficacy or safety of concurrent treatment with bupropion and SPRAVATO.
• In phase 3 clinical trials in patients with major depressive disorder and acute suicidal ideation or behavior, SPRAVATO was combined with standard-of-care (SOC) oral antidepressants (ADs), which was initiated or optimized with an AD alone or AD plus augmentation therapy.^1,2 Therefore, patients may have been taking concomitant bupropion. However, no systematic evaluation of safety or efficacy was performed in that subset of patients.
• In a phase 1 study, esketamine (ESK) 84 mg administered twice weekly for 2 weeks, and oral bupropion administered at baseline and 24 hours after the last dose of ESK, did not affect the pharmacokinetics (PK) of bupropion.³
• SPRAVATO may increase blood pressure and require monitoring prior to initiating, and during, treatment.⁴
• Please contact the manufacturers of bupropion for more information regarding the safety and drug-drug interactions for this product that may cause or exacerbate adverse events.

CLINICAL DATA

Phase 1 Study with Bupropion

An open-label, multiple dose, parallel-group study was conducted to evaluate the PK, specifically the induction potential, of ESK on CYP2B6 activity using oral bupropion (a CYP2B6 substrate) in healthy subjects.³

• The bupropion cohort (n=13) received 150 mg oral bupropion on days 1 and 19 and ESK 84 mg on days 4, 7, 11, 14, and 18.
• The plasma and urinary PK of bupropion and its metabolite, hydroxybupropion, were not affected by multiple administrations of ESK.

Literature Search

A literature search of MEDLINE^®, EMBASE^®, BIOSIS Previews^®, and DERWENT Drug File (and/or other resources, including internal/external databases) pertaining to this topic was conducted on 08 April 2024.