Open AccessBupropion-warfarin Combination: A Serious Complication
Author(s) -
Amar Bavle,
Akshay S Phatak
Publication year - 2013
Publication title -
indian journal of psychological medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 24
eISSN - 0975-1564
pISSN - 0253-7176
DOI - 10.4103/0253-7176.119488
Subject(s) - bupropion , warfarin , medicine , complication , depression (economics) , anesthesia , tricyclic antidepressant , antidepressant , tricyclic , deep vein , thrombosis , surgery , pharmacology , smoking cessation , atrial fibrillation , pathology , hippocampus , economics , macroeconomics
Depressive illness and thromboembolic disorders are both highly prevalent. Warfarin is frequently combined with an antidepressant drug, the choice of which depends mainly on the risk of a hemorrhagic complication. Patients requiring the warfarin are often in the older age group, where the newer antidepressants with a better safety profile are preferred over tricyclic antidepressants. We report herein, a patient who was on bupropion for depression, when he developed deep vein thrombosis high-risk. Warfarin was started. While on this combination bupropion was abruptly stopped. This caused a more than two-fold elevation of international normalized ratio (INR) above the level, which is considered a high-risk for a hemorrhagic complication. INR reverted back to the desired level on reintroduction of bupropion. This indicates that a bupropion-warfarin combination should be used with the caution, though there has been no reported interaction so far.