This question is more directed toward drug-drug interactions and the role of Cytochrome P450:
Atomoxetine is metabolized by CYP2D6, so we should avoid medications inhibiting CYP2D6.
CYP2D6 inhibitors are classified into following three categories:
(A) Strong inhibitors: one that causes a > 5-fold increase in the plasma AUC values or more than 80% decrease in clearance.
- Fluoxetine and
(B) Moderate inhibitors: one that causes a > 2-fold increase in the plasma AUC values or 50-80% decrease in clearance.
(C) Weak inhibitors: one that causes a > 1.25-fold but < 2-fold increase in the plasma AUC values or 20-50% decrease in clearance.
Based on this information, Sertraline is the best option available
Interaction Between Atomoxetine and Bupropion:
An open-label, non-randomized, two-period, sequential clinical trial was conducted (reference 3). They found:
- the effect of bupropion on CYP2D6 activity was responsible for an increased systemic exposure to atomoxetine (5.1-fold) and also for a decreased exposure to its main metabolite 4-hydroxyatomoxetine-O-glucuronide (1.5-fold)
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Psychotropic Medications: Drug-Drug Interactions
(1) Medications affecting Clozapine levels:
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(2) Interactions with Warfarin: (I) Antidepressants:
(3) Interactions with Warfarin: (II) Antipsychotics:
(4) Antidepressants and Cardiac Medications:
(5) Lamotrigine and Oral Contraceptive Pills:
(6) Lamotrigine and Other Anticonvulsants (Carbamazepine, Phenytoin, Phenobarbital, Pyrimidine or Valproate):
(7) Tamoxifen and Psychotropic Medications:
(8) Medical Cannabis and Psychotropic Interactions:
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