ADHD & Depression: Important Drug Interactions

This question is more directed toward drug-drug interactions and the role of Cytochrome P450:

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.

(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

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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