Seizure During Combination of Trimipramine and Bupropion

Letter to the Editor

Sir: In recent years, published reports have suggested that the combination of bupropion with either selective serotonin reuptake inhibitors or with tricyclic antidepressants (TCAs) may be safe and effective options for patients with treatmentresistant depression. I report a patient who was successfully treated with the combination of bupropion and trimipramine, but experienced an unexpected and substantial increase in her plasma level of trimipramine associated with a witnessed generalized seizure.