Pharmacy PEBC Practice Exam

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AM has been taking bupropion XL 300 mg po daily for four months for the treatment of depression and reports to the pharmacist that he is not experiencing any improvement in his symptoms. After the pharmacist consults with the prescriber, it is decided to change his medication to citalopram 20 mg po daily. Which of the following is the recommended method for making this switch in antidepressant therapy?

Stop bupropion and start citalopram 20 mg daily the next day.
Stop bupropion and wait 7 days before starting citalopram 20 mg daily.
Taper bupropion over 7 days and then start citalopram 20 mg daily.
Start citalopram 20 mg daily and then taper bupropion dose over 7 days.

The correct answer is: Taper bupropion over 7 days and then start citalopram 20 mg daily.

The recommended method for switching antidepressant therapy in this situation is to taper bupropion over 7 days and then start citalopram 20 mg daily. This allows for a gradual decrease in the bupropion dosage, which can help minimize any potential withdrawal symptoms. Option A and B are not recommended because they involve abruptly stopping bupropion, which can cause adverse reactions. Option D is also not recommended as it involves starting citalopram before fully tapering off bupropion, which can potentially lead to drug interactions and increased side effects. Therefore, option C is the safest and most effective method for switching to citalopram in this scenario.