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Is anyone taking Bupropion & SSRI together?


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Thankfully my body seems to be getting used to the med (Bupropion 300mg/day) and the side effect of excess irritability seems to have gone away. I haven't had an anger bout for a while now. I have more energy than before and was feeling well ... until a week ago, until I had one of the worst PMS/PMDD in a long while ... I felt like my depression suddenly came back. I was feeling tired all day, at one point I had to lie down for an hour or two. It was hard to concentrate and complete a task and that awful feeling of "things are not gonna get better" crept back ... 

I did some research and found out that unlike SSRIs, Bupropion doesn't help with PMS ... and it is rather common to couple Bupropion with an SSRI for a better, sustained result.

So, I'd like to ask those who are taking both Bupropion & SSRI, which SSRI he/she is taking and at what dosage, also if there were any bad side effects from combining the two meds ... I'm considering asking my doctor to add Prozac to my prescription. 

This topic may have been addressed in this forum before. In such case, I'd appreciate it if you could point me to the thread(s), 

Thanks,
Irene

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I am currently on Wellbutrin 100mg SR and I started with Lexapro for anxiety at 5mg a month ago. I started the Lexapro a week before Wellbutrin. It seemed like the Lexapro gave me terrible anxiety the first 3 days of taking it.. but then it went away and the obsessive anxious thoughts I used to have minimized a lot. Decided to go on Wellbutrin because of depression and sexual side effects of Lexapro. Been on Wellbutrin for 3 weeks, the first 2 weeks were hell with my PMS and just gave me 10x more anxiety than I had before I started any of this medication. Only these past 2 days I've noticed the anxiety subsiding, so I am trying to stick with it. Maybe the anxious side effects from the Wellbutrin is diminishing or maybe it's letting Lexapro help now. 

I would suggest adding an SSRI to help with anxiety though, definitely, How long have you been on the Wellbutrin so far?

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  • 2 weeks later...

I did Effexor 225mg and Wellbutrin SR 300mg together for some time and it's safe.  Wellbutrin is pretty compatible with SSRI's and SNRI's since it only affects dopamine, so it shouldn't be a problem.  But, as always, you can't be sure until you get a genetic test, since everyone's brain is different.

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Thank you all for your replies. I have added 20mg of Prozac and actually reduced Bupropion to 1x150mg-SR a day. Bupropion can give you energy (which I desperately need), but can increase anxiety level too ... I think I was being extra worrisome and having extra negative thoughts because of it, plus my OCD symptoms (I have a bad habit of fiddling with my hair when nervous), which had totally subsided when I was on an SSRI came back ... 

I did rather well when I was on Effexor (SNRI) 75mg, and wanted to increase to 150mg, but it raised my blood pressure to 150/110, and my doc. told me to discontinue ... So I thought I need something to work on my dopamine level, so decided on Bupropion. Guess I need both dopamine and serotonin level balanced ... 

It's only been a week since starting Prozac, but I think I'm beginnig to feel better ... (could be placebo effect?)  I hear Prozac is a slow-working med and could take several weeks to achieve full effect, so I should be patient. I'll see how I feel after a month and may increase Bupropion back to 300mg again. 

Trial and error may continue (such is life) ... but I hope I'll find my best meds combo. And I pray you all find relief from what you're struggling with. 

Irene

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On 8/16/2016 at 5:47 PM, ToxicBunny said:

I am currently on Wellbutrin 100mg SR and I started with Lexapro for anxiety at 5mg a month ago. I started the Lexapro a week before Wellbutrin. It seemed like the Lexapro gave me terrible anxiety the first 3 days of taking it.. but then it went away and the obsessive anxious thoughts I used to have minimized a lot. Decided to go on Wellbutrin because of depression and sexual side effects of Lexapro. Been on Wellbutrin for 3 weeks, the first 2 weeks were hell with my PMS and just gave me 10x more anxiety than I had before I started any of this medication. Only these past 2 days I've noticed the anxiety subsiding, so I am trying to stick with it. Maybe the anxious side effects from the Wellbutrin is diminishing or maybe it's letting Lexapro help now. 

I would suggest adding an SSRI to help with anxiety though, definitely, How long have you been on the Wellbutrin so far?

I'm no expert on antidepressants, but I hear many say that the first few months of Bupropion are rather rocky. I was extra impatient and irritable, had anger bursts too. But after a month or so, those negative feelings gradually lessened ... but not completely, so after 3 months of being on it, I decided to cut the dosage in half and added Prozac. I think I feel better now. I'm hoping adding SSRI eases my PMS too. 

Lexapro was the first med my current doc. prescribed for me, but I felt drowsy and zoned out, even fatigued, most of the time for 2 months so I had to change it to something that gives me energy. Seems the same med can have a different (sometimes totally opposite) effect on each person. 

I do agree Bupropion + SSRI is a good combo and learned that it's commonly prescribed. It's just that finding the right dosage of each could take some time. Hang in there, sister! Talk to your doctor periodically and inform him/her of the changes in your feelings/mindset, good or bad. I recommend keeping a diary to track what you experience, both physically and emotionally due to the meds.    
 

Edited by Irene Iesu
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2 hours ago, Irene Iesu said:

I'm no expert on antidepressants, but I hear many say that the first few months of Bupropion are rather rocky. I was extra impatient and irritable, had anger bursts too. But after a month or so, those negative feelings gradually lessened ... but not completely, so after 3 months of being on it, I decided to cut the dosage in half and added Prozac. I think I feel better now. I'm hoping adding SSRI eases my PMS too. 

Lexapro was the first med my current doc. prescribed for me, but I felt drowsy and zoned out, even fatigued, most of the time for 2 months so I had to change it to something that gives me energy. Seems the same med can have a different (sometimes totally opposite) effect on each person. 

I do agree Bupropion + SSRI is a good combo and learned that it's commonly prescribed. It's just that finding the right dosage of each could take some time. Hang in there, sister! Talk to your doctor periodically and inform him/her of the changes in your feelings/mindset, good or bad. I recommend keeping a diary to track what you experience, both physically and emotionally due to the meds.    
 

Thanks for the reply! I've felt better the past week. I asked my doctor to increase my Wellbutrin (well generic bupropion) dose after a month of being on 100mg SR   because all the bad side effects seemed to go away but I was still depressed, not anxious but depressed. But he'd only let me go up to one 150mg SR a day. I told him I heard a lot of people start at 150mg a day and take it for like a week then go up to 300mg a day. He said to give it another month on the 150mg and see how I do. >_< I've had bouts of 'happiness' periodically for like an hour at a time but then it'd just go away. I don't know if 150 a day is enough for me but he wants me to wait another week. Do you think I should be patient and wait? I never got the honey moon effect in the beginning either. Did you have bouts of happiness at times but then depression after? And did it finally level out to a consistent feeling of good? I'm just curious. It's been a month on 100mg SR and only now a week of 150mg SR. Haven't really had any bad side effects going up the 50mg other than a little anxiety and irrability. When do you take your Prozac? I take my 5mg Lexapro at night and my Bupropion around 10:30 am because I take Synthroid in the early morning around 7am.

And yes my PMS is horrid. Hoping this time around it'll be better. Hopefully for you too!

Edited by ToxicBunny
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On 8/28/2016 at 4:52 PM, ToxicBunny said:

Thanks for the reply! I've felt better the past week. I asked my doctor to increase my Wellbutrin (well generic bupropion) dose after a month of being on 100mg SR   because all the bad side effects seemed to go away but I was still depressed, not anxious but depressed. But he'd only let me go up to one 150mg SR a day. I told him I heard a lot of people start at 150mg a day and take it for like a week then go up to 300mg a day. He said to give it another month on the 150mg and see how I do. >_< I've had bouts of 'happiness' periodically for like an hour at a time but then it'd just go away. I don't know if 150 a day is enough for me but he wants me to wait another week. Do you think I should be patient and wait? I never got the honey moon effect in the beginning either. Did you have bouts of happiness at times but then depression after? And did it finally level out to a consistent feeling of good? I'm just curious. It's been a month on 100mg SR and only now a week of 150mg SR. Haven't really had any bad side effects going up the 50mg other than a little anxiety and irrability. When do you take your Prozac? I take my 5mg Lexapro at night and my Bupropion around 10:30 am because I take Synthroid in the early morning around 7am.

And yes my PMS is horrid. Hoping this time around it'll be better. Hopefully for you too!

Hi Bunny!  ... I think you're too sweet to be called toxic ;-)

Good to hear that your condition is getting better :) I'm taking generic Bupropion too. I read some user reviews that said the brand name Wellbutrin works much better with less side effects, but my insurance doesn't cover it, so ...

I'm now taking 150mg-SR once a day too. I take Prozac 20mg upon waking up around 6, since it has more activating effect on me than sedating, and Bupropion about an hour later with breakfast (it sometimes upsets my stomach if taken without food). It's been a week since I reduced Bupropion to 150mg, and I actually feel rather better. (or could be due to adding Prozac?) My anxiety is not that bad anymore, and I have much easier time falling asleep at night.

I totally understand that you're so anxious to feel better (I was too!), but your doctor may be right. If smaller dose works, it's always better. And perhaps for people who take other meds, there might be interactions, so caution is needed. You can always get a second opinion (see a different doctor), but I tend to trust doctors who are careful in prescribing meds.

I haven't really felt "happy" in an euphoric sense from Bupropion. Never had so-called honeymoon either. It gives me energy so I can get out of bed in the morning and don't have to lie down during the day, I don't get so easily tired like I used to. Since reducing the dosage, I feel I have a clearer mind and can function better. I think my condition is unipolar and not bipolar, I don't really have "ups" (as in bouts of happiness) per se. As long as I can evade "downs", I'm content.

I may have felt "happier" when I was taking Prozac 60mg (for me, it took this much to work), but I began to have severe dry mouth/throat and coughed a lot during the night to the point my sleep quality was compromised, so I had to stop. I'm hoping this time the small dose of Bupropion and Prozac will complement each other and avoid troublesome side effects altogether ... I'll wait another month before increasing either of the meds. If I can feel "normal", I think the meds are working.

I believe real happiness that lasts can't be achieved with drugs (don't mean to preach tho, I admit I used to drink every night seeking the euphoric feeling), but by finding a purpose in your life, something you'd be passionate about and can give you a sense of fulfillment. I myself have a lot of work to do to feel truly happy, but you know, I feel blessed that even I suffer from depression (and probably ADD), there are medicines for it and the society is becoming more understanding compared to, say, 50 years ago. There's always hope, so hang in there ;-)

Edited by Irene Iesu
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On 8/24/2016 at 11:45 PM, PollieSleeps said:

I did Effexor 225mg and Wellbutrin SR 300mg together for some time and it's safe.  Wellbutrin is pretty compatible with SSRI's and SNRI's since it only affects dopamine, so it shouldn't be a problem.  But, as always, you can't be sure until you get a genetic test, since everyone's brain is different.

Believe it or not, Wellbutrin actually has a much higher affinity for norepinephrine than dopamine. In fact it's a fairly weak inhibitor of dopamine in comparison to norepinephrine.

Prozac actually was approved for maintenance treatment of PMDD specifically in the form of Sarafem. The way Sarafem is dosed though for PMDD. I think you skip doses for a few days or something? I don't know I don't really understand that dosing schedule.

Also @Irene Iesu what you heard about the generics of Wellbutrin is actually partially true. The FDA conducted an investigation into specifically the generics of the bupropion XL formulation. They found that Watson and Teva pharmaceuticals were selling generics that were not bioequivalent. Essentially the pills were "melting" too fast and the dose was being released to quickly. I took the Watson generic at 150mg a few years ago and only lasted about 10 days on it for this very reason. I'm taking it now and have no issues (actually I'm taking Aplenzin, bupropion hydroBROMIDE vs hydroCHLORIDE, so the analogy I used in a previous post is like comparing lemons to limes, all the components of a citrus but different fruits).

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16 hours ago, flasquish said:

I take 50mg of Sertraline and 300mg of Buproprion. This combo is very effective for me, been on it for over a year and I'm very happy with the results, I'm calm and the effects of the Buproprion help me have a normal sexdrive. 

I can imagine that would be quite a good combination. Sertraline is one of those drugs that is an SSRI but it actually has more affinity for dopamine reuptake inhibition than other SSRIs that are equally effective, like Lexapro which is probably the most selective of all the SSRIs and considered by some to be the most "potent" (loosely speaking, interpret as you will).

So the effect on the dopamine transporter would in theory work synergistically with bupropion's effect on dopamine for a stronger effect.

Edited by browri
ambiguous wording
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  • 5 months later...

I take effexor 150mg (the generic) and wellbutrin (also generic). Two weeks and a day ago I started the wellbutrin at 150mg. About 10 minutes after taking my first one I felt the most relaxed I have felt in a long time and for the next two weeks. As directed I started 300mg of the wellbutrin yesterday. The headache started half way through the day. I feel a little irritable and the nausea has been off and on ALL day and I hate it! I'm only on day 2 of 300mg...will it get better? I go back in two weeks to see how I'm doing and if I'm not any better by then I'm going back to 150mg of the wellbutrin because I just felt awesome all around.

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  • 4 months later...

I've been on 25mg celexa for a year. Prior to that I was on 30 mg celexa for 5-6 years. Tried to tapper down due to emotional flatline, low energy but, only was able to go down to 25 mg.  Pdoc just added 150 Wellbutrin to my cocktail.  It has only been a week for me so I cannot if this combo will work for me.  Aside from more energy to do things and minor irritability, I don't feel much of a difference.   

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  • 3 months later...

I was formerly taking Prozac, by itself for years. Eventually, I was up to 60mg. per day.  Every time I tried to add Wellbutrin, I would get irritable, anxious, worried, emotional, etc. A few months ago, a decided to keep taking it to see if I would adjust to it. I was so depressed that I wasn't getting anything done. I figured it would motivate me.  In the beginning, I would wake up really early and not be able to go back to sleep, which was a good thing for me.  After a few weeks, The side effects subsided, as my body adjusted to the med. Now, i'm not as energetic and motivated, but I do think it's working and it might be helping with depression. I take 150 Wellbutrin SR, twice per day and 20mg of Prozac/per day (both are brand name). 

BTW, a common side effect of SSRI's anorgasmia, or ability to orgasm.  Wellbutrin totally overrides that side effect, for me.  I has been studied and documented. If anyone is having this side effect, combining Wellbutrin works. 

Edited by drumur
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