Posted by King Vultan on April 30, 2004, at 7:35:29
In reply to Can you take Strattera Wellbutrin together?, posted by alohashirt on April 29, 2004, at 23:32:46
> Can they be used in combination to address ADHD?
> Do they have competing effects?
>
> What about with concerta?Strattera is a powerful and selective norepinephrine reuptake inhibitor, while Wellbutrin is a combined norepinephrine/dopamine reuptake inhibitor. The combination might be a good one for ADD; however, keep in mind that Wellbutrin is a CYP-450 2D6 inhibitor, and Strattera is a 2D6 substrate. Wellbutrin will increase blood plasma levels of Strattera beyond what would normally be expected at any particular dosage. While this is not of the same concern as combining Wellbutrin with a tricyclic, which are cardiotoxic and lethal in overdose, it may cause excessive adverse effects with the Strattera if this is not taken into account and the Strattera dosage adjusted accordingly. I would not swing for the fences right away but rather, start at a lower level and increase the dosage cautiously.
Strattera itself is not a 2D6 inhibitor, and the Wellbutrin blood plasma levels themselves will be unchanged. The issue of 2D6 inhibition is one that is looked at closely on new drugs that are being introduced because it is such a problematic one.
Todd
poster:King Vultan
thread:341591
URL: http://www.dr-bob.org/babble/20040429/msgs/341699.html