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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by tony p on March 29, 2016, at 23:24:11
My pdoc has added Wellbutrin (bupropion) to my Cipralex (Lexapro, escitalopram). I started out on 20 mg Cipralex & 150 mg Wellbutrin, but had to cut back on both (10 mg Cip, 37.5-75 mg Wb) -- I am still trying to find the ideal dose, I'm very sensitive to Wellbutrin.
Recently I checked interactions on RxList and this combination was red-flagged, Wb can elevate escitalopram levels so there is risk of Serotonin Syndrome. On my pharmacist's advice I started checking my blood pressure & pulse, and found that by late afternoon my BP was considerably elevated -- 160+/85+. When I cut my Cipralex from 20 mg/day to 10, my BP dropped noticeably but was still elevated.
My GP checked my BP and found it normal and told me to stop worrying -- obsessing about my BP was probably driving it up! But I'm still concerned. Anyone else have experience with this combo, especially if you're sensitive to stimulants as I am?
Posted by tony p on March 29, 2016, at 23:30:51
In reply to Lexapro / Wellbutrin combination - dangers?, posted by tony p on March 29, 2016, at 23:24:11
Forgot to say, in the midst of my worries, that I am feeling *fantastically* better on this combo, almost hypomanic! I've been tackling chores I've put off for months or even years. I go to bed at night feeling that life is worthwhile again, especially if I've accomplished at least one sane thing during the day! Still feel pretty lousy waking up, but meds & a double espresso ;-) soon fix that.
Posted by rjlockhart37 on March 30, 2016, at 0:14:12
In reply to Re: Lexapro / Wellbutrin combination - dangers?, posted by tony p on March 29, 2016, at 23:30:51
There should not be an interaction, i knew a few frineds who took lexepro and wellbutrin, it's just like doing it with prozac....i was on prozac 60mg and wellbutrin 300mg for a long time, if you took another SSRI, or a MAOI, or tramadol you would be in trouble, but really there should not be any life threating reaction
lexepro is selective serotonin more than other SSRI's so it has low low interaction with bupropion
Posted by J Kelly on March 30, 2016, at 10:51:39
In reply to Re: Lexapro / Wellbutrin combination - dangers?, posted by tony p on March 29, 2016, at 23:30:51
> Forgot to say, in the midst of my worries, that I am feeling *fantastically* better on this combo, almost hypomanic! I've been tackling chores I've put off for months or even years. I go to bed at night feeling that life is worthwhile again, especially if I've accomplished at least one sane thing during the day! Still feel pretty lousy waking up, but meds & a double espresso ;-) soon fix that.
Wow this sounds great! Hope you get the kinks worked out. Seems worth tweaking this around a bit if you have to. I would love to have those results :)
Jade
Posted by Christ_empowered on March 30, 2016, at 12:04:03
In reply to Re: Lexapro / Wellbutrin combination - dangers? » tony p, posted by J Kelly on March 30, 2016, at 10:51:39
I know some people who were on lexapro+wellbutrin, and it worked fairly well. If I recall, one acquaintance did need Ambien for sleep issues that may have been related to the combo.
There's a little bit of research on AD combos. I think most of the research is on remeron+effexor. For a while that was a last ditch effort for depression. Now, I think some docs (at least around here) do lil cocktails from day 1.
Anyway...if it works, that's what matters. Tinkering with dosage may be the most important thing, or at least that's how it sounds to me. As rj mentioned, there are other ssri drugs you could try and there's also other augmenting drugs besides wellbutrin you could look into, with your pdoc. Remeron and some tca drugs come to mind, along with buspar and low dose stimulants.
Hope things work out for you.
Posted by tony p on April 3, 2016, at 12:19:07
In reply to Lexapro / Wellbutrin combination - dangers?, posted by tony p on March 29, 2016, at 23:24:11
Tnx for your contribs ... I'm pretty sure now there is a relationship between dose (of both meds) & BP, for me at any rate. I was just in hospital for a couple of days (dislocated shoulder), they gave me the full dose of Wb & Cip and the next morning my BP was 175/90. 2 days later, at home, & after 1/4 dose Wb & 1/2 Cipralex, I was 125/75 at same time of day.
Of course, being in hospital is enough to put anyone's BP up :-)
Oh, and inevitably I suppose, my orthoped-doc gave me Tramadol for pain! But I took quite a lot last night (8 x 37.5 in 18 hr. I think) and this morning was the normal BP reading above.
So, I'm going with 1/4 Wellbutrin tab (37.5 mg) and 10 mg Cipralex for now. Will titrate up if my mood goes downhill -- and I'll follow my GP's advice & stop worrying!
Posted by Zyprexa on April 7, 2016, at 0:47:27
In reply to Re: Lexapro / Wellbutrin combination - dangers?, posted by tony p on April 3, 2016, at 12:19:07
I think wb can raise BP. I've been taking it for many years now and have always taken a BP med with it. Also you take the ir version and that might have a BP spike. You might want to take an sr or er. Also BP med.
Posted by Samuel Morgan on April 7, 2016, at 23:39:29
In reply to Lexapro / Wellbutrin combination - dangers?, posted by tony p on March 29, 2016, at 23:24:11
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