I'm currently taking Lexapro 40 mg along with 300 mg Wellbutrin XL for MDD and anxiety. I take the WB to augment the Lexapro, as well as to deal with some of Lexapro's side effects (mainly anorgasmia). When I first upped to 300 WB XL, I felt the difference in about a week. I felt normal, even good for about 4 days. The last couple of days I've felt iffy. It doesn't help that it's gone from being really cold and blindingly sunny (I love sun, don't care about the cold...I'm a bit SAD-ish in there i'm sure too) to being really grey and drizzly. Total yuck. I also have a couple of stressful things coming up later this week.

Pdoc (who I see again in 2 weeks) said that I should go up to 450 Wellbutrin after a week at 300 if I wasn't feeling better. Thing is, I *was*- for about 4 days. Every time he has suggested a med change, he ramps it up pretty quickly. I started seeing him when I was only on 20 mg Lexapro and it had stopped working. Right away, we upped it to 30, and then after (only) a week at 30, he said to up it to 40, for example. This seems fast to me, but maybe this is what they usually do. Dunno.

Anywho, one of the stressful events is coming up this weekend. I have to go out of town to visit my mother with my kids, it involves being in the car for 6 hours each way. Not exactly relaxing.

So, my question is: Do I up to 450 mg WB? (I know pdoc would want me to do this.) And if so, when? I am thinking it might be safest to wait until Monday, when I am back in town, if I this feeling doesn't pass by then.

Also, I'm really wondering if I simply haven't given 300 mg enough of a chance. I started 150 mg on Jan 20, then upped to 300 mg on Jan 28, which means I've been on 300 for about 12 days.

I'm not feeling unbearable. Just a bit down with some low-level anxiety.

I guess the nagging thing at the back of my head is the risk of seizure. I don't have any of the risk factors. I did ask pdoc about this, he said that 450 mg of the XL is fine- that other formulations at high dosages carry more of a risk.

Also wondering if it is okay to take the odd 0.5 mg of ativan when the anxiety is a bit too much. I don't take it regularly, and I've never taken more than 1 mg total in a day.

The other nagging thing at the back of my head is that maybe it's all about the Lexapro. It has worked at various doses- for awhile. Maybe it isn't quite right for me. The next step he said would be to swap the Lexapro for Cymbalta.

Help? Anyone?