lexaro and wellbutrin

Has anyone ever been on these 2 together? My depression is not lifted enough on cymbalta at 90. I am drowsy after i take it. I dont know how much longer I should give this med. Its been about 3 or 4 weeks. I was better on lexapro but had a lot of difficulty sleeping and had sexual side effects.

Im wondering if I took 10 of lex instead of the 20 I was on before the side effects might not be so bad. My therapist suggested wellbutrin and lex as a possibility with a lower dose of lexapro. I see my PNP on wed.

Any thoughts?

Hi Blue, yes, lexapro (or other SSRIs) and wellbutrin are often prescribed together when the SSRI is not enough to alleviate depression, when the SSRI causes sexual dysfunction, when the SSRI has too numbing of an effect, or when the SSRI makes you sleepy.

One question I would have is have you reached a therapeutic dose with the Cymbalta, or are you still heading towards that? If you have only begun it in the last month or so, you may not have reached a therapeutic dose yet and may not have come into equilibrium yet. What does your prescriber say? Does he/she want you to discontinue the Cymbalta, or work towards a higher dose?

I have never taken an SSRI before, but I take Wellbutrin. I find it to be an effective AD even without an SSRI and it also helps with ADHD. I have often wondered why Wellbutrin isn't prescribed more frequently for depression by itself. Some people cannot tolerate it--it is too activating for them. For people who have a lot of anxiety with their depression, Wellbutrin on its own might not be a good choice.

I think I have been on that combo. Lexapro and whatever it's citalopram petered out on me after a while. Wellbutrin has been the most effective AD for me, but also seems to induce some anxiety symptoms, at least for me.

I took 300mg a day. It was pretty effective.

I took Lexapro and wellbutrin together for about a year and a half. I personally did not like lexapro. It really created a fog in my brain and made me really tired. (I will say though that a lot of psychotropic meds make me really tired.) When I dropped the lexapro, I felt SO MUCH better. Of course, I feel like crap now, and I've had a lot of med changes and really cannot find anything that works right for me. I digress...

Thank you so much for your replies. I will see my PNP wed if this snow storm here in the northeast allows it!

I will not go up any further with cymbalta. It makes me too tired and constipated. yuck. I am on 5 of lexapro and when i drop that on fri I dont think Im going to feel any better.

I was told wellbutrin alone wouldnt be for me as it is for anxiety symptoms and mild depression. My depression isnt mild and I dont have anxiety symptoms. But maybe it would boost lexipro which I loved. If only it didnt keep my brain going and going and let me sleep normally. I am slowed down a bit on cymbalta and this med doesnt hold up if I feel stressed. I get the same depression symptoms.

Perpetually- what will your doc try next? Have you tried cymbalta?

I just don't know what he will try next. I am really frustrated right now with all the trouble I've been through the last few months. I'll probably stay on the Wellbutrin for the immediate future, but I am also working on finding an anti-psychotic that works well for me. Once we get that worked out, then we move on to a mood stabilizer.

I'm tired of taking meds, but I've done the whole quitting thing 2 different times now and I know that's not the road I need to be on. Is cymbalta an SSRI? I don't really like the way those make me feel. I've taken several and its like its just not exactly the right thing...I don't know. I know that doesn't make any sense.

Ug, I don't know. Thanks for asking though. That was really thoughtful of you!

Do they ever make you feel fearful; and paranoid? I have had that feeling with tricyclics and I may have had that in the beginning with cymbalta.

I think it is an ssri, but someone else may know better than me.

Have you tried symbyax? It has a small dose of anti-psychotic with an AD (I think similar to prozac).

I've never even heard of symbyax. So I will ask my pdoc about it.

I tend to be paranoid in general, so I haven't taken note of whether the med I'm on amplifies my paranoia or not, I guess I just think I am going through on of those bad times when ever its worse.

((((Perpetually)))) Im sorry. Ask your pdoc about it, It couldnt hurt to ask, i guess.

Im now going off cymbalta and up in dose with lexapro and gradually to increase wellbutrin (its called something else on the bottle...buprion or something like that...).
Im basically on 3 meds now and trying to get off cymbalta. I wonder what the SE would be to get off quickly.

I would disagree with this. Wellbutrin is highly activating, and people with anxiety often have difficulty taking it (not universal, but often an issue). I think your prescriber might have got that backwards. Wellbutrin is often prescribed to people who are depressed but do not have anxiety. It can also be highly effective for some people who have major depression. If you are depressed but do not have anxiety, Wellbutrin may be helpful to you. The antidepressants that are particularly helpful for people with anxiety and depression are some of the SSRIs: lexapro, celexa, and paxil. And probably some of the other SSRIs too, but lexapro and paxil are classic in this regard. In fact, they are both frequently prescribed for anxiety with no depression.

Wellbutrin works primarily on dopamine. If you don't have enough dopamine in your system, wellbutrin is a good choice. It was interesting that after just one session with my PNP, she said to me, "you need more dopamine" LOL. Somehow, from all the questions she asked, she knew that. I also had anxiety, and she explained how more dopamine could make that worse, and it was going to be hard to find one med to do it all. So I might need a second drug to add to the wellbutrin to help with the anxiety. But I decided to use non-medical means to help with the anxiety. Wellbutrin is such a great drug for me, it has truly helped elevate my mood. Another thing that appealed to me is that it is weight neutral--some people lose weight on it too. I am overweight so the least thing I need is to take an SSRI and gain weight, which is not uncommon. My mother was severely underweight and was prescribed celexa and within a month was able to gain 8 pounds! That was literally a lifesaver for her. She was light as a feather and I often worried she would blow away in a strong wind. So if someone is having difficulty gaining weight, an SSRI can be helpful. (Some SSRIs are considered weight neutral, like lexapro, and others often result in weight gain, like paxil.)

Wellbutrin doesn't actually boost lexapro. It acts in a completely different path. It doesn't make lexapro more effective. It acts on its own, independently, whether lexapro is present or not.

Since wellbutrin is highly activating, it is probably not going to make sleep any easier for you. But who knows. It definitely sounds like it's worth a try.

(Cymbalta is an SNRI. It is also often prescribed for depression + anxiety.)

Maybe I got it wrong? She said she didnt want to put me on something that might increase "rages" in me. But I do want something activating and I told her that. I cant stand the slowed down-ness of cymbalta. I dont have anxiety, but my depression is not mild and needs to be treated.

Thanks for the lesson, Sunny. Yes, I really like that about lexapro and wellbutrin and I feel the effects already. I also feel some of the depression returning as I go off the cymbalta. I wish I could go up with lexapro. I am on now cymbalta 60, lex 10 and wellb 150. I am going to cymbalta 30 and 10 of lex but am I really going to feel better? This could only get worse until I go up on wellbutrin. I want to do it quicker than my PNP wants me to.

What are the effects of going off cymbalta too fast? I am at 60 from 90 this past tues. So, its been 3 days at 60. I want to go to 30 on mon or sun.

I wonder why I keep hearing the word boost. And that wellbutrin can actually block the sexual side effects of lexapro.

Im taking it in the morning. The lex I still take at night b/c it makes me dizzy. I may try again to do mornings and I think I would sleep better then.

What is SNRI? I can see where it would be for anxiety. But for me, I feel like my energy and drive is missing. Id rather sleep. I got so much accomplished on a daily basis with lexapro.

Lexapro worked great for me for a long time. I did have problems with foggy brain. And generally not giving a poop. But at the time it was a good thing because everything would either upset me or tick me off. There really wasn't a happy medium at that time. And I felt the effects of it almost immediately. Like within the week I felt relief. That worked for a long time. Then had some major stuff happen in my life (well, to me it was major). Doctor upped the dosage and that worked for awhile but then it just pooped out.

Now it feels like I'm just sampling all kinds of medications trying to find the right combo. Something that helps with my symtoms but without side effects that I just can't live with. I'm on 300mg of Wellbutrin. It doesn't seem to help enough. It seems to help in "waves" but leaves me drained by midday. But overall there is definite improvements. (I don't have the added energy boost people have mentioned) We tried adding in Effexor and that was horrible for me. We're using Prozac in place of the Effexor. I see the pdoc on Monday to find out what's next. Yay!?

Polarsmom- I think youre right- its a matter of tweaking to find the right combo of meds. I was on prozac for a long time and it pooped out after 2 yrs same with zoloft. This was in the 80s.

I am OK now, but going down tomorrow to 30 of cymbalta. I wasnt supposed to go up yet on wellbutrin, but I cant just go down. I will crash. I think I'll up the wellbutrin to 300 b/c that is what she told me to do next week, but I'll call her to do it a week early. Then after that off the cymbalta. I am hoping for the best.

How do you like prozac? I loved it when it worked.

I was switched over to Prozac when the Lexapro quit working. But my anxiety seemed more intense. And I tend to scrub when my anxiety is elevated. And I scrubbed like a mad women during that time!
Which is how/why I ended up on Wellbutrin. But the WB wasn't helping enough at 150mg so it was upped to 300mg. And that wasn't helping enough either. So she added Celexa. No good. Then we tried Effexor. OMG.... terrible. So I'm taking the Prozac to ween off of the Effexor.

Back to your original question..... Right now the last few days have been better. I'm not scrubbing. But it's only been a handful of days since I've been taking it.

I see my pdoc tomorrow. I am wondering what's going to be next. I need something that'll help with my exhaustion too. I have to talk myself out of NOT taking naps throughout the day. I also have trouble with motivation. I *want* to do stuff. (which is an improvement in itself) But I just don't have it in me to actually *do* it. It just seems like too much work. And then I get busy doing, well, nothing really. Just stuck in my head.

Wellbutrin can often help with the "slowed down-ness." I hope it helps you. Beware, sometimes Wellbutrin does increase "rages" so just watch yourself and see how it works in you. We are all so different, that finding the right meds is just trial and error.

I would follow your PNP's recommendations on the rate at which you increase the Wellbutrin. The body needs time to adjust. I was on 100 mg at first, then up to 150, then finally to 300 mg. Each time I would raise, I would get a boost, then it would level off. My hands were pretty shaky at 300 mg, and that never went away the whole time I was on that dose, which is considered a typical therapeutic dose. I am now down to 150 mg, and have been for quite a while. The hand shaking eventually went away. I take Vyvanse, which also increases dopamine, so I don't need as much of the Wellbutrin anymore. My PNP has suggested I completely stop the Wellbutrin, but I am doing well and don't want to rock the boat, at least at this time.

I think that can be hard. Don't go off too fast--follow the recommendation of your PNP.

I wouldn't use the word "block" as Wellbutrin on its own can somewhat increase sexual drive and functioning. So it is acting independently of Lexapro, which has the dampening effect. Wellbutrin has the "up" effect whether Lexapro is present or not. Use of the word "boost" is just sloppy usage--no biggy. (Your PNP may use it because she thinks it will make it easier for patients to understand, but hopefully she knows enough pharmacology to understand for herself that these drugs act in separate pathways.)

I have found Wellbutrin to be helpful in this same way. I was just able to do more. I hope it helps you too. Don't increase too fast. Follow guidelines of your prescriber. Wellbutrin at high doses (greater than 450 mg?) can have a side effect of seizures in some people. So best to go slow to get your body used to this drug. The body needs time to adapt.

Also, if you change too many things simultaneously, it can be hard to know which drug is causing what. Like if you decrease cymbalta a lot while simultaneously increasing Wellbutrin a lot, and you have some kind of unpleasant reaction, how will you know if it was caused by decreasing the Cymbalta or increasing the Wellbutrin? You might decide the bad effect was caused by the Wellbutrin and quit the wellbutrin, whereas the bad effect was really caused by decreasing the Cymbalta too quickly. So don't try to change too much at once, or you make it harder to figure out what is the best combo for you.

Good luck. Hope you can get to feeling really good soon.

That is quite a med story Polarsmom. I remember prozac giving me lots of energy. But wait! Before you are completely weaned off....please come visit me with your sponge!

That is pretty much exactly how I feel when I am depressed and need to up my medication. I want to "do" but cant. No motivation. Its all too much work. The lex took that away almost immediately.

I do hope you find some solution tomorrow. Post and let me know, OK?

Thanks Sunny, there was a lot of good info in your post. I went down to 30 tonight of cymbalta and I am supposed to stay at the same dose of lex and wellbutrin. I dont think it is going to be pleasant this week. How can this be a good thing unless I up the wellbutrin?
Well, maybe im jumping the gun here.

Question: Does wellbutrin begin to work quickly (like lexapro) or the effects are felt a little later, like weeks later?

I dont blame you for not wanting to rock the boat, I wouldnt either. When I find something that works, I stay with it and am thankful!

Not to be too cliche--but Rome was not built in a day. Would it be possible for you to tolerate it for a week?

It works very quickly, not like the SSRIs. I belive it would work more quickly than Lexapro. In some people, it can be pretty intense the first few days, and they cannot hang on and push through that, but just quit. That is one reason my PNP likes people to come onto Wellbutrin slowly, in several steps. But you are already at 150 mg, right? So if you were going to have a really intense reaction, it seems like you might have had it already--I don't know. Just hang in there, and go with your PNP's recommendations. One of my reactions each time I stepped up the Wellbutrin dose was reckless driving.

Guess I picked the perfect job for myself..... I'm a self-employed cleaning lady!

.

I agree about the WB. That first week can be a bit much for those that are stimulant sensitive. (which I can be as far as caffinated stuff. But with the WB it seem to make me feel calmer. Odd I know.) Anyway....I think they call it the honeymoon phase? (the first week or so) When I first started WB I was thrilled with the results. I was like YES! *This* is exactly what my body was looking for. I could think clearer. I felt motivated and felt like I had energy and just overall I felt better. Then it disappeared. I still had some clarity, but it didn't seem to last the whole day. That's when we upped the dosage to 300mg. And that helped for a short time too. Just doesn't last all day. And it comes in *waves*.

Lexapro worked like a magic pill for me. When I first started taking it I was, lets just say a tad bit on the cranky side. The Lexapro took that away.

Thanks Sunny and Polarsmom- This is the update. I am on 30 of cymbalta. I did not change the lexapro or wellbutrin. I am fine, I think. Im not as good as I was on 20 fo lexapro, but its OK.

The wellbutrin is fine- I dont notice any side effects at all. I take it in the morning and Id never know I took it. When I go off the symbalta (which I think will be friday) I will go up in the wellbutrin to 300.

So- all is well...so far...

Polarsmom- Isnt lexapro a good drug? I also love it.Too bad that it stopped working for you- most drugs have gone that way for me. I loved Lex at 20. I wonder if I COULD take it in the morning if it would have that effect. I was getting dizzy from it, but maybe it wouldnt have done that after taking it for as long as I did. I never tried to take it in the morning. I guess I should have before going down, huh?

Yes. It was. I didn't have any real complaints when I was on it. It definately did the trick for me and wishing that it hadn't pooped out on me. But then again, if it hadn't I wouldn't be with my T.

BlueMoon, how about taking 15 mg of Lexapro. Maybe that would work?

I am glad you are doing OK on the lower dose of Cymbalta.

Polarsmom- You found your T b/c of the meds? Or b/c of the result of it not working?

Sunny- I think if the WB and lex at 10 combo doesnt do it, that would be a next step. I think what I will do tonight is......take only the 30 of cymbalta (usually I would take cymbalta and lex) and then in the morning take the 10 of lex and WB together. Deeeeep breath for this brave move.....

Then tomorrow night not take any cymbalta. And on sat up the wellbutrin to 300.

Unless...weekends are usually harder for me anyway, maybe I should wait until monday...but then what if it isnt good> I have busy day to get through. OY!

And no, Im calling my PNP...she never returns a call. At least not until days later.

BlueMoon6- I found my T because my meds weren't working.

What happened was: I was taking Lexapro that was prescribed by my General Doctor. We upped the dosage but it just wasn't working anymore. After taking Lexapro for many years, it pooped out on me. So my doctor said that he will change my medication, BUT he wanted me to my an appointment with a T. He changed my meds, but I had to come back and see him in a month. And he wanted to see that I had gone to an appointment with T before he'd give me a refill. Basically he was going to make me come see him every month to get a new script and nag at me about seeing a T. Which he had asked me to do in the past. (I did go for a couple appts. but I didn't like her, didn't connect with her at all. And I didn't try to find another one)

Well, the doctor had put a call into T's office about needing an appointment. (the T is part of the same medical office/practice) So, my T's assissant called to schedule an appointment, and my general doctor's appointment scheduler (don't know what her title is ) also called me to set up an appointment. So between these two girls leaving messages on my VM for nearly a month I finally gave in and made an appointment. Yeah, I really didn't want to go.

I dont know why, but this story made me smile. You were basically blackmailed into therapy! LOL! I can visualize you not veryhappy about going to an appointment with this blackmail therapist with a ball and chain around your ankle...sorry...just my visual...

AND....the good news is....I took my lexa pro in the morning and not last night. I slept MUCH BETTER having not taken it before bed. I only took the cymbalta.

AND....I DID NOT feel drowsy or dizzy from taking the lex in the morning with my wellbutrin! This is amazing! So, tonight I will not take the cymbalta and only take the lex and WB in the morning. And not yet up the dose pf WB to see how I do on 150 and 10 of lex. I am wondering if I will notice that the cymbalta is gone. it might take a week or so.

Sunny- how long does it take for cymbalta to leave my system? Is it gone fast like lex?