Psycho-Babble Medication | about biological treatments | Framed
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Wellbutrin & Zoloft, it's a good thing!

Posted by Durga on September 1, 1998, at 0:00:17

In response to the safety/efficacy question of Wellbutrin and Zoloft as a comined treatment I can add my professional experience as well as personal experience. Professionally, I have seen/recommended the two medications often. Literature does not support the idea of the seizure thresh hold being lowered by adding Zoloft or any of the SSRI's. However, tricyclics and tetracyclics, especially Ludiomil and Vivactil do pose a greater risk of seizure activity. The other TCA's & TTCA's pose a greater risk for seizures when used with Wellbutrin, although not nearly as great as the two mentioned previously.
A second reason to consider adding a second antidepressant to any therapy is that Major Depressive Disorder is not a disorder involving only one neurotransmitter (serotonin, norepinepherine, Dopamine, GABA, and others). Most antidepressants target one receptor system more than others Eg: Zoloft targets serotonin, desipramine targets norepinepherine and Wellbutrin has a weak affinity for serotonin and norepinepherine receptors and a modest affinity for Dopamine receptors. Because depression is most likely a disease of multi receptor sites, it makes good sense clincally that if one is having only partial response being on a single antidepressant, to continue with that and add a second medication that compliments the other. Such would be the case with Wellbutrin and Zoloft.
Personally, I have chosen treatment for myself with Wellbutrin 400mg/day and Zoloft 200mg/day. Originally, Zoloft was working well on its own, albeit the maximum dosage was needed. It was difficult to tollerate (lower G.I. problems), so I chose Sinequan as a compliment and for its side effects from action on histamine and cholinergic sites. It proved to be the perfect compliment. Later, I switched to Tofranil from Sinequan as the depression lifted and I didn't need the strong "extra benefit" from side effects. Tofranil provided the same beneficial side effects (as well as both providing antidepressant effects) however it is not nearly as potent. At that point though, I didn't need the potency of Sinequan. As time went on, I discontinued Tofranil in favor of Wellbutrin, and have had a positive response with the two.
I hope I was able to help even though I went on a bit with my input.
Good luck.




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