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Re: Wellbutrin and Effexor -- Ok to combine? » fairnymph

Posted by medlib on August 2, 2002, at 1:58:01

In reply to Wellbutrin and Effexor -- Ok to combine?, posted by fairnymph on August 1, 2002, at 23:10:44

Hi fairnymph--

Yes, they can be combined safely. I've been taking Wellbutrin SR 300mg./day (150mg. x 2) with Effexor XR 225mg. for about 6 months. If you're taking Effexor currently, you may find that you need to lower your dose (if it's above 225mg.) once you've added Wellbutrin. I'd recommend ramping all the way up on the Wellbutrin before adjusting the E., though; reduction may not be necessary for you.

Although how Wellbutrin works is not certain, it's thought to inhibit the reuptake of dopamine (D) and norepinephrine (NE). It has no action on serotonin receptors, which are the primary site of action for Effexor (up to doses of 225mg.) At levels above 225 mg. E. acts on NE as well, and at 300mg. E. has a (weak) dopamine effect.

Before I began W., I took 300mg. E with 60mg. of Ritalin (20mg. x 3). The first thing I discovered after adding W. was that I could take R. or W., but not both (both affect dopamine and, together, promptly produced EPS). Even after d/c ing R., I experienced some EPS (jaw and neck tension, muscle twinges/jerks) upon taking the 2nd W. dose every day. Reluctantly, I lowered my E. dose. I have taken E. in 1 dose in the morning for 2+ yrs., but now find that the lowered dose makes me sleepy; will probably try it at bedtime.

Be aware that this combo is very activating for most, so it isn't appropriate for BPs, and probably not for anxious depressives, either. So, you may need chemical assistance to sleep--I do. (It would be truly delightful if E. at bedtime could replace Ambien--I definitely will try it!)

Good luck, and let us know how it goes.---medlib


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