Posted by King Vultan on August 9, 2004, at 16:38:40
In reply to Am I taking too many meds? Need opinions, posted by Charm on August 9, 2004, at 14:20:46
> Hello -
>
> My pdoc believes that 300 mg effexor, 30 mg Adderall and 300 mg Wellbutrin is too much.
>
> Before I was taking 300 mg of Effexor, 2.5 mg of Zyprexa and just recently started the 30 mg Adderall ( I also take 45mg buspar per day). I dropped the Zyprexa on my own because of sedative effects even at this low doseage.
>
> She said that in order to add the Wellbutrin I had to drop the Effexor to 150mg. So, during my appointment today, she told me to decrease my Effexor to 150 mg and gave me a prescription for 150 mg Wellbutrin xl. She says that we can increase it to 300 mg of Wellbutrin next month.
>
> Do you guys agree that there was a need to decrease the Effexor? She just seems to think its too much medicine.
>
> Thanks!
>
> CharmYes, from the standpoint of enzyme interactions, the Wellbutrin is likely increasing the blood plasma level of the Effexor greatly, as Wellbutrin is a powerful 2D6 inhibitor, and Effexor is a 2D6 substrate. This will be exacerbated in your case because 300 mg/day represents full therapeutic dosages of each, and the increase in the Effexor blood plasma level is likely to be enormous. There has been at least one case of serotonin syndrome reported from the combination of these two drugs, very likely because of this enzyme thing. Your doctor appears to be informed and prudent, and I think the decision is a wise one.
Todd
poster:King Vultan
thread:375668
URL: http://www.dr-bob.org/babble/20040805/msgs/375718.html