Psycho-Babble Medication Thread 44940

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Wellbutrin and MAOI - safe combo? - please advise

Posted by Angela5 on September 20, 2000, at 2:03:00

My pdoc is considering putting me on an MAOI, but is unsure if Wellbutrin would be safe concurrently or if a waiting period would be necessary.

I know that it is not recommended to take Wellbutrin with an MAOI, but I am pretty sure that I have read about it being done, and my pdoc remembers prescribing it a long time ago with no bad results.

I only have a very, very basic knowledge of the pharmacology of all this stuff, but I know that reboxetine is safe with MAOIs (and in some studies has shown to lessen the hypertensive crisis risk). If I remember correctly, reboxetine works on noradrenaline. Since Wellbutrin works on noradrenaline (and weakly dopamine), I was reasoning that it would be safe also, i.e. no risk of serotonin syndrome. However, I'm not sure by what different mechanisms these drugs actually "work" (again, sorry for the poor understanding), so I don't know if my reasoning has any merit.

Hopefully this made sense - any advice would be most welcome!

Thanks,

Angela

 

Re: Wellbutrin and MAOI - safe combo? - please adv Angela5

Posted by Tori on September 21, 2000, at 3:09:16

In reply to Wellbutrin and MAOI - safe combo? - please advise, posted by Angela5 on September 20, 2000, at 2:03:00

Greetings,

First of all, if your doctor doesn't know, why doesn't he/she consult a pharmacist or someone specialized in that area? I personally would not feel too confident working with a GP who seems to rely on their patients for current medication information! That seems a bit ridiculous.

I am all for being my own advocate, finding out the most information on my own before consulting with my psychiatrist and GP on meds - has been very helpful for me as a I debate medication issues with them and I am a part of the decision process in terms of what approach they will take next (rather than just sitting there like a guinea pig with my head in the sand) -- but having a medical professional unsure of what to do makes me very uneasy and this is your LIFE you are dealing with! Sorry if I sound a bit uneasy about that, possibly me overreacting (because I'm going through awful withdrawal) but it just worried me that he/she sounded like they were leaving the issue in your hands. ((sorry if I upset you or if I misinterpreted)) :-)

All I know from personal experience is that I was on WB and had to stop for two weeks before starting Parnate (which I am currently going through hell with, withdrawal-wise). Another very nice lady on this board said you could augment both wellbutrin and MAOI's, as well as lamictal, clonazepam, ec. Hopefully she will see this posting and respond. I think her name was Anita but I'm not sure....

Anyways good luck and keep us posted!

 

Re: Wellbutrin and MAOI - safe combo? - please adv Tori

Posted by Angela5 on September 21, 2000, at 3:21:59

In reply to Re: Wellbutrin and MAOI - safe combo? - please adv Angela5, posted by Tori on September 21, 2000, at 3:09:16

Actually, this isn't my GP - this IS my psychiatrist. He actually is very knowledgeable, but I think he deals more often with bipolar issues as opposed to treatment-resistant dual depression. Thanks for your concern and your reply - I was starting to wonder if I had upset people around here somehow, since no one seems to respond to my posts.

Thanks,

Angela

 

Re: both in same boat! Angela5

Posted by Tori on September 21, 2000, at 3:57:21

In reply to Re: Wellbutrin and MAOI - safe combo? - please adv Tori, posted by Angela5 on September 21, 2000, at 3:21:59

Hi Angela,

Sorry I got that mixed up ... I guess we're both in the same boat, being treatment-resistant.

I've been dx'd as bipolar although I don't believe it, doesn't make sense ... I just get very moody - extremely irritable to depressed ... the Lamictal helped with that .... but I don't get manic, i.e. staying awake for days .. I can't wait to start the Parnate.

I hope you find the right combination for you that works ..... keep me posted on your progress and the augmentation if it's started :-)

 

Re: Wellbutrin and MAOI - safe combo? - please advise

Posted by Sunnely on September 21, 2000, at 23:09:42

In reply to Wellbutrin and MAOI - safe combo? - please advise, posted by Angela5 on September 20, 2000, at 2:03:00

> My pdoc is considering putting me on an MAOI, but is unsure if Wellbutrin would be safe concurrently or if a waiting period would be necessary.

=============================

Hi Angela,

The Product Information (PI) of Wellbutrin SR (bupropion hydrochloride) clearly indicates the following CONTRAINDICATIONS with the use of Wellbutrin:

1. Wellbutrin SR is contraindicated in patients with a seizure disorder.

2. Wellbutrin SR is contraindicated in patients treated with ZYBAN (bupropion hydrochloride) or any other medications that contain bupropion because the incidence of seizure is dose dependent.

3. Wellbutrin SR is contraindicated in patients with a current or prior diagnosis of bulimia or anorexia nervosa because of a higher incidence of seizures noted in such patients treated with the immediate-release formulation of bupropion.

4. The concurrent administration of Wellbutrin SR Tablets and a monoamine oxidase (MAO) inhibitor is contraindicated. At least 14 days should elapse between discontinuation of an MAO inhibitor and initiation of treatment with Wellbutrin SR Tablets.

5. Wellbutrin SR is contraindicated in patients who have shown an allergic response to bupropion or the other ingredients that make up Wellbutrin SR Tablets.

 

Re: Wellbutrin and MAOI - safe combo? - please advise Angela5

Posted by anita on September 22, 2000, at 22:35:51

In reply to Wellbutrin and MAOI - safe combo? - please advise, posted by Angela5 on September 20, 2000, at 2:03:00

Hi Angela,

MAOIs and Wellbutrin can be taken together, but only if you are already on an MAOI and adding Wellbutrin very slowly to it. Officially, it's not a recommended combo, but a lot of pdocs have tried it w/ no problem and it is used by many psychopharms.
However, it is probably not a good idea to add an MAOI, particularly Parnate, to your existing dose of Wellbutrin. There haven't been any studies on the safety of this as far as I know.

good luck,
anita


> My pdoc is considering putting me on an MAOI, but is unsure if Wellbutrin would be safe concurrently or if a waiting period would be necessary.
>
> I know that it is not recommended to take Wellbutrin with an MAOI, but I am pretty sure that I have read about it being done, and my pdoc remembers prescribing it a long time ago with no bad results.
>
> I only have a very, very basic knowledge of the pharmacology of all this stuff, but I know that reboxetine is safe with MAOIs (and in some studies has shown to lessen the hypertensive crisis risk). If I remember correctly, reboxetine works on noradrenaline. Since Wellbutrin works on noradrenaline (and weakly dopamine), I was reasoning that it would be safe also, i.e. no risk of serotonin syndrome. However, I'm not sure by what different mechanisms these drugs actually "work" (again, sorry for the poor understanding), so I don't know if my reasoning has any merit.
>
> Hopefully this made sense - any advice would be most welcome!
>
> Thanks,
>
> Angela

 

Re: Wellbutrin and MAOI - safe combo? - please advise anita

Posted by Angela5 on September 23, 2000, at 0:11:51

In reply to Re: Wellbutrin and MAOI - safe combo? - please advise Angela5, posted by anita on September 22, 2000, at 22:35:51

Anita -

Would you mind telling me what meds you're on/doseage, etc.?


Thanks,

Angela

 

Re: Wellbutrin and MAOI - I take them both

Posted by stephanie l. on September 23, 2000, at 14:51:42

In reply to Re: Wellbutrin and MAOI - safe combo? - please advise anita, posted by Angela5 on September 23, 2000, at 0:11:51

> Anita -
>
> Would you mind telling me what meds you're on/doseage, etc.?
>
>
> Thanks,
>
> Angela

Angela: I take Nardil and Wellbutrin (plus more) and have been doing so for two years with no
bad effects at all. ( I added Wellbutrin to the Nardil.) Ironically, it was a doctor's letter (somewhere in the Dr. Bob site) where I first found out it was ok. I also consulted with a
well-regarded psychopharmacologist who is an expert on combining meds, and he said it was ok too. Good luck.

stephanie

 

Re: Wellbutrin and MAOI - safe combo? - please advise

Posted by anita on September 23, 2000, at 20:03:51

In reply to Re: Wellbutrin and MAOI - safe combo? - please advise anita, posted by Angela5 on September 23, 2000, at 0:11:51

Angela,

Currently I take Zoloft, Lamictal, and St. John's Wort. It is the best combo I've been on since I took Nardil, tho I still have problems with apathy and social phobia.

I took Nardil for several years, and added Wellbutrin at one point, with no improvement. When on Parnate I also added Wellbutrin, but couldn't tolerate the increased anxiety.

anita


> Anita -
>
> Would you mind telling me what meds you're on/doseage, etc.?
>
>
> Thanks,
>
> Angela


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