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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by jessers11581 on April 20, 2005, at 17:55:59
I recently began taking Cymbalta and it seems to be working much better for me than Lexapro. HOWEVER, I'm still having major sugar/starch cravings and am curious as to whether the addition of a dopamine reuptake inhibitor might make a difference. I've used Wellbutrin in the past, both by itself and in conjunction with a low dose of Lexapro. It made me super anxious both times (especially on its own). However, I'm wondering if it would have the same effect now that I'm on Cymbalta? Perhaps I could tolerate it better now that I'm on a drug that makes me feel more stable to begin with? I don't know. I've never seen anyone say that they mixed the two. What do you think? Please respond if you have any input. Thanks in advance! :)
Posted by banga on April 20, 2005, at 18:00:56
In reply to can Cymbalta be mixed with Wellbutrin?, posted by jessers11581 on April 20, 2005, at 17:55:59
I'm pretty sure you can combine them, however I have a feelng it would still make you anxious as well....
Posted by Phillipa on April 20, 2005, at 18:36:10
In reply to Re: can Cymbalta be mixed with Wellbutrin?, posted by banga on April 20, 2005, at 18:00:56
Very anxiety provoking for me. Fondly, Phillipa
Posted by med_empowered on April 20, 2005, at 19:52:19
In reply to can Cymbalta be mixed with Wellbutrin?, posted by jessers11581 on April 20, 2005, at 17:55:59
hey! The Wellbutrin-Cymbalta thing **might** work, but try to stick to the old rule: "start low, go slow" when doing potentially tricky drug combos. My new shrink considers cymbalta the equivalent of throwing a potent SSRI, like say zoloft, and a potent SNRI, such as Straterra, into one colorful capsule. Apparently, some research indicates that your average dose of Cymbalta is stronger on both the serotonin and the neuroepinephrine ends than your average dose of Effexor. Keep in mind though that Cymbalta (and effexor, and the TCAs...) raises blood-pressure, at least at the 60mgs/day dose; the average is 4pts, I think, but some people are hypersensitive and have to stop taking it. Wellbutrin also tends to raise blood pressure...keep in mind that Wellbutrin is chemically related to Tenuate, a stimulant diet-drug that was pretty popular in the '70s. So, expect stimulant-like effects; increased anxiety, over-stimulation, racing heartbeat, etc. are possible, along with the benefits, which may be considerable. If you try this, I'd seriously recommend doing some work on your anxiety first or while you introduce wellbutrin.
Posted by Phillipa on April 20, 2005, at 20:43:26
In reply to Re: can Cymbalta be mixed with Wellbutrin?, posted by med_empowered on April 20, 2005, at 19:52:19
Med_empowered, Well that certainly explains why wellbutrin put me in the hospital. My pdoc thought I was manic! Fondly, Phillipa
Posted by Colleen D. on April 20, 2005, at 21:33:27
In reply to can Cymbalta be mixed with Wellbutrin?, posted by jessers11581 on April 20, 2005, at 17:55:59
I'm on Effexor, Wellbutrin and Klonopin. I just went back to Effexor after Cymbalta made me lethargic and absent of any motivation at 60mg. I think Cymbalta + Wellbutrin is becoming a common combo, but I need something more for my anxiety (which by the way *decreased* with Effexor, Cymbalta and Wellbutrin) so I take a low dose of Klonopin and that is just perfect for me. Give the Cymbalta a fair trial...find out in the long run it's going to be activating or sedating for you and then consider adding Wellbutrin and/or Klonopin.
I have less cravings for the sweets with Wellbutrin. Cymbalta made my cravings worse. I lost 30lbs. when I was on Effexor the first time around and didn't want to gain it back...I could stand to lose 20 more so I hope the Effexor Wellbutrin combo can encourage that!
Just my thoughts! :-)
Colleen
Recurrent major depressive disorder, GAD, OCD and SP
Posted by Wildflower on April 21, 2005, at 15:11:29
In reply to Re: can Cymbalta be mixed with Wellbutrin? » jessers11581, posted by Colleen D. on April 20, 2005, at 21:33:27
That combination is indeed common. Just be careful that you're not taking anything higher than 300mg of Wellbutrin. They had me on 450 (higher than recommended) and 120 mg of Cymbalta (also higher than recommended.) It gave me the jitters, my hands shook and I was alway warm. SInce I've dropped back the Wellbutrin to 300, I'm doing better.
Note: I'm also on Klonopin, Provigil and Lamictal
Posted by hawkeye on April 21, 2005, at 16:56:43
In reply to can Cymbalta be mixed with Wellbutrin?, posted by jessers11581 on April 20, 2005, at 17:55:59
Cymbalta is metabolized by the CYP2D6 enzyme. Wellbutrin is a strong inhibitor of the CYP2D6 enzyme. Therefore, if you take the two together you will be getting a greater effective dose of Cymbalta than the actual size of the dose you are taking would indicate.
Posted by Racer on April 21, 2005, at 17:51:58
In reply to Careful With These Two, posted by hawkeye on April 21, 2005, at 16:56:43
What Hawkeye pointed out about the enzymes makes sense, because I was very lethargic and amotivated on Cymbalta 60mg and Wellbutrin XL 150. Now I'm having a relapse of depression, but we're going to raise the Wellbutrin XL to 300, and keep the Cymbalta at 30mg.
As for anxiety, this combo is better than, say, Zoloft was for me. The activating SSRIs were way more axiety-unfriendly than this current combo is. I think, personally, that when my depression is controlled, the anxiety is much easier to handle, and isn't such a problem. Maybe that would be true for you, too?
Anyway, I'm hopeful enough about my combo, although we'll have to see what happens raising the Wellbutrin. Hope that info helps.
Posted by Colleen D. on April 22, 2005, at 5:43:43
In reply to Careful With These Two, posted by hawkeye on April 21, 2005, at 16:56:43
I used to take 150mg of Effexor without Wellbutrin, but now 75mg of Effexor + 300mg Wellbutrin is working quite well.
Thanks,
Colleen
Posted by hawkeye on April 23, 2005, at 6:48:52
In reply to Is this true about Effexor + Wellbutrin too? » hawkeye, posted by Colleen D. on April 22, 2005, at 5:43:43
This is not true with Effexor + Wellbutrin.
The PDR for Effexor says that the difference between high and low CYP2D6 metabolizers "is not expected to be clinically important" for Effexor.
This is because Effexor is metabolized by CYP2D6 into it's metaobilite "NOD" and Effexor and NOD are equally psychoactive.
Posted by paul_d_234 on April 24, 2005, at 7:31:19
In reply to Careful With These Two, posted by hawkeye on April 21, 2005, at 16:56:43
Hawkeye, so what do you recommend if someone wants to try to mix Cymbalta and Wellbutrin? Or is a definite no-no?
I was on Zoloft and Wellbutrin and that worked well?
Shall I definitely not mix the two?
Posted by Racer on April 24, 2005, at 13:14:37
In reply to Re: Careful With These Two, posted by paul_d_234 on April 24, 2005, at 7:31:19
I'm on both Wellbutrin and Cymbalta, and it seems to be working. I did have to back down on the dosage of Cymbalta, which was OK -- from 60mg to 30mg.
Hope that helps.
Posted by paul_d_234 on April 24, 2005, at 17:24:01
In reply to Re: Careful With These Two » paul_d_234, posted by Racer on April 24, 2005, at 13:14:37
Racer, as always thanks.
> I'm on both Wellbutrin and Cymbalta, and it seems to be working. I did have to back down on the dosage of Cymbalta, which was OK -- from 60mg to 30mg.
>
> Hope that helps.
This is the end of the thread.
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