I recently switched to Wellbutrin, but I still have Celexa in my system and I feel great. So my question is whether or not taking these two medications in conjunction with each other will be a problem?
While not specifically a recommended therapy in most guidelines for the treatment of depression and associated disorders, the combination of Celexa citalopram and Wellbutrin buproprion has been used successfully in many different situations. There is a minor interaction between the two that you and your doctor need to be aware of, but taking both together may be appropriate for certain individuals.
Both Celexa and Wellbutrin are antidepressant medications but are in different classes and work via different mechanisms. SSRI drugs are often used as first line therapy for depressive disorders due to their efficacy and relative safety. They unfortunately are associated with certain side effects such as weight gain and sexual dysfunction, which are often challenging to deal with for many patients.
Wellbutrin is unrelated to other antidepressant medications and the exact mechanism of action is unclear. It thought to work by increasing the amount of the dopamine in the brain, but the antidepressant effects of the drug are known to occur at doses below what is needed to have a significant effect on dopaminergic systems. It does not appear that Wellbutrin has any effect on serotonin.
The few studies that have evaluated use of Wellbutrin and Celexa are generally positive. One review showed that the combination of the Wellbutrin and SSRI drugs are well tolerated, can improve the overall antidepressant response and, perhaps most importantly, can reduce or negate the side effects of SSRI drugs e. Another study , that specifically looked at the combination of Wellbutrin and Celexa, had similar results.
The combination was more effective than either drug alone and there was not an increased incidence of side effects. Bupropion is one of the better tolerated antidepressants, but concerns about anxiety, insomnia, and seizures have dampened its popularity.
Bupropion ranks fourth in the more frequently prescribed antidepressants, and has always lagged behind the serotonin agents SSRIs and SNRIs in popularity. The reason may have more to do with a few myths about bupropion than the actual evidence. Bupropion lacks many of the side effects that can hinder adherence to SSRIs: sexual side effects, weight gain, apathy, sedation, and withdrawal problems. Released in , it soon became associated with an alarming rate of seizures, particularly in patients with bulimia.
It was withdrawn from the market soon after, and rereleased in with a lower maximum dosage: mg per day instead of mg per day. By that time, Prozac fluoxetine had already come out in and was rapidly becoming one of the biggest blockbusters in psychiatry. Bupropion had lost ground, and never regained it. In a meta-analysis of articles from , it was clomipramine that came out with the highest seizure risk, and bupropion was not even at the top.
Yes it can, but the rate of anxiety as a side effect to bupropion are about the same as that of other antidepressants, according to several analyses of controlled FDA-registration trials. I also use this strategy when starting bupropion in a patient with bipolar depression. Although I try to avoid antidepressants in that population bupropion does have a lower risk of causing manic switches. I have reason to doubt this one. In a meta-analysis of 10 randomized controlled trials of depression with anxiety, outcomes for anxiety were not significantly different between bupoprion and the SSRIs, including several large trials where it was compared head-to-head with an SSRI.
The same authors of that paper reanalyzed the data looking specifically at patients with very high levels of anxiety. Those studies were done in patients with anxious depression, but what about patients with a separate anxiety disorder. Here bupropion may not fare as well, unless that anxiety disorder is the generalized type GAD. Food and Drug Administration. Revisions to Product Labeling. Silverman HM.
The Pill Book. Bantam Books; Wellbutrin buproprion hydrochloride tablets prescribing information. June Bupropion for attention deficit hyperactivity disorder ADHD in adults. Cochrane Database Syst Rev. ACOG guidelines on psychiatric medication use during pregnancy and lactation.
Am Fam Physician. College of Psychiatric and Neurologic Pharmacists. Bupropion Wellbutrin. Updated December
0コメント