Is it ok to take Wellbutrin and Effexor together? (Yes or No)

In this blog post, we will try to answer the question ‘is it ok to take Wellbutrin and Effexor together?’. In addition, we will also look at the difference between Wellbutrin and Effexor. 

Is it ok to take Wellbutrin and Effexor together? 

There has not been much evidence on  the combined intake of Wellbutrin and Effexor together. However, research by Fatemi Emamian & Kist on a 21-year-old white woman with chronic and recurrent major depression shows that  it is  ok to take Wellbutrin and Effexor together. Both Wellbutrin and Effexor are antidepressants used together to treat major depressive disorders. 

Effexor and Wellbutrin are different types of antidepressants. Effexor is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) and Wellbutrin is an aminoketone.

The woman presented the symptoms of depression with a lack of response to several antidepressants. On examination, the patient exhibited signs of depression, guilt feelings, and suicidal ideation. The patient was administered Effexor 75 mg three times daily. The dose was titrated to 150 mg three times daily over the next month. Later Wellbutrin was instituted up to 100 mg three times daily over a four-month period. The patient responded favorably to combination therapy and has remained free of depression for approximately 23 months.

Effexor and Wellbutrin are antidepressant agents with different pharmacologic profiles, each effective in the treatment of depression. Recent data indicate that combinations of selective serotonin-reuptake inhibitors and Wellbutrin can convert partial response to full response in patients with treatment-resistant depression. 

Gradual administration of Effexor and Wellbutrin acted synergistically to significantly reduce depressive symptoms and increase social function over a period of eight months.

Therefore it is okay to take Wellbutrin and Effexor together as a combination therapy for depression. 

Although, it is important that these medicines are prescribed by the doctor with the right amount of dosage. If left unadministered can lead to fatal injuries. 

Effexor vs Wellbutrin 

What are they?

Effexor is the brand name for venlafaxine. It is chemically identical to Pristiq) and belongs to a drug class called serotonin-norepinephrine reuptake inhibitors (SNRIs). Effexor works by blocking the reabsorption of serotonin, norepinephrine, and dopamine in the brain. Blocking their reabsorption, or reuptake increases their availability and overall effects. 

Wellbutrin, on the other hand, is the brand name for bupropion. It is a unique antidepressant classified as an aminoketone. Wellbutrin is believed to work by blocking the reuptake of norepinephrine and dopamine neurotransmitters to boost their effects. It was first approved for clinical use in the United States (U.S.) in 1985. It is one of the most frequently prescribed antidepressants in the English-speaking world.

Unlike Effexor, Wellbutrin does not alter serotonin levels as much.

How do SNRIs work? 

Depression is associated with low levels of serotonin and norepinephrine, neurotransmitters, or chemical messengers, known to affect mood.

Serotonin is also called a “feel-good” chemical because it’s associated with positive feelings of well-being. Norepinephrine is related to alertness and energy.

It’s believed that SNRIs helps treat depression by keeping up the levels of these two chemical messengers in your brain. They do this by stopping serotonin and norepinephrine from going back into the cells that released them.

How do aminoketones work? 

Unlike SNRIs, aminoketones do not regulate the serotonin level. Aminoketones like Wellbutrin are different. They are a norepinephrine-dopamine reuptake inhibitor (NDRI).

An NDRI boosts levels of the neurotransmitters norepinephrine, also known as noradrenaline, and dopamine.

Its action is complex, and its neurological effects are only partly understood.

As well as being an antidepressant, bupropion is an antagonist at nicotinic receptors. This means that it blocks receptors where nicotine normally binds, making it useful in smoking cessation.

Uses of Effexor and Wellbutrin 

Effexor is used to treat major depression or major depressive disorder. It can also treat anxiety disorders, among other mental health conditions. Immediate-release Effexor can help treat panic attacks while the extended-release form is approved to treat generalized anxiety disorder. In addition uses of Effexor include treatment of the obsessive-compulsive disorder (OCD) and premenstrual dysphoric disorder (PMDD).

Wellbutrin is an FDA-approved drug to treat major depressive disorder and seasonal affective disorder. It is also sometimes used as an off-label drug to treat bipolar disorder, attention deficit hyperactivity disorder (ADHD), and sexual dysfunction caused by SSRI antidepressants. 

In addition, Wellbutrin is also used in smoking cessation. It significantly reduces nicotine cravings.  Wellbutrin has been described as a “safe and cost-effective smoking cessation agent” that may help 1 in 5 people stop smoking.

Side effects of Effexor and Wellbutrin 

Like any antidepressants, both Effexor and Wellbutrin have their side effects. Some of the side effects are similar to each other while others vary. 

 Some common side effects of Effexor include:

• nausea,
• constipation,
• insomnia,
• dizziness,
• asthenia,
• drowsiness,
• dry mouth,
• nervousness,
• strange dreams,
• blurred vision,
• changes in appetite or weight,
• decreased sex drive,
• impotence,
• difficulty having an orgasm, and
• increased sweating.

Apart from the common side effects, Effexor also has a few serious side effects. They include the following: 

• easy bruising or bleeding,
• decreased interest in sex,
• changes in sexual ability,
• muscle cramps or weakness, or
• shaking (tremors).

Serious side effects of Effexor include clinical worsening of symptoms and suicide risk, especially in younger patients.

SIde effects of Wellbutrin 

Like any other medication, Wellbutrin too has side effects, although when taken at higher dosages, there are chances of individuals suffering from seizures. Around 1 in 1,000 people who use Wellbutrin are at risk of a seizure.

Common side effects of Wellbutrin include:

• agitation,
• dry mouth,
• insomnia,
• headache,
• nausea,
• vomiting,
• constipation,
• stomach pain,
• dizziness,
• ringing in the ears,
• vision problems or blurred vision,
• loss of interest in sex,
• sore throat,
• muscle pain,
• itching or skin rash,
• increased sweating,
• increased urination,
• tremor,
• changes in appetite,
• weight loss or gain,
• joint aches,
• strange taste in the mouth,
• diarrhea, and
• seizures (especially at higher doses).

Is Effexor or Wellbutrin more effective?

Effexor and Wellbutrin are effective medications for treating depression symptoms. However, more effective antidepressant is unique to every individual. Some users prefer Effexor, while others prefer Wellbutrin depending on the kind of side effects they experience. 

According to a meta-analysis, Effexor and Wellbutrin are similarly effective for treating adults with major depressive disorder. Although they both work similarly, Wellbutrin has been shown to produce less sexual dysfunction as a side effect. Sexual dysfunction is a common side effect of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs).

Drug interactions of Effexor and Wellbutrin

Effexor and Wellbutrin are seen to interact with monoamine oxidase inhibitors (MAOIs). Taking an MAOI, like isocarboxazid or phenelzine, with Effexor or Wellbutrin can increase the risk of serotonin syndrome. Effexor and Wellbutrin should not be taken with an MAOI or within 14 days of stopping an MAOI.

Effexor and Wellbutrin can interact with serotonergic drugs. For example, taking serotonergic drug-like nortriptyline, a tricyclic antidepressant, can increase the risk of serotonin syndrome when combined with another antidepressant.

 Effexor and Wellbutrin should also be avoided with St. John’s wort, an herbal drug frequently used for its antidepressant effects. Herbal Medicine, such as Kratom. Check the Best Kratom for Depression and Anxiety.

Tell your doctor if you’re taking other antidepressants before starting Effexor or Wellbutrin.

Effexor and Wellbutrin can affect the functions of platelets and blood clotting. The use of Effexor or Wellbutrin could decrease the effectiveness of warfarin or other anticoagulants.

Warnings of Effexor and Wellbutrin

The use of Effexor or Wellbutrin can lead to an increased risk of suicidal thoughts, especially in adolescents and young adults. Behavioral and mood changes should be monitored when starting a medication like Effexor or Wellbutrin. If you experience severe behavioral changes, antidepressants may be discontinued or adjusted by your healthcare provider.

Effexor and Wellbutrin can increase blood pressure. Therefore, it’s important to monitor blood pressure while taking these medications. Consult your doctor if you have a history of high blood pressure before taking these medications.

Certain antidepressants like SSRIs and SNRIs can increase the risk of bleeding. Effexor should be avoided with anticoagulants and other drugs that affect blood clotting. Wellbutrin, which is not an SSRI or SNRI, is less likely to affect platelet functions.

When used with serotonergic drugs, Effexor and Wellbutrin can increase the risk of serotonin syndrome. Symptoms of serotonin syndrome include an increased heart rate, increased blood pressure, and fever. Consult your doctor if you experience any of these symptoms. Serotonin syndrome may require emergency medical attention.

Withdrawal from antidepressants 

Whenever a person stops taking antidepressants like Effexor, Wellbutrin, or similar drugs, they may develop a condition that doctors call antidepressant discontinuation syndrome. This condition occurs in about 20 percent of patients who have taken antidepressant medication for at least six weeks and then abruptly stop. 

Common symptoms of antidepressant discontinuation syndrome include:

• Flu-like symptoms, such as fever, cough, sore throat, runny or stuffy nose, and muscle aches.
• Excessive sweating and flushing, particularly in warm environments.
• Changes in mood, irritation, anxiety, increased depression symptoms, and a variety of other psychological effects.
• Difficulty sleeping, ranging from sleep onset insomnia (trouble falling asleep) to waking up in the middle of the night, nightmares, and unusual dreams.
• Tremors and restless legs syndrome, as well as difficulty balancing, numbness, and other temporary neurological issues.
• Electric-shock-like experiences in the brain occasionally referred to as “brain zaps.”
• Digestive problems, including diarrhea, nausea, vomiting, and a weak appetite. 
• Nicotine cravings

Any time someone stops taking an antidepressant, the sudden change impacts the chemical makeup of the brain. For this reason, in some cases, antidepressant discontinuation syndrome may lead to mania or a psychotic break.

Conclusion 

In this blog post, we will try to answer the question ‘is it ok to take Wellbutrin and Effexor together?’. In addition, we will also look at the difference between Wellbutrin and Effexor. 

FAQs: Is it ok to take Wellbutrin and Effexor together? 

References 

https://www.medicalnewstoday.com/articles/326678#how-to-take

https://www.medicalnewstoday.com/articles/264418

https://pubmed.ncbi.nlm.nih.gov/10410184/