What is the best antidepressant to take with Wellbutrin? (3 risks) 

In this blog post, we are going to answer the question, “What is the best antidepressant to take with Wellbutrin?”. Wellbutrin (Bupropion) is one of the most commonly prescribed antidepressants and it is used for the treatment and management of several mental health conditions and addictions. 

However, monotherapy with Wellbutrin may not be enough in some people and combination treatment is preferred. This is what we are going to discuss today. 

What is the best antidepressant to take with Wellbutrin? 

The best antidepressants to take with Wellbutrin include:

• Selective serotonin reuptake inhibitors (SSRIs) 
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) 

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors are probably the best choice of antidepressants to be combined with Wellbutrin. There are a huge number of research studies that can claim the therapeutic efficacy and safety of this combination. 

However, not all SSRIs can produce fruitful results. Although all SSRIs belong to the same class and have the exact same mechanism of action, they have different potencies. Some are stronger than others. Some produce more side effects. 

Some are less tolerable than others. This is why not every single SSRI can pair well with Wellbutrin. If you think that your depression or any other mental health condition is not being managed easily by monotherapy, you should talk to your doctor. 

It is not recommended to start using a combination of antidepressants without your doctor’s approval. If we take a deeper look at the combination of SSRIs and Wellbutrin, there are a few combinations worth mentioning. 

The combination of Wellbutrin and Lexapro (Escitalopram) is known to give great benefits. 

Several research studies have indicated that this combination has been tolerated well by people for decades now, and it works very well in the management and treatment of symptoms associated with major depressive disorder (MDD), a kind of depression that does not respond to monotherapy of antidepressants. 

The combination of Wellbutrin and Zoloft (Sertraline) is also a good one. It is prescribed frequently because of its safety and efficacy. However, the doses at which you take these combinations can make a huge difference in your therapeutic outcome. 

If you take doses too high, you will be subjected to harmful symptoms and the combination will have more risks than benefits. One combination of this class is avoided, the combination of Wellbutrin and Prozac (Fluoxetine). 

Studies suggest that both Wellbutrin and Prozac possess the risk of seizures. When these two are combined together, a number of complications can occur and this combination is completely contraindicated in people who are epilepsy comorbid with depression. 

Some of the common side effects associated with the use of SSRIs include

• Nausea 
• Vomiting 
• Diarrhoea or Constipation 
• Acid reflux or heartburn 
• Abdominal pain 
• Loss of appetite 
• Weight gain or loss 
• Excessive sweating or night sweating (nocturnal/night hyperhidrosis) 
• Frequent urination 
• Polydipsia or excessive thirst
• Tremors 
• Muscle twitching and pain
• Drowsiness 
• Dizziness 
• Excessive tiredness or fatigue 
• Insomnia or inability to fall asleep 
• Xerostomia or dry mouth 
• Dysmenorrhea or heavy periods
• Flu-like symptoms, including irritation in the eyes and a runny nose
• Loss of libido in both males and females. Males may suffer from an inability to ejaculate, while females may suffer from an inability to have an orgasm. 

Serotonin-norepinephrine reuptake inhibitors (SNRIs) 

SNRIs are also considered good when it comes to the combination treatment with Wellbutrin. Studies suggest that several case studies showed good responses to the combination treatment of Wellbutrin and SNRIs. 

However, this combination may not suit everyone. Just like SSRIs, all SNRIs are also different when it comes to the side effect profile and potency. They all have a mechanism of action, which is why they all are members of the same family. 

However, the combination of Wellbutrin and Effexor (Venlafaxine) does hold some good clinical importance. Research shows that these two together can be used for the treatment and management of persistent depression. 

The combination is also quite effective when it comes to the treatment of post-traumatic stress disorder (PTSD). Wellbutrin is considered a good antidepressant for eating disorders. 

The combination of these two can help people who suffer from depression comorbid with an eating disorder. Wellbutrin can also be paired with Cymbalta (Duloxetine). 

The combination of these two antidepressants at low doses can help quite significantly to counteract your symptoms associated with major depressive disorder (MDD), anxiety, and other mental health conditions. 

However, one important thing to bear in mind is that not everyone can tolerate the combination of antidepressants, and those who can tolerate them should always stick to the adjusted doses. 

The combination treatment of antidepressants possess more risk when not taken as per the doctor’s directions. If your doctor thinks that your mental health condition requires a combination treatment, only then a combination is prescribed. 

If your condition can be cured by antidepressant monotherapy then that option would be preferred. Some common side effects associated with the use of SNRIs include:

• Drowsiness
• Fatigue
• Sleepiness or hypersomnia
• Decreased salivation leading to dry mouth 
• Vertigo 
• Loss of appetite 
• Excessive sweating
• Constipation or diarrhoea 
• Weight gain or loss
• Abdominal pain
• Bloating 
• Flatulence 
• Headache 
• Muscular pain 

What are the risks associated with the combination of Wellbutrin and other antidepressants? 

There are some risks that always follow a combination treatment of antidepressants, no matter what the combination is. This is because all these meds can affect your brain. 

When you take not one, but two of such meds, there is no way to predict how your body will respond. Some of the risks associated with the combination of Wellbutrin and other antidepressants include

• Risk of seizures 
• Risk of psychological side effects
• Risk of serotonin syndrome 

Risk of seizures 

The risk of seizures is one of the main risks associated with the use of Wellbutrin in combination. However, the antidepressant used with it can also affect this side effect. Wellbutrin is not like other antidepressants. 

It is one of the atypical antidepressants which has a distinct mechanism of action. It does not work like SSRIs or SNRIs, which are the most commonly used antidepressants. Wellbutrin inhibits the reuptake of norepinephrine and dopamine. 

It does not actively inhibit the reuptake of serotonin, just like SSRIs and SNRIs. This is why it has a different side effect profile, and one of the major side effects is the risk of seizures. 

When Wellbutrin is combined with any such antidepressant, which can cause seizures, it can make things much more complicated for you. Make sure you talk to your healthcare provider about this. This side effect can affect some people more than others. 

Some people are naturally sensitive to antidepressants and taking two at one time can cause a number of complications. The rapid change in the chemistry of your brain can trigger seizures. 

Risk of psychological side effects 

The risk of other kinds of psychological side effects, apart from seizures, is also a general concern. The combination of Wellbutrin and other antidepressants may make you suffer from the following side effects:

• Anxiety 
• Agitation 
• Irritability 
• Confusion 
• Forgetfulness 
• Inability to understand surroundings 
• Difficulty in speech
• Intrusive thoughts 
• Paranoia 
• Hallucinations 
• Insomnia 
• Fear

These side effects can vary from person to person. Some people suffer from severe psychological side effects while being treated with a combination of Wellbutrin and other antidepressants. 

Risk of serotonin syndrome 

Although Wellbutrin does not directly affect the amount of serotonin in your body, the combination of this antidepressant with a serotonin-specific antidepressant can increase the risk of serotonin syndrome. 

Dopamine and norepinephrine may affect the levels of serotonin at some point. If not serotonin syndrome, the combination of these antidepressants can give rise to symptoms like serotonin syndrome as a result of increased activity of different kinds of excitatory neurotransmitters in your brain. 

This is why you should always stick to your doctor’s recommended dose. If you think taking more than the prescribed dose will help you more with your mental health condition, you could not be any more wrong. 

Conclusion 

In this blog post, we have discussed the combination of Wellbutrin with other antidepressants. Wellbutrin (Bupropion) is one of the most commonly prescribed antidepressants and it is used for the treatment and management of several mental health conditions and addictions. 

However, monotherapy with Wellbutrin may not be enough for some people and combination treatment is preferred. It can be paired with Selective serotonin reuptake inhibitors (SSRIs) and Serotonin-norepinephrine reuptake inhibitors (SNRIs). 

Always make sure you talk to your healthcare provider about the safe and effective use of the combination of Wellbutrin and some other antidepressants. 

FAQs: best antidepressant to take with Wellbutrin

Can you combine Wellbutrin with other antidepressants?

Yes, you can combine Wellbutrin with other antidepressants. Selective serotonin reuptake inhibitors are probably the best choice of antidepressants to be combined with Wellbutrin. There are a huge number of research studies that can claim the therapeutic efficacy and safety of this combination. However, not all SSRIs can produce fruitful results. SNRIs are also considered good when it comes to the combination treatment with Wellbutrin. Studies suggest that several case studies showed good responses to the combination treatment of Wellbutrin and SNRIs. 

What is the best combination of antidepressants?

There are a huge number of possibilities when it comes to the combination of antidepressants. It’s hard to tell which one is considered the best, as all of the combinations act uniquely for different mental health conditions. However, research suggests that the combination of two SSRIs, mainly Sertraline and Escitalopram is considered a good, safe, and effective choice for the treatment and management of depression, anxiety, and several other mental health conditions. 

Can Zoloft and Wellbutrin be used together?

Yes, Zoloft and Wellbutrin can be used together. In fact, this combination is believed to possess good therapeutic responses from people. It can be used for the management and treatment of treatment-resistant depression and depression comorbid with eating disorders. However, this combination may not suit everyone. This is why you should always stick to your doctor’s recommended advice. 

What anti-anxiety medication can be taken with Wellbutrin?

Following anti-anxiety medications can be paired with Wellbutrin for the management and treatment of anxiety disorders:

• Selective serotonin reuptake inhibitors (SSRIs). Examples include Lexapro, Celexa etc. 
• Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples include Effexor, Pristiq etc. 
• Short-acting benzodiazepines. Examples include Xanax, Ativan, Halcion etc. 

What is the best combination with Wellbutrin?

Selective serotonin reuptake inhibitors are probably the best choice of antidepressants to be combined with Wellbutrin. There are a huge number of research studies that can claim the therapeutic efficacy and safety of this combination. However, not all SSRIs can produce fruitful results. SNRIs are also considered good when it comes to the combination treatment with Wellbutrin. Studies suggest that several case studies showed good response to the combination treatment of Wellbutrin and SNRIs. 

References

• Sidney Zisook et al. Biol Psychiatry. (2006) – Use of bupropion in combination with serotonin reuptake inhibitors https://pubmed.ncbi.nlm.nih.gov/16165100/
• Chu A, Wadhwa R. (2015) – Selective serotonin reuptake inhibitors https://www.ncbi.nlm.nih.gov/books/NBK554406/#_NBK554406_pubdet_ 
• Stephen M Stahl et al. CNS Spectr. (2005) – SNRIs: their pharmacology, clinical efficacy, and tolerability in comparison with other classes of antidepressants https://pubmed.ncbi.nlm.nih.gov/16142213/#:~:text=Abstract,and%20norepinephrine%20with%20differing%20selectivity.