What is the best combination of antidepressants with Wellbutrin? 

The best antidepressants to be combined with Wellbutrin include:

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

Selective serotonin reuptake inhibitors (SSRIs) 

SSRIs are most commonly used along with Wellbutrin. The concomitant use of these two types of antidepressants holds some great clinical importance. 

This is because together these meds aim to increase the amount of three excitatory monoamine neurotransmitters; serotonin, dopamine, and norepinephrine. 

These neurotransmitters can significantly help counteract the symptoms associated with depression, anxiety, and several other mental health conditions. 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. The combination that usually stands out is the combination of Wellbutrin and Lexapro. 

This one holds some great clinical significance in the management and treatment of the major depressive disorder (MDD). It is also very well tolerated and causes fewer side effects than other Wellbutrin + SSRI combinations. 

However, Wellbutrin can also be paired with Zoloft. The two can be used together for the management of MDD, PTSD, and certain anxiety disorders. Experts believe this combination can prevent some side effects caused by SSRIs, like weight gain and sexual side effects. 

However, not everyone can bear this combination very well and it may not be the best choice of treatment for every other individual. If your doctor has prescribed you a combination of Wellbutrin and an SSRI, make sure you take them as properly as you can. 

Improper dose administration is the biggest reason why people fail to achieve a good therapeutic response from such combinations of antidepressants. 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 can also be combined with Wellbutrin. The combination can be used for the management and treatment of the major depressive disorder (MDD). This is because MDD is a persistent kind of depression which does not respond well to a single antidepressant. 

If you take only Wellbutrin or only an SNRI for managing MDD, you will most likely experience therapeutic failure. This is why such combinations are preferred over the individual use of any one antidepressant. 

The combination of Wellbutrin and Effexor 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 can also be paired with Cymbalta. However, these combinations are not tolerated by everyone. 

You should always stick to your doctor’s recommended dose and combination. Never change your meds without your doctor’s approval. Some of the 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 

References

• Use of bupropion in combination with serotonin reuptake inhibitors (Pubmed, 2006)
• Selective serotonin reuptake inhibitors (Pubmed, 2015) 
• Serotonin-norepinephrine reuptake inhibitors (Pubmed) 
• Bupropion – A systemic review (Pubmed, 2016)
• Bupropion (National Library of Medicine, NIH)