What is the dosage of Bupropion and Sertraline combination treatment? 

In this blog post, we are going to answer the question, “What is the dosage of Bupropion and Sertraline combination treatment?”. Bupropion and Sertraline both are antidepressants and can be used for the treatment of depression, anxiety, and several other mental health conditions. 

They both can also be combined together and the combination does hold some great clinical importance. This blog will cover the appropriate dosage for this treatment combination and how to ensure its proper use. 

What is the dosage of Bupropion and Sertraline combination treatment? 

The combination treatment of Bupropion and Sertraline is usually started with the dose of 25 mg Sertraline and 75 mg Bupropion. The doses can later be increased by your healthcare provider. The ideal dosage that usually works best for people is 50 mg Sertraline and 75-100 mg Bupropion.

However, the doses are usually low doses are essential in the early course of the treatment, especially when you’re taking this combination for the first time. It is a known fact that this combination may not work in the exact same way for every other individual.

 Some may gain benefits, while others don’t. This is why it is best to start the treatment from the lowest effective dose. If you don’t tolerate the combination well your doctor will easily shift to another one. If you suffer from an allergic reaction, your symptoms will be easier to manage because of the low dose. 

Once your doctor becomes certain that the combination of Bupropion and Sertraline is the best possible choice for you, then your dose will be increased. Make sure you stick to your doctor’s recommended doses and don’t take any more than what is prescribed. 

What are the benefits of using Bupropion and Sertraline together? 

The combination of Bupropion and Sertraline is considered a good one for the management and treatment of the major depressive disorder (MDD). MDD is known to be a persistent kind of depression that does not respond to monotherapy. 

Most healthcare providers pair two antidepressants, which are compatible together, to work against the symptoms associated with MDD. This type of depression can be a clinical emergency. A case study involved 4 patients who suffered from clinical depression and needed proper and constant care, hence they were hospitalised. 

First, a few different antidepressants were given, but as monotherapy did not seem to do any good, the doctor made an intervention and the combination of Bupropion and Sertraline was introduced. The doses were kept low at first and then they were closely escalated. 

All four of the patients seemed to tolerate the combination really well and showed no signs of an allergic reaction. None of them suffered from any side effect that might become a cause of discontinuation of the treatment. 

This is why the treatment was continued and the researchers observed some promising results. All of the patients showed good responses and their symptoms significantly improved after a few weeks of the treatment. This study 

showed that the combination of Bupropion and Sertraline is quite effective in the treatment of the major depressive disorder (MDD) and other persistent types of depression. There are other studies which indicate the exact same thing. 

However, not every case is smooth and well tolerated. There are some people who may not respond well to the combination treatment of Bupropion and Sertraline. 

For such patients, other combinations are preferred. The key to achieving maximum therapeutic response is to use the meds properly. If you’re taking more than the prescribed dose by thinking that you’ll achieve more enhanced effects then you are absolutely wrong. 

What is the difference between Bupropion and Sertraline? 

Bupropion and Sertraline, although they both are antidepressants, are entirely different from one another. Bupropion is characterised as an atypical antidepressant or a dopamine-norepinephrine reuptake inhibitor. 

This med works actively by inhibiting the reuptake of two excitatory monoamine neurotransmitters; dopamine and norepinephrine. This way more of these chemicals are available to bind to their respective receptors throughout the body. 

They collectively counteract the symptoms associated with depression and related mental health conditions. However, Bupropion has nothing to do with the amount of serotonin, which is another excitatory monoamine neurotransmitter. 

The deficiency of serotonin, in some cases, is the primary cause of depression. This is where Sertraline comes into the picture. Sertraline is a selective serotonin reuptake inhibitor. It works by actively inhibiting the reuptake of serotonin by blocking serotonin transporters (SERT). 

This way more serotonin is available in the synaptic cleft to bind to its respective receptors. The excess serotonin compensates for its deficiency and actively counteracts the symptoms associated with depression and other mental health conditions. 

What are the side effects associated with the use of Bupropion and Sertraline? 

Both Bupropion and Sertraline are associated with some side effects. Let’s look at them individually. 

Side effects of Bupropion 

Bupropion is associated with the following side effects:

• Anxiousness 
• Unexplainable excitement and happiness 
• Insomnia or inability to fall asleep 
• Xerostomia or dry mouth 
• Dizziness 
• Drowsiness 
• Nausea with or without vomiting 
• Abdominal pain 
• Headache 
• Tremors 
• Weight loss 
• Loss of appetite 
• Tinnitus or ringing in the ears 
• Excessive sweating 
• Altered sense of taste and smell
• Constipation 
• Throat infection 
• Increased frequency of urination

Side effects of Sertraline 

Sertraline is associated with the following side effects:

• 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 eyes and runny nose
• Sexual side effects in both men and women

These side effects can vary from person to person. Some people may experience more severe side effects as compared to other people. 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. There are some risks that are associated with the combination therapy of Bupropion and Sertraline. 

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

It is one of the atypical antidepressants which has a distinct mechanism of action, which is associated with seizures as side effects. When Bupropion is combined with any such antidepressant, which can cause seizures, it can make things much more complicated for you. 

Sertraline can cause seizures. However, it is not a common side effect of Sertraline and may only occur at higher doses, it can still increase the risk when paired with Bupropion. 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. 

Conclusion 

In this blog post, we have discussed the concomitant use of Bupropion and Sertraline and the most appropriate dosage of this combination. We have learned that it is best to start this combination treatment with the lowest effective dose. 

The doses can later be increased by your healthcare provider. If you don’t tolerate the combination well your doctor will easily shift to another one. If you suffer from an allergic reaction, your symptoms will be easier to manage because of the low dose. 

Once your doctor becomes certain that the combination of Bupropion and Sertraline is the best possible choice for you, then your dose will be increased. Make sure you stick to your doctor’s recommended doses and don’t take any more than what is prescribed. 

FAQs: Bupropion and sertraline combination treatment dosage 

Can you combine SSRI and Wellbutrin?

Yes, you can combine SSRI and Wellbutrin, but only if your healthcare provider approves the combination. The combination of these two antidepressants holds a lot of clinical importance, but it might not work in the exact same way for every other individual. 

Make sure you stick to your doctor’s recommended doses and don’t take any more than what is prescribed. The combination is usually started from the lowest effective dose. Once your doctor becomes certain that the combination of Bupropion and Sertraline is the best possible choice for you, then your dose will be increased.

What antidepressant can be added to bupropion?

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 is the first drug of choice for depression?

The first drug of choice for depression is selective serotonin reuptake inhibitors (SSRIs). These drugs are very well tolerated and can significantly help restore your mental health. In the case of major depressive disorder (MDD), some doctors prescribe two SSRIs in combination, mostly Sertraline and Escitalopram, to help relieve the disturbing symptoms associated with persistent depression.

References 

• R D Marshall et al. J Psychopharmacol. (1995) – Bupropion and sertraline combination treatment in refractory depression https://pubmed.ncbi.nlm.nih.gov/22297770/ 
• Drug Interactions between bupropion and sertraline https://www.drugs.com/drug-interactions/bupropion-with-sertraline-440-0-2057-0.html 
• 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_