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Are There Any Interactions Between Wellbutrin, Lamictal And Synthroid?

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Posted on Wed, 5 Aug 2015
Question: I start radiation on my left breast Monday, and I'm concerned because A: I have Hashimoto's, B: I just titrated off Paxil, which I've been on since 1998, and my doctor prescribed wellbutrin instead, but I haven't started taking it yet, and C: I'm also taking lamictal, propranolol, and synthroid, gabapentin, and ropinirole. The Oncologist will be starting me on tomoxifen when the radiation treatments are done. My concern is all of the potential interactions. I also take omeprazole daily for GERD. I'm 53, and obviously a mess. Thanks for listening.
doctor
Answered by Dr. Kathy Robinson (1 hour later)
Brief Answer:
do not start wellbutrin

Detailed Answer:
Hello,
I am glad that you wrote to us with your concerns. There is a serious interaction of wellbutrin with the tamoxifen and that combination should be avoided. You should also know that there is a drug interaction between the propranolol and the wellbutrin so I think you may want to see your doctor and consider another alternative to the wellbutrin. There are also serious interactions with the paxil so this is a situation that you need to discuss with the oncologist and your doctor that prescribed the wellbutrin. The interaction with propranolol and the antidepressants may not be an issue if you are on a low dose of propranolol but the combination of paxil or wellbutrin with tamoxifen should definitely be avoided
Please let me know if you have further questions.
Regards,
Dr Robinson
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kathy Robinson (1 hour later)
I just typed a long response then my tablet locked up while I was sending it. So this will be brief. Thank you for clarifying what I had found on drugs.com. I will feel more confident now when I go in next week.

The dose of propanolol is very low as i take it for an irregular heartbeat.

My thoughts on most everything that's going on is that it is thyroid related. They assume I have all these separate issues that I need meds for, and have basically ignored the fact that I have hypothyroidism. I have been on 50mcg of synthroid since 2013 and its not working! I ask her all the time to send me to a good endocrinologist, so finally last week she said she would. But I almost think I should go to a naturopath and be put on armour thyroid and supplements instead. I read too that radiation reeks havoc on the thyroid, is that true? What are your thoughts on armour thyroid? Do you have ideas on what supplements I might want to take to help my thyroid?
There's so much info on the internet I get overwhelmed trying to figure it out.

Thank you once again.
doctor
Answered by Dr. Kathy Robinson (8 minutes later)
Brief Answer:
propranolol is probably okay at low dose

Detailed Answer:
Hello,
Since the propranolol is low dose it is probably okay. I am glad you are going to an endocrinologist but I have to warn you that most endocrinologists do not like armour thyroid. Armour is dessicated pig thyroid so the dose is somewhat erratic and hard to get regulated. Synthroid is what most doctors use unless the T3 is low. Have you had your TSH, free T3 and free T4 measured. That is what you need to see if your thyroid is functioning properly. We usually only check the TSH regularly but if you feel that the synthroid is not working then you need free T3 and T4 checked at least once. I am sure that the endocrinologist will do that.
A naturopath may be helpful.
I suggest that you take a multivitamin with iodine in it for thyroid support and extra vitamin C and fish oil as antioxidants.
Radiation of the breast should have no effect on the thyroid function
Regards,
Dr. Robinson
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kathy Robinson (24 minutes later)
OK. Thank you very much ☺
doctor
Answered by Dr. Kathy Robinson (1 minute later)
Brief Answer:
you are welcome

Detailed Answer:
Please let me know if I can help you in any other way
Best regards,
Dr. Robinson
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kathy Robinson (6 hours later)
I will let you know what the endocrinologist does. I'm nervous about radiation and tomoxifen, but no chemo which is great!

By the way, I love this service, I really appreciate your quick response. It's comforting.
XXXX
doctor
Answered by Dr. Kathy Robinson (6 hours later)
Brief Answer:
wishing you the best

Detailed Answer:
I would love to hear what the endocrinologist says. I am very glad that you will be seeing them soon. The radiation can cause some side effects but most people tolerate the tamoxifen just fine. I am concerned about the serious drug interactions with the antidepressants and tamoxifen so make sure to talk to the doctor and oncologist about that.
Best wishes,
Dr. Robinson
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kathy Robinson (7 hours later)
I'll definitely talk to them about the antidepressants, but in the meantime I'm off paxil, never started the wellbutrin, and only take lamotrigine, propanolol, ropinorole, gabapentin, omeprazole, synthroid. What about the lamotrigine and tomoxifen? I've considered going off it too.
XXXXX
doctor
Answered by Dr. Kathy Robinson (2 hours later)
Brief Answer:
not a problem

Detailed Answer:
When I did the drug interaction check for you, the lamotrigine did not show up as a problem with the tamoxifen. It is a good mood stabilizer so if you are tolerating it okay it might be a good idea to stay on it, especially since the antidepressants seem to have major interactions with the tamoxifen
Best to you,
Dr. Robinson
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kathy Robinson (5 hours later)
Fantastic! I'm very satisfied with all the information you have given me, and appreciate that now I can go there not being so in the dark. I will continue lamotrigine since I tolerate it very well, and thank you, thank you, thank you! I'll be telling friends about this service.
XXXXX
doctor
Answered by Dr. Kathy Robinson (7 hours later)
Brief Answer:
you are wellcome

Detailed Answer:
XXXXX, thanks for using our service.
I wish you the best
Dr. Robinson
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kathy Robinson

General & Family Physician

Practicing since :1989

Answered : 3535 Questions

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Are There Any Interactions Between Wellbutrin, Lamictal And Synthroid?

Brief Answer: do not start wellbutrin Detailed Answer: Hello, I am glad that you wrote to us with your concerns. There is a serious interaction of wellbutrin with the tamoxifen and that combination should be avoided. You should also know that there is a drug interaction between the propranolol and the wellbutrin so I think you may want to see your doctor and consider another alternative to the wellbutrin. There are also serious interactions with the paxil so this is a situation that you need to discuss with the oncologist and your doctor that prescribed the wellbutrin. The interaction with propranolol and the antidepressants may not be an issue if you are on a low dose of propranolol but the combination of paxil or wellbutrin with tamoxifen should definitely be avoided Please let me know if you have further questions. Regards, Dr Robinson