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What Causes Depression And Anxiety After Taking Wellbutrin?
Question: I am a healthy 48 year old professional male.
I have be taking Lexapro for approximately 8 months with mixed results. I finally achieved some results at 40mg dosage. My doctor has added 150mg of Wellbutrin - it's been 8 days since I started it. He wanted me to start dropping my Lexapro dosage over the following 2 weeks to 20mg. I did start to drop to 30 when I started the Wellbutrin but my anxiety started to go up so I've stayed at 40mg of Lexapro. So, in this week of starting Wellbutrin I've been depressed, lack energy and have not wanted to leave the house. I'm pretty confused.
I have be taking Lexapro for approximately 8 months with mixed results. I finally achieved some results at 40mg dosage. My doctor has added 150mg of Wellbutrin - it's been 8 days since I started it. He wanted me to start dropping my Lexapro dosage over the following 2 weeks to 20mg. I did start to drop to 30 when I started the Wellbutrin but my anxiety started to go up so I've stayed at 40mg of Lexapro. So, in this week of starting Wellbutrin I've been depressed, lack energy and have not wanted to leave the house. I'm pretty confused.
Brief Answer:
These are self limited side effect of wellbutrin
Detailed Answer:
Hello,
Thanks for using healthcare magic.
I read your query with keen interest and after considering all available details I feel that these are just time limited side effects of wellbutrin and if they are not incapacitating, you can continue with the same dosages.
In case these symptoms are causing a significant stress and impairing your ability to do the activities of daily living it is highly recommended to reduce the dose of wellbutrin to half. I like to inform you that 75 mg wellbutrin is available and used in individuals who have difficulty in tolerating the standard starting dose.
Your decision to continue Lexapro with previous dose was in right decision and I do not feel that it should have been reduced from the first day of wellbutrin. In a patient with partial response(e.g you) it is better to continue the initial medication at same dosage and augmentation should be done from other class of antidepressant. The dose of first antidepressant should not be reduced unless at causing intolerable side effects.
The time limited side effects generally last from two to four weeks and it is expected that once you get antidepressant effect of wellbutrin side effects will not be a matter of concern.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Dr Ashok Kumar
These are self limited side effect of wellbutrin
Detailed Answer:
Hello,
Thanks for using healthcare magic.
I read your query with keen interest and after considering all available details I feel that these are just time limited side effects of wellbutrin and if they are not incapacitating, you can continue with the same dosages.
In case these symptoms are causing a significant stress and impairing your ability to do the activities of daily living it is highly recommended to reduce the dose of wellbutrin to half. I like to inform you that 75 mg wellbutrin is available and used in individuals who have difficulty in tolerating the standard starting dose.
Your decision to continue Lexapro with previous dose was in right decision and I do not feel that it should have been reduced from the first day of wellbutrin. In a patient with partial response(e.g you) it is better to continue the initial medication at same dosage and augmentation should be done from other class of antidepressant. The dose of first antidepressant should not be reduced unless at causing intolerable side effects.
The time limited side effects generally last from two to four weeks and it is expected that once you get antidepressant effect of wellbutrin side effects will not be a matter of concern.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Dr Ashok Kumar
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks for that Dr. XXXXXXX
So you believe that the feelings I am having are normal for starting Wellbutrin? Is this common for people when they start. I have read that some people feel positive effects very early...
I did not know that it was so hard to start this medication.
Do you think that 40mg of Lexapro is too much - is there any interaction between the two?
Would you consider I change SSRI?
So you believe that the feelings I am having are normal for starting Wellbutrin? Is this common for people when they start. I have read that some people feel positive effects very early...
I did not know that it was so hard to start this medication.
Do you think that 40mg of Lexapro is too much - is there any interaction between the two?
Would you consider I change SSRI?
Brief Answer:
I think no change of SSRI is indicated
Detailed Answer:
Hello,
Welcome back to Healthcaremagic.
In my view the change of SSRI is not indicated as you had some partial response with lexapro. It has been classically advised to not to lose already gained response in a symptomatic patient. If you feel that there is no positive response with lexapro than changing it to any other SSRI or SNRI is genuine option.
Yes the dose of lexapro you are receiving is beyond the FDA approved dose but at the same time the dose determining criteria are tolerability and efficacy. If you are tolerating it well than you need some time to reduce the dose in future. In case there are side effects due to lexapro it is advisable to use the lower dose of it. The FDA has approved 20mg per day of Lexapro for depression.
There is no significant interaction in between both of these medication and there is nothing to worry about it.
Yes the literature mentions that some people gain early response but I have seen a very different picture in clinical practice. I have seen patient getting deteriorated during first few weeks leading to treatment discontinuation. At the same time I have observed that those patients who continue it show good response in few weeks.
"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
I think no change of SSRI is indicated
Detailed Answer:
Hello,
Welcome back to Healthcaremagic.
In my view the change of SSRI is not indicated as you had some partial response with lexapro. It has been classically advised to not to lose already gained response in a symptomatic patient. If you feel that there is no positive response with lexapro than changing it to any other SSRI or SNRI is genuine option.
Yes the dose of lexapro you are receiving is beyond the FDA approved dose but at the same time the dose determining criteria are tolerability and efficacy. If you are tolerating it well than you need some time to reduce the dose in future. In case there are side effects due to lexapro it is advisable to use the lower dose of it. The FDA has approved 20mg per day of Lexapro for depression.
There is no significant interaction in between both of these medication and there is nothing to worry about it.
Yes the literature mentions that some people gain early response but I have seen a very different picture in clinical practice. I have seen patient getting deteriorated during first few weeks leading to treatment discontinuation. At the same time I have observed that those patients who continue it show good response in few weeks.
"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Okay, last question.
So you generally see people having a hard time in the first few weeks but those that stick it out (don't quit) show good response?
Thanks
So you generally see people having a hard time in the first few weeks but those that stick it out (don't quit) show good response?
Thanks
Brief Answer:
Yes this is my observation
Detailed Answer:
Hello,
Thanks for reverting back to me.
Yes I observed this thing very frequently but I must acknowledge that those who continue wellbutrin have generally mild to moderate side effects and patients with severe side effects generally discontinue wellbutrin due to side effects.
Thanks and regards
Yes this is my observation
Detailed Answer:
Hello,
Thanks for reverting back to me.
Yes I observed this thing very frequently but I must acknowledge that those who continue wellbutrin have generally mild to moderate side effects and patients with severe side effects generally discontinue wellbutrin due to side effects.
Thanks and regards
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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