From the Guidelines
Combining Wellbutrin (bupropion) and Lexapro (escitalopram) is generally considered safe and is sometimes prescribed together by healthcare providers. This combination can be effective for treating depression, particularly when one medication alone doesn't provide adequate symptom relief. Wellbutrin works primarily on norepinephrine and dopamine neurotransmitters, while Lexapro affects serotonin, so they have complementary mechanisms of action [ 1 ]. This combination may help address a broader range of depression symptoms and can sometimes reduce certain side effects like sexual dysfunction or fatigue that can occur with Lexapro alone [ 1 ].
Key Considerations
- The combination of Wellbutrin and Lexapro may increase the risk of side effects such as anxiety, insomnia, or rarely, seizures [ 1 ].
- The dosage of each medication needs to be carefully determined by your healthcare provider based on your specific condition, medical history, and response to treatment.
- It is essential to inform your doctor about all other medications you're taking to avoid potential drug interactions [ 1 ].
Mechanism of Action
- Wellbutrin works primarily on norepinephrine and dopamine neurotransmitters.
- Lexapro affects serotonin.
- The combination of these two medications can help address a broader range of depression symptoms [ 1 ].
Potential Benefits
- Reduced sexual dysfunction or fatigue that can occur with Lexapro alone [ 1 ].
- Effective for treating depression, particularly when one medication alone doesn't provide adequate symptom relief [ 1 ].
Potential Risks
- Increased risk of side effects such as anxiety, insomnia, or rarely, seizures [ 1 ].
- Potential drug interactions with other medications [ 1 ].
From the Research
Combination of Wellbutrin and Lexapro
- The combination of bupropion (Wellbutrin) and selective serotonin reuptake inhibitors (SSRIs) like escitalopram (Lexapro) can increase the risk of serotonin syndrome, a potentially life-threatening condition 2, 3.
- A study found that the combination of SSRIs and other antidepressants, including bupropion, was associated with a higher risk of serotonin syndrome 2.
- Another study reported a case of serotonin syndrome induced by the combination of bupropion and sertraline, an SSRI 3.
- Bupropion can also cause serotonin toxicity on its own, especially at high doses 4.
- However, some studies suggest that the combination of bupropion and SSRIs can be effective in treating major depressive disorder and reducing sexual side effects associated with SSRIs 5.
- A case report described a patient who overdosed on multiple medications, including bupropion, escitalopram, and other psychotropic agents, and presented with serotonin syndrome and diffuse encephalopathy 6.
Risks and Precautions
- Close monitoring for symptoms of serotonin syndrome is recommended when combining bupropion with SSRIs like escitalopram 2.
- Patients should be aware of the potential risks and symptoms of serotonin syndrome, including agitation, confusion, rapid heart rate, and changes in blood pressure 2, 3.
- Healthcare providers should carefully evaluate the benefits and risks of combining bupropion with SSRIs and monitor patients closely for signs of serotonin syndrome 5.