From the Guidelines
Taking Atarax (hydroxyzine) as needed (PRN) while on Lexapro (escitalopram) and Wellbutrin (bupropion) is generally considered safe for most people, but it's crucial to consult with your healthcare provider before combining these medications, as noted in the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1. When considering the combination of these medications, it's essential to understand their mechanisms of action and potential interactions. Lexapro affects serotonin, Wellbutrin affects dopamine and norepinephrine, while Atarax is an antihistamine with anxiolytic properties. Some key points to consider when taking Atarax with Lexapro and Wellbutrin include:
- Starting with a lower dose of Atarax (typically 25mg) to assess tolerance and response before taking higher doses
- Being aware of potential side effects such as drowsiness, dry mouth, and confusion, and contacting your healthcare provider promptly if you experience any unusual symptoms
- Monitoring for symptoms of serotonin syndrome, especially when combining serotonergic drugs, as cautioned in the guideline 1
- Regularly assessing treatment response using standardized symptom rating scales to optimize the benefit-to-harm ratio, as suggested in the guideline 1 It's also important to note that medical education, training, and experience are necessary to safely and effectively prescribe antidepressant medications, and a conservative medication trial may entail increasing the dose as tolerated within the therapeutic dosage range in the smallest available increments at approximately 1- to 2-week intervals 1.
From the Research
Medication Interactions
- The use of Lexapro (escitalopram) with Wellbutrin (bupropion) is a common combination for treating depression and anxiety disorders 2.
- Atarax (hydroxyzine) is an antihistamine that can be used for anxiety and insomnia, and its use with Lexapro and Wellbutrin may be considered for patients with generalized anxiety disorder (GAD) 3, 4.
- However, there is limited information on the specific interaction between Atarax and this combination of antidepressants.
Safety and Efficacy
- Hydroxyzine has been shown to be effective in treating GAD, with some studies suggesting it is more effective than placebo 3.
- The combination of antidepressants and hydroxyzine may be considered for patients who do not respond to traditional treatments, but more research is needed to fully understand its safety and efficacy 4.
- It is essential to monitor patients for potential interactions and side effects when combining these medications, particularly given the potential for increased risk of hemodynamic adverse events when combining certain antidepressants with beta-blockers 5.
Dosage and Administration
- The dosage of Atarax (hydroxyzine) can vary depending on the patient's condition and response to treatment, but it is typically taken as needed (prn) for anxiety and insomnia 3, 4.
- Patients should be closely monitored for side effects, such as drowsiness and dry mouth, when taking Atarax with Lexapro and Wellbutrin.