Safety of Wellbutrin (Bupropion) and Keppra (Levetiracetam) Combination
Wellbutrin (bupropion) and Keppra (levetiracetam) can generally be taken together safely, as there are no significant documented drug interactions between these medications. However, caution is warranted due to their individual side effect profiles.
Mechanism and Safety Considerations
Bupropion (Wellbutrin) is a dopamine-norepinephrine reuptake inhibitor used primarily for depression and smoking cessation, available in immediate release (IR), sustained release (SR), and extended release (XR) formulations 1.
Levetiracetam (Keppra) is an antiepileptic medication used for seizure management and has been shown to be effective as both monotherapy and adjunctive therapy for seizure control 2.
There is insufficient evidence to recommend levetiracetam for migraine prevention, indicating its primary use remains for seizure management 3.
Important Safety Considerations
Seizure Risk with Bupropion
Bupropion carries a dose-dependent risk of seizures (approximately 0.4% at recommended doses), which is its most significant adverse effect 4, 5.
The seizure risk with bupropion appears comparable to that seen with therapeutic doses of tricyclic antidepressants 5.
Bupropion should be used with caution in patients with factors that may lower seizure threshold 3.
Combination Considerations
While there is no specific contraindication for using bupropion and levetiracetam together in the clinical guidelines reviewed, caution is warranted due to bupropion's known seizure risk 3.
The combination of bupropion with medications that lower seizure threshold (like certain antipsychotics) has been associated with increased seizure risk in case reports 4.
Levetiracetam is generally well-tolerated with a favorable safety profile compared to traditional antiepileptic drugs 2.
Monitoring Recommendations
Regular monitoring for adverse effects is recommended when taking these medications together 3.
Common side effects to monitor with bupropion include dry mouth, insomnia, headache, nausea, and anxiety 3.
Common side effects to monitor with levetiracetam include dizziness and rash 3.
If a patient is taking both medications and experiences any neurological symptoms, immediate medical attention should be sought 4.
Special Populations
Bupropion is contraindicated in patients with seizure disorders according to its use in combination with naltrexone for weight management 3.
Both medications are contraindicated in women who are pregnant or actively trying to conceive 3.
Conclusion
While there is no specific contraindication for using bupropion and levetiracetam together, patients should be monitored for potential adverse effects, particularly neurological symptoms. If you have a history of seizures, the combination should be approached with extra caution, and alternative antidepressants might be considered.