From the Guidelines
Taking Vyvanse (lisdexamfetamine) with Wellbutrin (bupropion) should be done with caution and under a doctor's supervision, as there are no studies on the combination of these medications, but no significant interactions have been reported 1. When considering this combination, it's essential to weigh the potential benefits against the risks, particularly in terms of increased side effects like anxiety, insomnia, and cardiovascular effects. The dosages of both medications may need to be adjusted when used together, with Vyvanse typically taken once daily in the morning at doses ranging from 20-70mg, and Wellbutrin usually taken once or twice daily at 150-450mg total per day, depending on the formulation. This combination may be intentionally prescribed for conditions like ADHD with comorbid depression, as they work through different mechanisms - Vyvanse affects dopamine and norepinephrine release, while Wellbutrin inhibits their reuptake 1. Some key points to consider when taking these medications together include:
- Monitoring for potential interactions and side effects
- Adjusting dosages as needed to minimize adverse effects
- Educating the patient and family on the treatment and monitoring plan
- Obtaining assent/consent before implementing the treatment trial
- Developing a clear rationale for using medication combinations, as outlined in principle 12 of the practice parameter on the use of psychotropic medication in children and adolescents 1.
From the Research
Lisdexamfetamine and Bupropion Combination
- There is limited research on the combination of lisdexamfetamine (Vyvanse) and bupropion (Wellbutrin) specifically 2, 3, 4, 5, 6.
- Studies have investigated the use of lisdexamfetamine for attention-deficit/hyperactivity disorder (ADHD) 2, 5 and bupropion for depression, ADHD, and smoking cessation 4.
- One study examined the combination of stimulants and non-stimulants for ADHD, but did not specifically address lisdexamfetamine and bupropion 3.
- Another study reported on the combination of venlafaxine and bupropion for treatment-resistant depression, suggesting potential benefits of combination therapy 6.
- However, there is no direct evidence on the safety and efficacy of combining lisdexamfetamine and bupropion 2, 3, 4, 5, 6.
Potential Interactions and Considerations
- Lisdexamfetamine is a prodrug that is converted to d-amphetamine, which may interact with other medications, including bupropion 2, 5.
- Bupropion has a unique pharmacokinetic profile and may interact with other medications, including stimulants like lisdexamfetamine 4.
- Combination therapy may increase the risk of adverse effects, such as increased heart rate and blood pressure, and may require close monitoring 3, 6.
- Further research is needed to determine the safety and efficacy of combining lisdexamfetamine and bupropion 2, 3, 4, 5, 6.