Can I add Bupropion (Wellbutrin) to Escitalopram (Lexapro) and Buspirone (Buspar)?

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Last updated: April 23, 2025View editorial policy

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From the Research

Adding Wellbutrin to a regimen of Lexapro and Buspar should be done with caution and under the supervision of a healthcare provider, as it may increase the risk of serotonin syndrome and other adverse effects, as reported in a case study from 1. When considering the addition of Wellbutrin to Lexapro and Buspar, it's essential to weigh the potential benefits against the risks. Wellbutrin works differently than Lexapro, an SSRI, and Buspar, an anxiolytic, as it primarily affects dopamine and norepinephrine rather than serotonin. This different mechanism of action can sometimes provide additional benefits for mood, energy, and motivation. However, combining these medications requires careful monitoring for potential side effects or interactions, including increased risk of serotonin syndrome, changes in blood pressure, or worsened anxiety in some individuals.

Some studies suggest that combining bupropion with SSRIs can be effective in treating depression, as seen in a study from 2, which reviewed the literature on combining bupropion with SSRIs or SNRIs. Another study from 3 found that augmentation of citalopram with either sustained-release bupropion or buspirone appears to be useful in actual clinical settings. More recent research from 4 investigated optimized dose regimens of escitalopram and bupropion combination and found that combination treatment was superior in remission rate compared to monotherapy.

However, it's crucial to consider the potential risks, including serotonin syndrome, as reported in a case study from 1. A more recent review from 5 highlights the importance of a risk-benefit analysis when prescribing SSRIs, considering potential adverse effects, and dangers of the illness to be treated.

In terms of specific guidance, the most recent and highest quality study from 4 suggests that combination treatment with escitalopram and bupropion can be superior to monotherapy in speed of onset and remission rate, but it's essential to carefully monitor patients for potential side effects and adjust dosing accordingly. Ultimately, the decision to add Wellbutrin to a regimen of Lexapro and Buspar should be made on a case-by-case basis, taking into account the individual patient's symptoms, medical history, and response to current medications, and under the close supervision of a healthcare provider.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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