Can I take bupropion (Wellbutrin) 150 mg extended‑release together with amphetamine/dextroamphetamine (Adderall) 10 mg?

Can You Take Wellbutrin 150 XL and Adderall 10mg Together?

Yes, you can take bupropion (Wellbutrin) 150 mg XL and amphetamine/dextroamphetamine (Adderall) 10 mg together, but this combination requires careful monitoring for specific risks including increased blood pressure, heart rate, and potential for serotonin syndrome, though the latter is less common with this particular combination.

Key Safety Considerations

Cardiovascular Monitoring Required

• Both medications can increase blood pressure and heart rate 1
• Blood pressure and heart rate should be monitored periodically, especially in the first 12 weeks of treatment when using bupropion 1
• Amphetamines should be avoided in patients with a history of cardiovascular disease and uncontrolled hypertension 1
• Monitor for hypertension, tachycardia, and arrhythmias 1

Seizure Risk

• Bupropion lowers the seizure threshold and should be avoided in patients with seizure disorders 1
• The maximum dose of bupropion is 300 mg per day to minimize seizure risk 2
• Your dose of 150 mg XL is within safe limits, but combining with stimulants requires extra caution 1

Drug Interaction Profile

• Caution is warranted when combining two serotonergic drugs, though this combination is less problematic than others 1
• Stimulants (amphetamine class) and bupropion both have serotonergic activity, requiring monitoring for symptoms of serotonin syndrome in the first 24-48 hours after dosage changes 1
• Start the second medication at a low dose and increase slowly 1

Clinical Context for Combined Use

ADHD Treatment

• Bupropion is less efficacious than stimulants for ADHD but can be used as an alternative or adjunct 1
• Stimulants (methylphenidate and amphetamines) are first-line therapy for ADHD, with more than 90% of patients responding to one of the psychostimulants 1
• Bupropion may be considered when treating co-occurring depression with ADHD 1

Depression and Smoking Cessation

• Bupropion is FDA-approved for depression and smoking cessation 1
• The combination might be appropriate if treating both ADHD (with Adderall) and depression or smoking cessation (with Wellbutrin) 1

Monitoring Parameters

What to Watch For

• Neuropsychiatric symptoms: Monitor for development or worsening of depression, suicidal ideation, hostility, or agitation 1
• Cardiovascular: Check blood pressure and heart rate regularly, especially during the first 12 weeks 1
• Serotonin syndrome symptoms: Agitation, confusion, tremors, muscle rigidity, fever, tachycardia (though rare with this combination) 1
• Appetite and weight changes: Both medications can affect appetite 1, 2
• Sleep disturbances: Take bupropion in the morning to avoid insomnia 1, 2

Important Contraindications

Absolute Contraindications for This Combination

• History of seizure disorder (bupropion contraindicated) 1
• Current use of MAO inhibitors (contraindicated with bupropion) 1
• Brain metastases (both medications contraindicated) 1
• Uncontrolled hypertension or cardiovascular disease (amphetamines should be avoided) 1

Practical Recommendations

Dosing Considerations

• Your doses (Wellbutrin 150 XL and Adderall 10 mg) are both at the lower end of therapeutic ranges, which is appropriate for combination therapy 1, 2
• Bupropion 150 mg once daily is a standard starting dose 1
• Adderall 10 mg is a typical starting dose for ADHD 1

Timing

• Take Wellbutrin XL in the morning to minimize insomnia risk 1, 2
• Adderall is typically taken in the morning as well 1
• If insomnia occurs, do not take Wellbutrin XL too close to bedtime 2

Common Pitfalls to Avoid

• Do not abruptly stop either medication without medical supervision 1
• Do not crush or chew Wellbutrin XL tablets - they must be swallowed whole 2
• Be aware that bupropion can cause false-positive amphetamine results on urine drug screens 2
• Do not use with other bupropion-containing products (e.g., Zyban for smoking cessation) 2