Drugs Q & A

What Are The Benefits Of Combining Wellbutrin And Zoloft Together?

Combining medications can change the way the active ingredient works. This can increase the effect of that ingredient on your body, make it less effective, or have other unexpected results.

Potential advantages of combining medications include increased compliance, synergy and increased efficacy, and reduced side effects and cost. However, there are several risks when taking multiple medicines. You may be more likely to have side effects. Because most medicines can have side effects, the more medicines you take, the more likely you will have side effects. Taking certain medicines can also increase the risk for severe interactions some of which can be fatal.

What is Wellbutrin?

Bupropion, or Wellbutrin, is a commonly used antidepressant. Wellbutrin is classed as an aminoketone. It was first approved for clinical use in the United States (U.S.) in 1985. It is one of the most frequently prescribed antidepressants in the English-speaking world.

It is mainly used to treat and prevent depression and as a smoking cessation aid. It is less likely to cause weight gain or sexual dysfunction than an SSRI, but it can trigger seizures in those who are susceptible.

Bupropion, or Wellbutrin, is different. It is a norepinephrine-dopamine reuptake inhibitor (NDRI). An NDRI boosts levels of the neurotransmitters norepinephrine, also known as noradrenaline, and dopamine. Its action is complex, and its neurological effects are only partly understood.

As well as being an antidepressant, bupropion is an antagonist at nicotinic receptors. This means that it blocks receptors where nicotine normally binds, making it useful in smoking cessation.

What is Zoloft?

Zoloft is the brand name of a generic medication called sertraline, which belongs to a group of drugs called Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs like Zoloft are antidepressants that work by increasing levels of serotonin in the brain.

Doctors commonly prescribe Zoloft to treat anxiety, but it can also be used to treat depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic attacks, and premenstrual dysphoric disorder (PMDD).  

When taken correctly, Zoloft can make people feel less anxious or fearful, and it can reduce the urge to perform repeated tasks. It can improve sleep quality, appetite, and energy levels, restore interest in daily life, and reduce unwanted thoughts and panic attacks. 

Are there any benefits of combining Wellbutrin and Zoloft together?

Yes, according to a study published in the Journal of Psychopharmacology, combining Wellbutrin and Zoloft together can provide some therapeutic benefits, especially for depression patients who experience depressive symptoms that are persistent beyond appropriate treatment.

Combining Wellbutrin and Zoloft together works for this group of patients because each drug targets a different part of the brain, which results in increased efficacy and none of the participants of this study experienced adverse effects from the combination, but combining these drugs may increase your risk of seizures and heightened adverse effects.

It can take several weeks before you notice the effects of these drugs, and up to 12 weeks to feel the full effects. Side effects can appear sooner, but changes in your mood may take longer. Talk to your healthcare provider if you don’t see improvements after a few months.

It is important to seek medical advice about drug interactions from your healthcare provider before taking Wellbutrin and Zoloft at the same time.

What medications can interact with Wellbutrin?

Wellbutrin can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

Examples of drugs that can cause interactions with Wellbutrin are listed below.

Do not take the following drugs with Wellbutrin. Doing so can cause dangerous effects on your body. Examples of these drugs include:

•          Monoamine oxidase inhibitors (MAOIs): such as phenelzine or selegiline. Using these drugs with Wellbutrin can result in severe high blood pressure. At least 14 days should pass between your use of an MAOI and the use of Wellbutrin.

Interactions that increase your risk for side effects

Taking Wellbutrin with certain medications raises your risk for side effects from these drugs. Examples of these drugs include:

•          Antidepressants: such as venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, or sertraline. Increased side effects can include seizures. If these drugs are needed, your doctor may start you on a low dosage and increase it slowly.

•          Antipsychotics: such as haloperidol, risperidone, or thioridazine. Increased side effects can include seizures. If these drugs are needed, your doctor may start you on a low dosage and increase it slowly.

•          Beta-blockers:  such as metoprolol. Increased side effects can include low blood pressure. Your doctor may lower your dosage of these medications if they’re taken with Wellbutrin.

•          Anti-arrhythmics: such as propafenone or flecainide. Increased side effects can include fainting and changes in your heartbeat (too fast or too slow). Your doctor may lower your dosage of these medications if they’re taken with Wellbutrin.

•          Theophylline: Increased side effects can include seizures. If this drug is needed, your doctor may start you on a low dosage and increase it gradually.

•          Corticosteroids: such as prednisone or methylprednisolone. Use of these drugs with Wellbutrin may result in seizures. If these drugs are needed, your doctor may start you on a low dosage and increase it gradually.

•          Levodopa and amantadine: Increased side effects can include restlessness, agitation, shakiness, loss of body movements, dizziness, loss of balance, or trouble walking.

•          Blood thinner drugs: such as ticlopidine or clopidogrel. If you use one of these drugs with Wellbutrin, your doctor may adjust your Wellbutrin dosage to keep the levels of Wellbutrin in your body from getting too high.

•          Benzodiazepines: such as alprazolam or clonazepam. Using these drugs with Wellbutrin can increase the risk of seizures. It’s also increased if you’re taking these drugs and suddenly stop. Talk with your doctor to see if you have a greater chance of seizures.

What medications can interact with Zoloft?

Zoloft can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Do not take the following drugs with Zoloft. When they are used with Zoloft, they can cause dangerous effects in your body. These drugs include:

•          Pimozide. Taking this drug with Zoloft can cause serious heart problems.

•          Monoamine oxidase inhibitors (MAOIs): such as isocarboxazid, phenelzine, and tranylcypromine. Taking these drugs with Zoloft increases your risk for serotonin syndrome. You must also wait 14 days between taking these drugs and taking Zoloft.

•          Linezolid, intravenous methylene blue: Taking this drug with Zoloft increases your risk for serotonin syndrome.

•          Nonsteroidal anti-inflammatory drugs (NSAIDs): such as ibuprofen, naproxen, aspirin, and warfarin. Taking these drugs with Zoloft increases your risk of bleeding or bruising.

•          Triptans such as sumatriptan: Your risk for serotonin syndrome is increased when you take these drugs with Zoloft. Your doctor should watch you closely if you take these drugs together.

          Lithium: Taking this drug with lithium increases your risk for serotonin syndrome.

•          Serotonergic medications: such as fentanyl, tramadol, and St John’s wort. Taking these drugs with Zoloft increases your risk for serotonin syndrome.

•          Cimetidine: Taking cimetidine with Zoloft may cause a build-up of Zoloft in your body. Your dose of Zoloft might need to be lowered if you take it with cimetidine.

•          Tricyclic antidepressants: such as amitriptyline, desipramine, and imipramine. Taking Zoloft with these drugs may cause these drugs to build up in your body. Your doctor may need to adjust your dosage of tricyclic antidepressants while you take Zoloft.

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