Wellbutrin combined with effexor

[marywarydary]

My doctor has consulted with a psychiatrist and wants that I  begin with 150 mg Wellbutrin in addition to my current dose of 150 mg of Efexor. I have in that context some questions for you

1) According to interaksjoner.no (interaction.no) wellbutrin increases the concentration of Efexor 3 times when combined with Wellbutrin. It will therefore give an increase of 3 times the concentration of Efexor in the blood if I start directly on 150 mg Wellbutrin. This will give the insane sideeffects. Will there be a solution to cut straight down to Efexor 75 mg same day that I start with Wellbutyrin? Alternatively, how would you do this transition? (The reason I ask you is that I have tried to reach my MD for 2 weeks but not available to get in touch with him)

2) Can you drink alcohol when using this combination? Not talking about a lot of alcohol, but a glass of wine now and then.

3) What should doctor follow up during treatment and how often?

4) What  side effects are likely?

5) I have in addition to depression Panic attack. Panic anxiety has been completely lost during treatment with Efexor. Could Wellbutrin cause that panic comes back ?(since Wellbutrin is activating)

6) Does there excist studies that show efficacy / sideeffects of the combination of Efexor and Wellbutrin?

7)How are my risks aty getting seizures with this combo? (I have heard seizures are normal with wellbutrin)
Does taking Effexor with Wellbutrin make it more risky than wellbutrin alone?

8) Do you have any further advice to me in connection with the start of wellbutrin with efexor?

[marywarydary]

Hi Liz:)

Thank you very much for your answer:)
I would like to start with only 75 mg Wellbutrin, but they only WEllbutrin available here in Norway is the XR version and only in 150 mg capsules or 300 mg capsules:(

[Liz C, RPh]

You will need to discuss with your doctor about decreasing the Effexor dose when you add Wellbutrin. Another option would be to start on a lower dose of Wellbutrin such as 75mg. It is not recommended to drink any alcohol with either of these medications. Common side effects of Wellbutrin are changes in appetite; constipation; dizziness; drowsiness; dry mouth; headache; increased sweating; nausea; nervousness; restlessness; taste changes; trouble sleeping; vomiting; weight changes. Severe side effects that need medical attention right away are severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue, unusual hoarseness); blurred vision or other vision changes; changes in sexual desire or ability; chest pain; confusion; dark urine; delusions; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; hearing problems; menstrual changes; new or worsening mental or mood changes (eg, concentration problems, depression, "panic attacks", aggressiveness, agitation, anxiety, impulsiveness, irritability, hostility, exaggerated feeling of well-being, inability to sit still); red, swollen, blistered, or peeling skin; "seizures"; severe headache or dizziness; severe or persistent joint or muscle pain; severe or persistent nausea, vomiting, or stomach pain; severe or persistent nervousness, restlessness, or trouble sleeping; shortness of breath; suicidal thoughts or attempts; tremor; unusual swelling; yellowing of the skin or eyes. Taking Effexor with Wellbutrin is not any more risky of getting seizures than wellbutrin alone. There are studies out that show there is an improvement when patients take Effexor with Wellbutrin together. Ultimately, it depends on how well you respond to the combination therapy and being monitored by your doctor with the side effects.