Wellbutrin is an antidepressant medication for depression and other mental health conditions. It is also used to aid smoking cessation. This medication affects the chemical messengers norepinephrine and dopamine measure in the brain, which regulate mood and feelings. Wellbutrin comes in two dosage forms, namely, Wellbutrin XL and Wellbutrin SR brand names. Wellbutrin XL is typically prescribed to treat depression and seasonal affective disorder. Doctors generally prescribe Wellbutrin SR for depression in adults. Like other medications, Wellbutrin may interact with other drugs or foods. This article discusses Wellbutrin drug interactions, warnings and precautions, and frequently asked questions. Read on to know more.
Wellbutrin Drug Interactions
Like other antidepressant drugs, interactions may occur when Wellbutrin is used with other medications or substances.
Some substances or drugs can cause Wellbutrin to have a different effect than expected when they interact.
In addition, certain health conditions can also cause interactions when using Wellbutrin.
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How many drug interactions does Wellbutrin have?
In general, there are 491 drugs recorded to interact with Wellbutrin. Similarly, Wellbutrin has 8 disease interactions and 1 alcohol interaction. Of the 491, 5 are minor, 269 are moderate, and 217 are major.
When to stay away from Wellbutrin
Wellbutrin is famous for being effective against depression and other mental health conditions.
However, people with certain health conditions should avoid the drug as it can raise the risk of harm from use.
The effects of these interactions are called contraindications.
People with seizures should avoid Wellbutrin. One of the side effects of Wellbutrin is a reduced threshold for seizures.
People with seizures, epilepsy, or taking drugs that increase the risk of seizures should avoid this medication and speak to a doctor for safer treatment options.
People diagnosed with an eating disorder should avoid using Wellbutrin.
Research indicates an increased risk of seizures in patients with bulimia or anorexia using Wellbutrin.
This is why doctors avoid recommending Wellbutrin to patients with either condition.
People using or recently stopped a benzodiazepine, barbiturate, or epilepsy drug have a higher risk of seizures if they use Wellbutrin.
In addition, people who consume alcohol excessively or recently stopped drinking excessive alcohol have a higher risk of seizures if they use Wellbutrin.
Also, taking a monoamine oxidase drug with Wellbutrin increases patients’ risk of high blood pressure.
Wellbutrin and MAOI drugs typically cause interactions.
Examples of MAOIs
- isocarboxazid (Marplan)
- selegiline (Emsam, Zelapar)
- phenelzine (Nardil)
- linezolid (Zyvox)
- methylene blue (Provayblue)
Because of the increased risk of high blood pressure, patients should avoid using Wellbutrin with MAOIs. Suppose you’re already using an MAOI. Your doctor will let you stop it for at least 14 days before taking Wellbutrin.
People with an allergic reaction should avoid Wellbutrin. Patients who have noticed an allergic reaction to Wellbutrin or its compositions should not use this medication to prevent unwanted adverse reactions.
Your healthcare professional can recommend safer treatment options.
Does Wellbutrin Contraindicate Other Drugs?
According to the Food and Drug Administration, 491 drugs were recorded to interact with Wellbutrin. Similarly, Wellbutrin has 8 disease interactions and 1 alcohol interaction. Of the 491, 5 are minor, 269 are moderate, and 217 are major.
Wellbutrin Interactions with other antidepressants
Wellbutrin is a generally favorable antidepressant with mild side effects. However, when used with other antidepressants, specific interactions may occur.
These interactions may be triggered by different reasons depending on the medication involved.
For instance, some interactions may occur because Bupropion (Wellbutrin) inhibits specific proteins that work on the drug in the body.
In addition, combining Wellbutrin with other antidepressants may increase a patient’s risk of serotonin syndrome or seizures.
Serotonin syndrome is triggered by too much serotonin in the body and can be fatal.
For example, combining Wellbutrin with Prozac can significantly increase patients’ seizure risk.
In addition, Wellbutrin restricts the body from breaking down the other antidepressants correctly, leading to other adverse effects. This medication is cleared out from the body through the kidney. Patients with renal impairment may experience some side effects due to its build-up in the body.
The following antidepressants interact with Wellbutrin:
- fluoxetine (Prozac)
- sertraline (Zoloft)
- escitalopram (Lexapro)
What could happen with Wellbutrin drug interactions?
Using Wellbutrin with other antidepressants can increase the risk of side effects from both medications. Wellbutrin restricts the body from breaking down certain other antidepressants properly.
This means the drug levels of these antidepressants continue to build up in the body, increasing the risk of adverse effects.
The possible negative effects will vary, considering the medication paired with Wellbutrin.
Patients must discuss this with their doctors before using Wellbutrin with other medications. For instance, it may be safe to use Wellbutrin with other antidepressants, but a qualified healthcare professional must prescribe the amount.
A doctor may prescribe a low dose of Wellbutrin with another antidepressant medication or vice versa.
Wellbutrin and stimulants
Patients on stimulant drugs should speak to a doctor before using Wellbutrin.
Wellbutrin contraindicates stimulant medications typically prescribed for mental issues like attention deficit hyperactivity disorder (ADHD) and narcolepsy.
Other stimulants like phentermine are used for weight management in specific situations.
The following are examples of stimulant medications:
- methylphenidate (Concerta)
- mixed amphetamine salts (Adderall)
- lisdexamfetamine (Vyvanse)
Stimulant medications already increase a patient’s risk of a seizure. Combining this medication with Wellbutrin further increases the risk of seizure.
Patients on stimulant drugs must discuss with their doctors before using Wellbutrin. Your healthcare specialist will most likely recommend a low dose of Wellbutrin with the stimulant medication, then slowly adjust your dosage over time.
However, your doctor will immediately discontinue your dosage if you have a seizure while using both drugs.
Wellbutrin and specific diabetes medications
Like stimulants, Wellbutrin (Bupropion) interacts with specific diabetes medications. This applies to patients taking oral diabetes medications or insulin drugs.
The following diabetes drugs interact with Wellbutrin:
- insulins, such as Tresiba (insulin degludec)
- metformin (Glumetza, others)
People with diabetes must speak to a qualified healthcare professional before using Wellbutrin.
Patients with diabetes stand a high risk of seizures when using Wellbutrin.
This is especially true when there’s a drop in blood sugar due to a diabetes medication or insufficient food.
To use Wellbutrin with diabetes medications, patients must discuss it with their doctors.
The healthcare specialist will closely monitor the patient for adverse effects while also monitoring the blood sugar.
However, your doctor will immediately discontinue your dosage if you react negatively to the medications.
Are There Other Interactions With Wellbutrin?
Patients must speak to a healthcare professional before using Wellbutrin. Your doctor will consider the list of drugs you’re using to check for any possible interactions.
Wellbutrin may cause interactions when used with the following:
Drugs that are broken down in the liver
Wellbutrin is broken down by a protein called CYP2B6 in the liver. Other drugs that affect this protein can increase or decrease Wellbutrin levels in the body. People with hepatic impairments may slowly break down the medication, increasing the half-life in the body.
Your doctor can recommend taking a higher or lower dose of Bupropion, as the case may be.
These drugs include the following:
- Efavirenz (Sustiva) and any medications containing efavirenz
- Clopidogrel (Plavix)
- Carbamazepine (Tegretol, Tegretol XR)
- Ritonavir (Norvir) and any medications containing ritonavir
- Phenytoin (Dilantin, Phenytek)
- Phenytoin (Dilantin, Phenytek)
Wellbutrin (Bupropion) also inhibits the protein CYP2D6 found in the liver. This can boost the levels of other medications that CYP2D6 breaks down. Patients should make sure to speak to their doctors for safety.
Your specialist may recommend a lower dose of Wellbutrin or the interacting medication to avoid severe side effects.
These medications include the following:
- Tricyclic antidepressants (TCAs), like nortriptyline (Pamelor)
- Antipsychotics, like risperidone (Risperdal)
- Some heart rhythm medications, like flecainide
- Selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor XR)
- Beta-blockers, like metoprolol (Lopressor, Toprol XL)
Drugs that reduce the seizure threshold
Combining Wellbutrin with medications that reduce a patient’s seizure threshold is not advisable.
This is because Wellbutrin reduces the seizure threshold as one of its side effects.
Lower doses of Wellbutrin are less likely to cause seizures than higher doses.
Taking Wellbutrin with the following medications can be dangerous:
- Antipsychotics, like clozapine (Clozaril)
- Diphenhydramine (Benadryl)
- Cyclobenzaprine (Flexeril)
- TCAs, like amitriptyline
- Opioids, like tramadol
Drugs that boost dopamine measures in the brain
Medications like Levodopa (Inbrija) and amantadine (Gocovri, Osmolex ER) treat Parkinson’s disease and raise dopamine levels in the brain like Wellbutrin. Sinemet also (carbidopa/levodopa) contains Levodopa.
Combining these drugs with Wellbutrin puts a patient at risk of excessive dopamine levels in the brain. This can lead to toxicity in the nervous system.
Excessive dopamine in the brain can cause tremors, restlessness, dizziness, agitation, and poor coordination.
Monoamine oxidase inhibitors (MAOIs)
Doctors prescribe MAOIs to treat depression. Bupropion is also effective against depressive disorders in numerous clinical trials. Combining MAOIs and Wellbutrin can heighten the risk of critically high blood pressure. This can lead to critical conditions like a hypertensive crisis.
MAOIs, similar to Wellbutrin, raise the dopamine and norepinephrine levels in the brain.
Combining both medications may cause unwanted side effects.
Examples of MAOIs include the following:
- Isocarboxazid (Marplan),
- Phenelzine (Nardil),
- Selegiline (Emsam, Eldepryl)
Both medications should not be taken together. You must not take them two weeks within each other to avoid severe interactions.
Wellbutrin and Alcohol
Using Wellbutrin with alcohol may affect some parts of the brain. Alcohol has different effects on the body and the brain.
Combining both substances may lead to increased instances of suicidal thoughts.
In addition, alcohol and Bupropion can affect your concentration and make you dizzy or unsteady.
If you drink a lot of alcohol, it is vital to let your healthcare professional know before using Wellbutrin.
When To See A Doctor
Wellbutrin is an antidepressant that treats various mental illnesses, including depression.
This drug is also used for smoking cessation. You should immediately contact your doctor if you’re on Wellbutrin and experience the following:
- mood swings,
- worsening depression,
- suicidal thoughts,
- panic attacks,
- impulse actions,
- rapid speech.
It is essential to watch out for developing symptoms when starting an antidepressant dose.
Read also: Is Wellbutrin Safe During Pregnancy?
Frequently Asked Questions
Talk to your doctor before using these medications to avoid severe adverse reactions.
Excessive use of valium, or sudden discontinuation after long-term use, may cause seizures in patients taking Wellbutrin.
Combining these drugs can lead to Wellbutrin drug interactions.
It would be best to speak to a healthcare expert before taking Wellbutrin and Adderall, as they can increase the risk of seizures.
Wellbutrin is linked to seizures in 4 out of 1,000 patients who used the 450mg, while the risk increases tenfold for people taking between 450mg and 600mg daily.
Methadone, when used in high doses, can boost the risk of seizures.
Using this medication with Wellbutrin can increase the risk of seizures.
Wellbutrin and Celexa can be taken together when prescribed by a healthcare professional.
These medications are used to treat depression. Sometimes, doctors recommend adding Wellbutrin to medications like Celexa for more effectiveness and results.
Taking too much caffeine while using Wellbutrin can cause interactions.
Your doctor will likely advise you to stay off caffeine while using Wellbutrin to reduce the risk of seizures.
Using Wellbutrin and Vyvanse can boost the risk of adverse reactions.
Side effects such as high blood pressure, insomnia, restlessness, and heart palpitations may occur when these two medications interact.