Why would your doctor prescribe both Citalopram and Wellbutrin?

Answer 1

Are you a smoker? Wellbutrin is Zyban (the smoking cessation pill) and they both are referred to in their generic forms as bupropion and budeprion, respectively. If you're trying to quit smoking and also dealing with depression, citalopram is a good SSRI to address it; Wellbutrin however may have been prescribed as a smoking cessation aid. I began taking Effexor about 10 years ago and have just recently finished the 1 YEAR weaning process (SSRI's and SNRI's are kind of hard to come off of but when you're ready, you're ready -- it took almost a year to wean off the Effexor in a way that was semi-comfortable, although the electric shock sensations, a symptom of reduced levels of serotonin, were very annoying). Adding 2 of these drugs means you'll have to one day wean off both of them - at different times, however. Anyway, about 4 years ago I was prescribed Wellbutrin as a smoking cessation aid and we (my doctor and I) discussed the Effexor/Wellbutrin combo. Wellbutrin is going to result in an increase in the level of serotonin and affects dopamine too (increasing it), which is the neurotransmitter that affects the sense of well being, euphoria and energy, etc. (In the case of methamphetamine, dopamine is actually reversed back out of the cells and left to stir around in your synapse, and that's when people get a rush and get addicted, etc.) In fact, Wellbutrin turns into amphetamine when it is metabolized. The effects are mild, however, but many say Wellbutrin has an energizing effect. Now take another similar antidepressant such as citalopram (or Paxil, Zoloft, Effexor, etc.) - keeping in mind that all of these drugs affect either one or both of the neurotransmitters serotonin and norepinephrine. Go to Google and type in SEROTONIN SYNDROME. It occurs when people basically overdose on serotonin, and it can be deadly. You should familiarize yourself with the symptoms so if you start to have any problems (and most people do not), at least you're prepared and educated. Also evaluate your family medical history and look at heart conditions, high blood pressure, Diabetes, basically anything that might put you at risk because both drugs tend to increase blood pressure and heart rate, etc. So it's common sense - you don't want to wear out your body. Your doctor should order some testing to make sure you don't have any of these conditions. Of course you'll want to think about the eventual withdrawal from the meds. Taking another SSRI/SSNRI would compound that issue because it'll be another hurtle to jump over when the time comes (and weaning should be done at separate times and I'd say a year+ apart, based on my own experience; these drugs work SLOWLY - it took the Effexor probably a good 6 months to affect me and the Wellbutrin took almost a full year. If you have the means, I'd take twice as long to wean off as it took to work up to your personal max dosage (for myself the max was 300mg Effexor and 300mg for Wellb.)