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Started Taking Wellbutrin And Prozac. Feeling Even More Anxious. What Should Be Done?

Posted on Thu, 7 Nov 2013

Question: I need to talk with a pshychiatrist about my panic attacks. I started wellbutrin 150 + prozac 20 mg for one week, but i feel even more anxious.

Answered by Dr. Seikhoo Bishnoi (21 minutes later)

Brief Answer:
Hello

Detailed Answer:
Welcome to XXXXXXX

Panic attacks are part of anxiety spectrum disorders. They are usually treated by anti-anxiety drugs and for episodic relief of anxiety usually medicines like low dose benzodiazepines are used. Apart from medicines other therapies like behaviour therapy and relaxation exercises like Progressive Muscle Relaxation Exercises, Breathing Exercises are also useful.

You have been prescribed Bupropion 150 and Fluoxetine 20 mg per day. Fluoxetine is a SSRI drug and when it is started in a patient it causes slight increase in anxiety in first week of therapy. The rebound increase in anxiety go away in a week or two. There is no need to worry. The drugs usually take about 4-6 weeks to show their effects.

You can ask more queries in follow up for you anxiety disorder and panic attacks.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (7 minutes later)

Thanks for reply.

Actually nobody prescribed me that. I decided to choose that combination. I also study in this field, so i thought that a it could be a good combo. But i am not sure anymore, i know also that wellbutrin can increase my anxiety but i thought that fluoxetine could get rid of it. I am not sure if i should wait longer or change combo. I dont want sexual dysfunction this is why i am using wellbutrin as well. I also take sometimes only if needed Xanax 0.25 one or two tablet, but i dont want to rely on it too much since it is a benzo. I know i should go to a psychiatrist but now i cant really, probably next month i can, but i need a little help now. Thanks.

Answered by Dr. Seikhoo Bishnoi (14 minutes later)

Brief Answer:
Hello again

Detailed Answer:
First of all I would like to tell you that you should consult a Psychiatrist for detailed evaluation. Self prescription of medicines usually prove harmful.

Fluoxetine is a good anti anxiety drug and it is known to cause sexual side effects like delayed ejaculation and anorgasmia. The side effects are usually seen in high doses like 40-60 mg per day. There is no need to take bupropion for now. Wait for the effects of drug and only then you can start bupropion in consultation of a Psychiatrist.

You can take 20 mg daily and wait for few weeks to see the effect. Dont take tension about sexual side effects as these are not very common at this dosing.

For episodic relief of anxiety you can take Xanax 0.25 mg per day. You can take the drug on sos basis. Dont take the drug on regular basis as it may result in dependence.

Thanks, if you have more questions you can ask again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (9 minutes later)

Thank you, I appreciate your help. I will try to go for fluoxetine only now and see what happens.

Is it ok to take it after dinner? I dont want to feel too drowsy during the day.

And also, can i stop bupropion cold XXXXXXX or should i decrease it? Thank you again for your time.

Answered by Dr. Seikhoo Bishnoi (7 minutes later)

Brief Answer:
Hello again

Detailed Answer:
Fluoxetine causes decrease in sleep and a little activation of brain so best time to take this drug is in morning after breakfast. It do not cause drowsiness.

Decrease the dose of Bupropion to 75 mg per day for next two weeks and then stop completely. This will prevent any mild withdrawals also.

Thanks, you can ask again if you have more questions.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar