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Does Donepezil work well with Wellbutrin and Celexa?

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Posted on Thu, 12 May 2016
Question: My mom is 85- she always took celexa and wellbutrin- then her neurologist recommended donepezil-
For about a year and a half the Donepezil really seemed to make her very alert- she's on 10 milligrams
Does they affect of donezil lesson after awhile-where you need to increase dosage
Does donzepil work well with wellbutrin and celexa- her neurologist wanted her to get off wellbutrin but her doctor felt when she did she became more anxious- we are working with all our doctors but i just wanted an initial opinion if these drugs work well together
doctor
Answered by Dr. Olsi Taka (4 hours later)
Brief Answer:
Some risk of interaction.

Detailed Answer:
I read your question carefully and I understood your concern.

Donepezil is a drug used for dementia, a condition characterized by a gradual decline in higher mental functions (memory, speech, judgment etc). Dementia is of different origins, but generally it is a progressive condition, so Donepezil can not stop it only slow down the progression of symptoms, but they will progress eventually. It does not cause depression though. It might rather be stroke which predisposes to depression.

Wellbutrin and Celexa on the other hand are used for a different purpose, for depression and anxiety. Now generally they are not used both since they have the same end effect and using both doesn't make much sense, may also add to each others side effects such as increased risk for seizures. Furthermore Wellbutrin increases the effect of Celexa by affecting its metabolism. At a minor scale it increases the effect of Donepezil as well, but it's a minor side effect.

So to resume, combination of Donepezil with Celexa should be fine. Combination of Donepezil with Wellbutrin has some interaction but minor one and can be used if really necessary. What I would be more reluctant about would be the combination of wellbutrin and celexa, especially in an elderly person, increased risk for side effects.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Olsi Taka (28 hours later)
Thank you so much- I had actually heard about wellbutrin and celexa before- but i think my mom became anxious when we went off wellbutrin- and this was before she was on donnepezil. But we will talk to her doctor again because i think the neurologist felt the same way. My question is on donepezil- when they first gave her 5 milligrams within a day or two we saw her far more alert, responsive- it seemed to really work- and now she's on 10 milligrams. I have always felt that it kicked up her brain- do they ever go higher to like 15 or 20 milligrams- is it like coffee- after awhile you build up a tolerance and need more to get the desired affect. It could be that age is making her a bit depressed but she was doing so well for so long- even though she has some dimensia and the stroke 2 1/2 years ago did leave some affects to the brain- she is still very alert and with it. So we're just trying to see what we can do- we will also see her doctor but i would love your opinion as well about raising the donezepil
doctor
Answered by Dr. Olsi Taka (8 minutes later)
Brief Answer:
Can be raised, but not for depression itself.

Detailed Answer:
Hello again!

Donepezil dosage can be raised more than 10 mg. The maximal dosage is 23mg (there are 23mg tablets). There is also the option of adding a second drug for dementia which is memantine.

However I repeat that Donepezil is for dementia, cognitive decline. It doesn't have any known effect on depression. So that increase is advised only if there is a decline of cognitive functions, possibly verified with objective neuropsychological tests done by professionals (neurologist or neuropsychologist). Otherwise you risk increasing the risk of side effects without any added benefit.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Olsi Taka (49 minutes later)
You have been great- i have one last question-I understand that donezepil is for dimentia- and when the neurologist prescribe it my mom was not doing well- she was not able to walk well- she had broken her hip and she had very tight muscles long after physical therapy- he explained it could be the dementia as well. She was also a little confused- but she had urine infections. I had heard about donezipil but wasn't too impressed from what I heard- but I swear that from day one it might have had an unintended affect- it seemed to put a sharpness in her, and she almost did a whole turnaround -even in her walking. So forgetting if it holds of dimensia have you seen where the brain responds in a positive way and makes you a little sharper or do you think i imagined it a year ago- but i really don't think i did
doctor
Answered by Dr. Olsi Taka (6 hours later)
Brief Answer:
Read below.

Detailed Answer:
Hi...
Welcome back.

Of course I believe what you noticed last year, you are the one close to her in daily life and the most equipped in noticing improvements. I also find it understandable that a patient looks more "sharp" when symptoms of dementia improve. Dementia as we said involves higher mental functions such as memory, judgement, planning and performing tasks etc. So seems only natural that when these inabilities are lifted the patient becomes more alive, more assured in what he is doing and being able to do certain actions, which before he was uncertain and confused about due to the dementia.

At times the withdrawal due to cognitive decline may be taken mistakenly for depression. The other way around is also true, depression may be taken for dementia because patient is not concentrated and motivated. So that is why I said you should be careful and use standardized neuropsychological tests to judge whether recent decline is due to worsening of dementia or depression (or both) and raise donepezil, just wanted you to know that both sides of the medal can apply.

Hope this helps you.
Get back to me if you have further query.

Regards.
Above answer was peer-reviewed by : Dr. Deepak
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Dr. Olsi Taka

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Does Donepezil work well with Wellbutrin and Celexa?

Brief Answer: Some risk of interaction. Detailed Answer: I read your question carefully and I understood your concern. Donepezil is a drug used for dementia, a condition characterized by a gradual decline in higher mental functions (memory, speech, judgment etc). Dementia is of different origins, but generally it is a progressive condition, so Donepezil can not stop it only slow down the progression of symptoms, but they will progress eventually. It does not cause depression though. It might rather be stroke which predisposes to depression. Wellbutrin and Celexa on the other hand are used for a different purpose, for depression and anxiety. Now generally they are not used both since they have the same end effect and using both doesn't make much sense, may also add to each others side effects such as increased risk for seizures. Furthermore Wellbutrin increases the effect of Celexa by affecting its metabolism. At a minor scale it increases the effect of Donepezil as well, but it's a minor side effect. So to resume, combination of Donepezil with Celexa should be fine. Combination of Donepezil with Wellbutrin has some interaction but minor one and can be used if really necessary. What I would be more reluctant about would be the combination of wellbutrin and celexa, especially in an elderly person, increased risk for side effects. I remain at your disposal for other questions.