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Does Librium Interact With Tynept, Quetiapine And Bupropion?

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Posted on Thu, 20 Apr 2017
Question: good afternoon doctor - I have been put on bupron xl 300 along with other medication as under:
quetiapine 150, tynept 12.5, Librium 10, lurasid 60 all in the night
tynept 37.5 od, bupron xl 300, Librium 10 in the morning
my fear of meetings and meeting strangers is still there, thought bupron would help me but it has not helped me significantly. after 10 days of taking bupron I am feeling burning sensation (pins and needles like sensation ) on the tongue and getting a slight pain on the side and the top of the tongue while swallowing. spoke to my doctor and he has told me to take neurobion forte in the morning but that does not seem to be helping me. does bupron cause such side effect? it is quite bothersome for me and am in a dilemma as to what to do? what would your advise be?
doctor
Answered by Dr. Seikhoo Bishnoi (5 hours later)
Brief Answer:
If tongue sensations persist then divide the doses to 150 mg twice a day

Detailed Answer:
Hello again,

The drug will supplement the actions of the drugs you're taking but please give the medicines time to show effects. Avoid anticipating the things, keep your hopes alive. Anticipation is resulting in anxiety and this is resulting in problems in social situations.

Weird sensation, pin needles like sensation on tongue, even altered taste sensation etc could occur due to rare side effects of Bupropion. If these are resulting in distress then you can talk with your doctor and take Bupron XL 150 mg twice a day instead of 300 mg in morning. This should solve the problem.

Just continue the same medicines in same doses. This will reduce the anxiety.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (17 minutes later)
Twice a day means morning/night or morning /afternoon
doctor
Answered by Dr. Seikhoo Bishnoi (3 minutes later)
Brief Answer:
Take morning and afternoon doses.

Detailed Answer:
Hello again

Bupropion is known to disturb sleep especially in first 4 weeks of therapy so better to take 150 XL in morning and afternoon, you can use the drug even with food.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (18 hours later)
Went to my doctor today as I was feeling depressed, felt like crying, didn't go to work. Feeling of worthlessness and hopelessness. Missed work today as I had an important meeting and was scared whether I would be able to introduce myself. Took bupron xl 150 and tingling is slightly better. Along with other medication, my doc has made following changes:
Reduced bupron to 150 and added imipramine. I have following questions:
Does imipramine help with social anxiety/anticipatory anxiety?
Will bupron 150 be helpful?
Between clofranil, prothiaden, doxepin and imipramine, which will be helpful for my symptoms?
My doc has said to take 25 imipramine mor/Eve, should I stick to that or start with 25 for first few days, if yes then 25 should be taken mor or evening for few days?
Is imipramine ok for stomach as I suffer from IBS, will it aggravate my IBS symptoms?
Do you agree with the addition of imipramine or you would have added other tricyclic for my symptoms?
Pls advise.
doctor
Answered by Dr. Seikhoo Bishnoi (4 hours later)
Brief Answer:
Imipramine might cause slight sedation and constipation.

Detailed Answer:
Hello again

Try to stay relaxed and avoid any anticipation. Your mood swings are related to severe anxiety. Please don't anticipate. Try to think and note the things that are bothering you most. Make a list of things that are bothering you and try to find out why these things are bothering you. Find out the maladaptive thoughts in you and try to correct them. Avoid generalising the things. Always disqualify the negative and make any positive thing important. The anxiety is occurring due to anticipation which is ultimately resulting in hopelessness or worthlessness. You are doing good in your job so how can you label yourself worthless. This is in your head only. You can use Zapiz 0.25 MG in events of severe anxiety.

If your doctor agrees then Bupron XL 150 morning and afternoon doses can be given. This dose adjustment will reduce side effects without compromising the efficacy.

Imipramine is a TCA drug and might cause constipation. So this might worsen IBS symptoms especially for first few days of starting the treatment.

Imipramine helps in anxiety and intractable depressive symptoms. But in my opinion Bupron XL 150 twice a day should be given try.

Clomipramine has more sedation but is effective. Imipramine too has good effectiveness. Prothiaden I have used in somatic symptoms mostly. I haven't tried Doxepin. In my opinion Imipramine or Clomipramine can be tried.

Imipramine morning dose might cause sedation for few days but that will decrease with time.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (20 hours later)
after reducing bupron to 150, still am getting strange taste and slight tingling in the tongue, I have following questions:
I have started imipramine 25 last night, for how long should I take it before making it 50? should I take 50 in the night or make it 25 mor/eve?
I don't think I will be able to live with bupron 150 as I am a smoker and I think my smoking is adding to the tingling as it is given for stopping smoking also.
If I have to stop bupron, for how long should I take it before stopping it to avoid withdrawal symptoms?
Will imipramine compensate for bupron, I mean will stopping bupron and continuing with imipramine add to the anxiety or imipramine will take care of it? what is the best dose of imipramine to control anxiety?
Have read that imipramine helps to control panic attacks, along with it, is it also useful for social/anticipatory anxiety?
Pls advise.
doctor
Answered by Dr. Seikhoo Bishnoi (1 hour later)
Brief Answer:
Imipramine can be increased to 50 mg after a week.

Detailed Answer:
Hello again

You can keep taking Imipramine 25 mg for about a week and then increase it to 50 mg in evening.

Yes Bupropion is given for smoking cessation but that is an anti craving. Bupron doesn't react with smoking so smoking will not add to tingling in my opinion. Still if you are not happy you can stop using it.

Bupropion usually doesn't result in withdrawal symptoms. You can stop it without worries.

Yes Imipramine will also augment the actions of other drugs. The drug will take care of anxiety. Dose of 50-100 mg helps in anxiety but in some individuals higher doses are needed.

Yes the drug will be useful in social anxiety and acute anxiety like symptoms. Personally I haven't used the drug in my patients.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (2 hours later)
have tried nortryptyline and amitryn in the past with not much benefit, is imipramine more efficacious than nortrytyline and amitryn, also little worried to stop bupron fearing that it might bring my anxiety back, will imipramine take care of it? is imipramine as stimulating as bupron? with bupron my anxiety was lil better its just that side effects are bothersome, hope impiramine works as good as bupron if not better! pls advise
doctor
Answered by Dr. Seikhoo Bishnoi (1 hour later)
Brief Answer:
Imipramine has good efficacy.

Detailed Answer:
Hello again

Imipramine, Nortriptyline or Amitriptyline all are TCA drugs and have similar efficacy. In my opinion even if you failed to tolerate Nortriptyline or Amitriptyline even the you can give a try to Imipramine. This will be more tolerable.

Stopping Bupropion will not bring anxiety back. No need to worry. Imipramine will take care of any anxiety. Imipramine has good efficacy in depression but I don't think its stimulating. Yes Imipramine will do good in controlling the symptoms and even should do better than Bupron.

Thanks.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5193 Questions

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Does Librium Interact With Tynept, Quetiapine And Bupropion?

Brief Answer: If tongue sensations persist then divide the doses to 150 mg twice a day Detailed Answer: Hello again, The drug will supplement the actions of the drugs you're taking but please give the medicines time to show effects. Avoid anticipating the things, keep your hopes alive. Anticipation is resulting in anxiety and this is resulting in problems in social situations. Weird sensation, pin needles like sensation on tongue, even altered taste sensation etc could occur due to rare side effects of Bupropion. If these are resulting in distress then you can talk with your doctor and take Bupron XL 150 mg twice a day instead of 300 mg in morning. This should solve the problem. Just continue the same medicines in same doses. This will reduce the anxiety. Thanks.