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Is Latuda Safe To Take Along With Wellbutrin?

Posted on Tue, 5 Jul 2016

Question: Is it safe--or does it make sense--to add Latuda or another atypical antipsychotic to Wellbutrin? I stopped taking SSRI's a few months and eventually added Wellbutrin 150 mg XL to help with motivation and depression, but I am suffering severe social anxiety, ruminations, persecution complex, etc. that it does not treat. I know that wellbutrin works to increase dopamine while most antipsychotics suppress dopamine, that is why I ask.

I have a possible dx of Bipolar II AND complex trauma in addition to depressive symptoms, so we are avoiding SSRI for the time.

Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)

Brief Answer:
It can be done

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

Although it is not common practice to prescribe wellbutrin and antipsychotics together but it can be done. In many of my patients I use wellbutrin and abilify when there is issue with weight gain in setting of depression with psychotic features.

I understand the working mechanism of these two set of molecules of antagonizing nature but fortunately the area of action is different in brain and so they do not interact with each other. Having said this they can be used along with wellbutrin without any significant interactions.

I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards.

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

Follow up: Dr. Dr. Ashok Kumar Choudhary (41 hours later)

thank you for responding. Upon doing some experimentation, I have found that a lot of the unmotivated, depressed feeling, as well as obsessive thinking about persecution is coming from the lamictal, and I may not need to take an antipsychotic (I would prefer not to). Right now I just take the Lamictal 150 mg and klonopin .25 mgs.

I feel good in the morning before taking medicine. About an hour after taking my lamictal, I become sad and obsessively fight with people in my head over small problems or arguments that haven't occurred yet. Conversely sometimes when I take it I soon feel like I'm "on fire" and in a very good mood, also emotional, and wanting to do many things at once.

This is a consistent pattern but I know it is uncommon for Lamictal. I am now trying to take only 50mgs during the day and 50 at night, but I consistently feel awful after taking my daytime dose. If I take it all at night I cannot sleep well.

I really would like to stop taking this as I HATE feeling withdrawn and sad, but I know I shouldn't stop rapidly. Do you have experience treating people with Lamictal?

Answered by Dr. Dr. Ashok Kumar Choudhary (3 hours later)

Brief Answer:
Yes I have experience of Lamictal

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

I have gone through additional details and I think some information is missed while describing the problem.
It is not clear to me whether you are taking wellbutrin or lamictal on current day.

It will be appropriate to direct your question in understandable language without making it confusional.

Regarding your question about my experience with lamictal I must inform you that I have enough experience of lamictal prescription.

Thanks and egards.

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

Follow up: Dr. Dr. Ashok Kumar Choudhary (2 days later)

I'm sorry I wasn't clear. I was trying to determine the role of Lamictal (which I've taken for 10 years, currently at 150 mgs) in the lack of motivation, and hypervigilance/constant fears of persecution before adding an antipsychotic.

It turns out these symptoms are made worse at this level of Lamictal, but if I go down too low I have more problems with depression and keeping my thinking on track.

So yesterday I started taking 10mgs of Latuda to reduce the persecution and improve mood. I'm not sure what I will do regarding the dose of Lamictal or if I should add Wellbutrin

Answered by Dr. Dr. Ashok Kumar Choudhary (11 hours later)

Brief Answer:
Lamictal have little role for lack of motivation and constant fears

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

Although lamictal is good option for bipolar depression but it fails to work for few symptoms like lack of motivation and persecution in few individuals.

I think you have done right choice as Latuda have good role in all components of bipolar disorder and likely to help you. The another best option in this regard is Seroquel which also takes care of depressive symptoms along with hyperactivity.

I do not think wellbutrin is good choice in bipolar disorder as it likely to cause switch which could be more detrimental.

Regarding Lamictal please keep the dose constant for at least next two weeks and than depending on response a next decision can be taken.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.

In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386

Thanks and regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Ashok Kumar Choudhary (1 hour later)

I saw your link in this page how does it work if I want to consult regularly with you?

Answered by Dr. Dr. Ashok Kumar Choudhary (47 minutes later)

Brief Answer:
Yes you can consult

Detailed Answer:
Dear XXXXXXX
I am glad to know that you are interested for regular follow up.

While posting your question use this like which will direct you to my profile and your post will be visible to me only. This will save time for you and you will have privileged to get answer from expert of your choice. I must acknowledge that this is question answer platform and there will be no real time consultation.

In case you are interested in video or real time consultation the following link can be used.
icliniq.com/ashok
At this link you can book a consultation as per your choice of time.

I hope this will help you.
Thanks and regards.

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

Above answer was peer-reviewed by : Dr. Arnab Banerjee