Brief Answer:
These symptoms should subside soon...

Detailed Answer:
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that you are going through a distressing time after the recent alteration in your treatment regime. Usually, when a new antidepressant is started, it is common to experience a transient period of worsening of symptoms during the first few weeks. This is because of the fact that the side effects of the medication can be more prominent than the beneficial effects in the first few weeks and also because of the fact that many anti-depressants are known to cause a paradoxical worsening of anxiety during the first one or two weeks. So, I would advise you not to get too worried about your worsening of symptoms. These should gradually subside and you should be feeling better in the next 1 or 2 weeks.

I'm not sure whether your doctor's plan is to switch over fully from Lexapro to Wellbutrin or whether to have it as an add-on / augmentation strategy. Either ways, looking at the way things have been in your case, it is wise to do the transition very gradually.

So, it would be a good idea to hold on to the 40mg dose of Lexapro for a while till you come out of this difficult phase and then taper it down very gradually, while gradually building up the dose of Wellbutrin.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist

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Brief Answer:
Better not to add on any other medication...

Detailed Answer:
Hello,

I know it must be quite frustrating to have these depressive symptoms despite being on antidepressant medication, but this phase is only going to be short-lived.

There are several herbal remedies or supplements which have antidepressant properties, but I would suggest that you rather avoid them at this juncture. The reason is that these herbal medicines can often have interactions with antidepressants and can sometimes even result in adverse effects. Especially, in your case, you're on the maximum dose of Escitalopram and you are on a significant dose of Wellbutrin as well. So, I would be very cautious in adding on anything else which would alter your Serotonin levels (Serotonin is the chemical which is enhanced by most antidepressant medication or their herbal counterparts).

If, however, your symptoms are very distressing, one option would be to decrease Wellbutrin to 75mg and then make the further increases very gradual.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)

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Brief Answer:
Yes, you can continue 40mg...

Detailed Answer:
Yes, the response to antidepressants varies very widely. A small proportion of people require much higher doses than others. The time taken for full response also varies significantly from person to person. That's why it is always better to wait patiently if there has been a partial response to a particular antidepressant.

In your case, since there has been a partial response to Lexapro and since you've just been started on Wellbutrin, it would definitely be worthwhile to wait for a few more weeks for the full effects of medication to kick in.

Till then, you can try relaxation techniques like deep breathing, yoga, meditation, etc. to keep yourself relaxed. Try to have a strict activity schedule so that your mind stays engaged and doesn't wander off to negative thoughts.

Best regards,
Dr.Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist

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