Psychotropics: The Story of Welloft (Zoloft and Wellbutrin Combination)

[@matthewbennett1972]

Zoloft keeps me out of prison and welbutrin keeps me from being sad and feeling like life is pointless. I’m ok as long as I don’t run out.

[@ShrinksInSneakers]

Glad to hear you had a positive outcome with medication mangement.

[@user-tocava]

Facts

[@SherineHatoun]

I was prescribed Wellbutrin (generic) for ADD. I have been taking an SSRI (sertraline) for about 5 years when I experienced severe anxiety and depression. I appreciate this info.

[@ShrinksInSneakers]

Thanks for the comment, if you haven't subscribed to the channel please do and help us spread the word

[@vgshortsandvideos4576]

How r u now?

[@Mmcermes]

Zoloft destroyed my gut and libido...never an ssri again ever

[@Corleone007]

I just got Wellbutrin to my Zoloft taken for months... that combination makes me sleepy but it's good . But what is max dose of sertraline since both drugs affect metabolism of each other ?

[@userpandr]

Its honor to watch your videos , doctor

[@emirubio1]

I am adding 25 mg zoloft to my 150mg wellbutin. I am so glad I will have this combo again. I was in this combo for about a week before, and only stopped because my apetite was non existent & it was hard to get to sleep, but I am starting again because i felt immediate relief of my depression & anxiety. I was energetic, positive, and my focus and executive function was amazing. I also have add and take focalin (which I stopped today) and been through the gamut of ADD medication (even desoxyn) and nothings worked quite like this. Looking forward to what the day brings tomorrow

[@ShrinksInSneakers]

Glad to help, if you haven't subscribed to the channel please do and spread the word about what we are doing here.

[@Tzippi]

Did you gain weight?

[@vgshortsandvideos4576]

Was u emotionally numb?

[@Aismail96]

I'm finally taking the plunge and I've been prescribed this combination. I am dealing with little to zero motivation to do anything, lacking concentration/pleasure in doing things and recently sexual dysfunction. I'm actually a little afraid of how it will work but optimistic it will help me finally get up and live my life.

[@ShrinksInSneakers]

Best of luck with treatment, many people have had improvements in their symptoms and with depression the goal is to get you to remission. If you haven’t subscribed to the channel please do, and spread the word about what we are doing here. Follow us on Instagram for additional daily content.

[@darkmom8903]

Any update?

[@UNPACKed.]

I've been taking it over a month and it helps with all the symptoms of depression you mentioned plus extreme fatigue, chest pain, can't breathe, body pain, memory lost, irritability etc. But the side effects is tremor which is not too bad anymore and feeling a bit anxious sometimes and sleepiness

[@ljnv]

@@UNPACKed. ohh that's good im on zoloft and it's helped my ocd but everything is meh feeling

[@nymetsfan912]

I’ve been on 150mg of Zoloft for about a year now and the sexual side effects are pretty rough for me. The doc just had me taper down to 50mg of Zoloft and added 150mg of Wellbutrin XL. I haven’t started it yet but I will be tomorrow or the next day and am just trying to learn a little before I begin.

[@sarahnewcomb3686]

I was on Zoloft for 15 years. It was causing major sexual side effects so I asked to be out on Wellbutrin. My sex drive is back but wellbutrin does nothing for my PMDD or OCD. I’ve also had issue with weight gain since taking it, which I know is the opposite of the usual side effect. I would like to do a combo and add Zoloft back in but I don’t know if my sexual side effects will come back. I hate having to choose between my mental health and my sexual health.

[@joanamarques4749]

I'm having the same problem

[@plasticpunch]

You will never learn if you dont try. I had sexual problems with zoloft and switched to wellbutrin. Im almost a month on it and nothing positive up now. I m planning to try the combination of them

[@unshackledmind7863]

Is Zoloft blocking the dopamine the reason it causes such fatigue and hunger? I'm on 50mg of Zoloft and I'm always tired and feel like laying down half of the day, and I've never felt this tired on any other SSRI or SNRI.

[@koosh7299]

I was on Zoloft last year. It helped tremendously for my anxiety and OCD (mostly my intrusive thoughts) and helped my depression but… it caused horrible memory, was effecting my cognitive function, almost like I was showing very mild signs of dementia-forgetting why I walked into a room, having immediate short term memory etc But it also took away all my motivation, before Zoloft I was eating very healthy, working out, was physically in great shape but I was an emotional wreck, severe health anxiety, intrusive thoughts, emotional etc (before Zoloft) So again, Zoloft helped my anxiety maybe a little too good cause I became emotionally flat, couldn’t very if I wanted to (literally) I topped out at 125mg and then after a year total, I tapered off. Now 5 months off Zoloft, I’m back to being depressed, intrusive thoughts, health anxiety, and I’m back to being a as*hole… I want to try Zoloft again but also maybe adding Wellbutrin at some point. Should the Wellbutrin help with the motivation issues and the memory/cognitive issues I get from Zoloft alone?

[@koosh7299]

@Koriander Yander yeah pretty much why I got off it.

[@tehhdjsj]

Same issue exactly although my doc recommended starting Wellbutrin as well rather than tapering off Zoloft. I just started Wellbutrin today so I will report back how it is. On 100mg Zoloft, 150 wellbutrin

[@seawolph]

Hello! Out of curiosity, how did it go?

[@tehhdjsj]

@@seawolph hey just super neurotic so far but definitely had a ton of energy. Kinda felt like before starting Zoloft where I was anxious and really irritable. The last few days my brain has started slowing down again (in a good way). Also, been super tough getting a good nights sleep. Nothing I can’t manage for now tho. I’ll report back in like a week if I remember!

[@jacobladwig7033]

@@tehhdjsj hey Trevor, how are you feeling on both? I’m starting back up on my Zoloft after going off but my doc also wants me to take bupropion. Looks like we’re taking similar dosage.

[@omer-jl9rn]

Due to my bipolar 2 disease and anxiety, I started the combination of zoloft 50 mg, wellbutrin 300mg and lithium 1200mg. What kind of combination do you think? Do I have mania or depression with this combination

[@vedatzorro]

My doctor said that, Wellbutrin inhibits dopamine more than noradrenaline. He said actually Wellbutrin very week inhibitor for noradrenaline. Working on dopamine so much more. Is that true?

[@Queenoftangents999]

I have been on 300 Bupropion XL for 9 years. Recently, because of lack of effectiveness, my new psych has me trying 450 bupropion XL with 25 mg Zoloft. Im nervous.

[@czanderrr]

I've been on 10mg Lexapro and it was helping my anxiety pretty significantly but wasn't addressing my depression so my doctor added Wellbutrin, because we didn't want to increase the side effects of the lexapro. First couple days of Wellbutrin the stimulating effect really helped my depression and motivation, but past couple of days it really made me anxious. I'm gonna stick with it, hoping my body adjusts to it because I really want this combo to work

[@feverdream__9]

How are you now? My anxiety couldn’t handle Wellbutrin

[@czanderrr]

@@feverdream__9 I'm actually quite good! My anxiety lessened as I adjusted, and especially so once I switched from Wellbutrin SR to XL. SR was a quite noticeable stimulating and foggy feeling that made me anxious, but XL is a lot more subtle and doesn't seem to bring on any additional anxiety. For me anyway, it seems everyone is different as to whether XL or SR works better for them

[@milanic7267]

Hello. Are you still taking wellbutrin and lexapro? Greetings

[@czanderrr]

@@milanic7267 hello! I am. All is well, it seems like the combo for me. I plan on sticking with it for the long run, my doc thinks I should stay on it for at least a year with no changes. Seen some great results!

[@ifyoudontworkyoudonteat7644]

I think my Dr needs to lower my doses because I be frowning and laughing at the same time 😾😹

[@laurah674]

I could not possibly relate to this more 😂 😩

[@angelakanteh6226]

😂😂😂

[@mohammadkhadra2604]

Zoloft was prescribed more frequently than any other antidepressant in the USA in 2018 with over 38 million prescriptions.

[@ShrinksInSneakers]

I sometimes joke with my medical students that you could open up your prescriber’s guide, close your eyes, and randomly select from a list of SRIs. The joke being that many of these medications have similar efficacy and do not separate from each other in the randomized controlled trials. We are mainly selecting medications based on side effect profile and patient preference. I will usually start with escitalopram, bupropion XL, or Sertraline as first line options. Sertraline is an older medication with a proven track record and is well tolerated in patients with cardiovascular disease. Bupropion is a good choice for those concerned about sexual side effects but vortioxetine and vilazodone would also work here. They are new and very expensive. If you work in the community mental health setting most patients will not be able to afford these medications that’s why I do not put them in the first line options category. With escitalopram I’ve had good results treating both depression and anxiety, it has the least drug interactions but may increase QTc interval like citalopram.

[@ronnie-lynn]

@@ShrinksInSneakers that guy comments the exact same message on every video I’ve watched about Zoloft lol

[@ShrinksInSneakers]

@@ronnie-lynn I've noticed 😃

[@milanic7267]

greetings! is the combination of escitalopram and wellbutrin good or is zoloft+wellbutrin better? thank you

[@EphesianRose]

does Lexapro and Wellbutrin have the same synergy?

[@Corleone007]

Zoloft (taken for months) and added recently Wellbutrin makes me sleepy initially but it's good as I have strong GAD. Does it mean I may have kind of ADHD ? since mild stimulant makes me sleepy ? Since I've born I am a bit hyperactive (mild) BTW What is proper max. dose of sertraline when combined with buproprion? as those drugs affect metabolism (mild to moderate) of each other.

[@marieb9961]

In my country ( Mex CDMX )there is no more Wellbutrin ( among other things 😬) can we use another similar medication ?

[@chabelo5156]

Is it safe to take 100mg setraline and 150 mg bupropion

[@ShrinksInSneakers]

Always talk to you doctor before making medication changes this is not medical advice. In general this combination is safe and effective. If you haven’t subscribed to the channel please do and spread the word about what we are doing here. If you haven’t checked lately we are posting daily content on Instagram to combat mental health stigma and to educate.

[@keyliving3071]

Is 25 mg Zoloft safe with 300mg Wellbutrin Sr? (150mg twice a day)

[@_-_-_-_K]

Zoloft causes restless legs syndrome for me, can I take Lexapro instead with Wellbutrin? Another question, are seizures a very common side effect of Wellbutrin in people who have never had seizures before?

[@ShrinksInSneakers]

Theoretically any SSRI would work in this combination, so Lexapro would be a reasonable substitute. Yes, seizure is a risk but the important thing to remember it is dose dependent. The risk of a seizure with bupropion sustained-release preparation up to 300 mg/day is about (one in a thousand), which is as the risk with SSRIs. Thus, 150 mg/day or 300 mg/day of bupropion, it is true, that bupropion has a higher risk of seizures than the SSRIs. The risk of a new onset seizure in the general population is about so the risk with SSRIs or bupropion sustained-release up to 300 mg/day is at the most only minimally greater than that in the general population (0.1% vs. 0.08%). On the other hand, the risk of seizures with tricyclic antidepressants is about or times that with SSRIs or with bupropion sustained-release up to 300 mg/day. The risk of seizures with bupropion sustained release 400 mg/day (its maximum recommended dose)? The risk is about or four times greater than at doses up to 300 mg/day. So, the risk goes up once we use more than 300 mg/day. When using a dose greater than 300 mg/day is when we definitely need to tell patients about this elevated risk and to obtain informed consent.

[@raycasias5069]

I am currently taking both meds and have been on them for 6months. Is this something I can be taking long terms. This combo has benefited me and I am curious if this is something that can be taken for an extended period of time

[@ShrinksInSneakers]

It's a complicated question and this is not medical advice it's for educational purposes in general. Both of these medications have been around a long time and have good safety data. They can be used long term if needed and that need is based on factors like number of previous depressive episodes. Also things like attempts to lower the medication, were they successful, did symptoms reemerge when the dose was lowered. My general philosophy is people who have a single major depressive episode can attempt to lower the dose and come off the medication after 12 months. Most guidelines will tell you if a person had 3 or more major depressive episodes in a lifetime they should remain on medication given that each subsequent episode gets harder to treat and likelihood of another episode occurring is high. Hope this helps, if you haven't subscribed to the channel please do and spread the word about what we are doing here

[@nawafpsy]

Can Welloft cause Emotional Blunting as Zoloft alone can trigger? Because when I used Zoloft 50mg I had very miserable Emotional Numbness

[@bpggg]

When you mention DAT, although in a small amount in the PFC wouldn't it be more active in the striatum where you get maybe some extra antidepressant effect as well? Or is DAT there more associated with the smoking cessation? WIth NET in the PFC doing the majority (maybe?) of the work with DA wouldn't the DAT effect there be negligible? I'm just a layman so I would love your thoughts on the matter.

[@markallman418]

Zoloft made anxiety and panic things of the past. Wellbutrin was added to my regimen to help ED, depression, and possibly ADHD, it was the first thing my new family doctor suggested. Unfortunately it sent me spiraling into zero appetite, nonstop panic and anxiety, and at one point 70 hours without sleep. I had to start taking lorazepam just to regain my self-control. Needless to say Welloft did not work for me.

[@gts447]

Thanks for this dr Rossi., do you have any clinical experience with the mirtazapine/effexor combo sometimes called California rocket fuel? Thanks

[@dfgdfg_]

Pretty sure there is a video from him on it if your search

[@the21program10]

I’m doing prozac and wellbutrin together i like it so far

[@martinlutherkingjr.5582]

What dosage

[@sandymike2418]

Yes! How much Prozac do you take

[@myviews469]

I get the mechanics of Bupropion but does it help psychological issues with mental blocks, anxieties, lost of logic perception in ex: geometric drawings? Lastly when discontinuing Bupropion does it have withdrawals that magnify these anxieties symptoms?

[@fdddff47]

Nice to see you responding to comments. I have a question, too. Would you augment Fluoxetine or any other SSRI with buptopion or nortriptyline? Im taking 40 mg prozac and feel a lot better but motivation and sleepiness is a problem. I'm constantly tired and only function on caffeine.

[@Irishgemini1990]

I am taking lexapro and wellbutrin to try to combat the sexual side effects of lexapro. Has this worked for anyone?

[@jarebare00]

You seem to answer comments, so I am about to post this. A little bit of back story. When I turned 25 or 26 I started not feeling myself. It felt i was in a weird "Stoned" state and it was driving me crazy. I was scared, had trouble sleeping, and did not feel myself. It's so hard to explain the feeling but, it felt like a permanent cloudy bad marijuana high is the best way i can describe it. I did smoke weed prior for a couple of years. I still don't feel 100% but, I am now 32. I am taking Sertraline 100mg a day and I have been on this for awhile. I notice my energy has been very low and I have been having a hard time not taking a nap in the middle of the day and losing interests in wanting to do things. I definitely feel MUCH better now than before I was on meds, but still not all the way and I have tried other medications that just didn't work. Prozac and Sertraline seemed to be good for me but, Prozac had me gaining a lot of weight. I also take Clonazepam. Anywhere from 1-2mg a day. Was taking 3mg but, my doctor wanted to lower it as he thought it was too high. This drug really helps when I have a cloudy feeling and it being hard for me to concentrate. But, with it being a benzo, i know its robbing me of my gamma? I think my doctor said or something like that. I have been on clonazepam for along time now and I hate to say it, but even staying at the same dose for so long, it helps when I take it. I don't know if this is a placebo effect, but it does calm me, make me feel better and help with cloudiness. That be said, I heard its bad to even say on benzos past a few months and its been a couple years and I'm nervous but I'm doing it under a doctors care. Where I am getting with this is, he recently added bupropion and I feel weird on it. But, I literally have only taken it for like two days and I feel my anxiety kind of spikes when I take it and it makes me pop a clonazepam and I have read that it can help anxiety as well. I have no idea if I am depressed or if its more on the anxiety side, but I don't have any crazy side effects like dizziness etc. But, I don't know if I should keep on trying. The dosage I am taking is 100mg SR, 1 in the morning and 1 after lunch. I know I have a psych I can talk to, but its hard to cough up money every single time and I know my mental health is more important than money, but its manageable at least for right now. I want to wait it out because I have heard amazing things. Someone I talked to said, "Zoloft saved my life, but Wellbutrin let's me live my life" and that stuck with me hard, so I am very conflicted. I went on a crazy long rant. I apologize. Wanted to share my story and any advice is appreciated.

[@ShrinksInSneakers]

This is a lot and I always say in these cases it’s best to talk to the person prescribing the medication and I cannot provide specific medical advice, I’m not your doctor. What I can say is based on the details I’m not sure what the diagnosis is, and a good diagnostic evaluation will set the rest of the treatment up for failure or success. All the RCTs have very specific inclusion criteria meaning the people in the trial only have bipolar or MDD and nothing else. We call these people unicorns, fable creatures impossible to capture. I got some hints of dissociation, maybe trauma, anxiety, depression, possibly psychosis it’s hard to say. Let’s assume it’s anxiety and depression. Sertraline is a good first line option and 100 mg is a good dose. Results tend to fall off above 100 mg but it might be worth considering 150 mg to 200 mg prior to adding another medication. There is also a taper of clonazepam going on at the same time which may have an effect on outcomes. With side effects the rule is to wait wait and wait as they tend to get better with time. My rule is wait two weeks before determining something is not working. This is a lot and I would talk with your doctor before making any changes. If you haven’t subscribed to the channel please do and spread the word about what we are doing here. Check out my Instagram I’m creating daily content there as well.

[@jarebare00]

@@ShrinksInSneakers thanks so much. It's just nice to hear another perspective. Especially when it's someone who has the knowledge and credentials. I do have appointments with my doctor soon, but I really feel the Wellbutrin is giving me a weird anxiety feeling and increasing it. I'm not sure if 3mg a day is a high dose. But, I can say that, this literally came out of no where. I hit 25, I have a great life and still do, but I still suffer and have these moments of an insane impending doom feeling or just in general don't feel like myself. Get very cloudy and hard to concentrate. I've heard it's GAD and depression? I'm not sure what caused it. I have heard maybe bipolar, but never psychosis. I may need to look into that but the internet sucks and tells you a lot of false information that scares you more than anything. I would like to minimize medication. I will say, taking clanzopam even after being on it for years. 1 to 2 mgs makes me feel very good and calm and helps with that brain fog and anxiety like feeling. I just been on it for years I feel I would be scared to get off of it, being that I see results when taking it. I never abuse it because I'm scared of stuff like that. I get really tired on Zoloft which is why they wanted to add Wellbutrin but, I don't like the way it makes me feel. I swear only for taking it for a week it's made anxiety worse if that's even possible. Maybe talking to them about upping Zoloft? I just don't want to get more sleepy or gain more weight

[@CC12398]

@@ShrinksInSneakers this information is good thank you. Maybe you could do a video on the dangers of benzos?

[@verticalexit7253]

Could the Wellbutrin counteract the sexual side effects of Zoloft?

[@michealjohn7793]

I saw online more levels of serotonin decrease levels of dopamine so whats the purpose of mixing two .i want more dopamine levels . Will mixing zoloft with welllbutrin decrease dopamine levels versus wellbutrin alone

[@mr.timebombman2230]

I was on Cymbalta and Wellbutrin. Was thinking of trying Zoloft, but I'm just trying to check some reviews first. One thing I know is that I don't want the weight gain. Cymbalta don't do that, but it's not helping my anxiety much. Thoughts?

[@ShrinksInSneakers]

There is some risk of weight gain even with Cymbalta. The Wellbutrin should help in that regard to prevent some of the weight gain. As in my video on weight gain primary prevention is king and good foundation with diet and exercise is important. I don’t think Zoloft is any more effective than Cymbalta and Cymbalta has some precognitive effects that may be work keeping. kzbin.info/www/bejne/oZyVpnqtq9hooaM

[@dfgdfg_]

What does were you on @Man? I'm on Cymbalta for anxiety and depression and want to add wellbutrin to offset the tiredness

[@drozek24]

I have been on Zoloft 50mg and Wellbutrin xl 150mg for two and a half years now. First year and a half- felt like I was myself again and finally felt better. Over the last year though, I have become extremely cold towards people. I lack empathy and I can no longer choose one path. I overwhelm myself to the point of not choosing a path because it’s too hard. I am going to try to wean myself off of both. There’s just no way life should be this dull and boring at age 25.

[@moonmarcherspade8678]

I strongly recommend upping both medications. Sometimes that happens then you stop at a certain point. I'm on 100 Zoloft and 300 Wellbutrin

[@MrxPr1me]

Other lifestyle factors could be at play. Look at your diet, physical health, relationships in your life, work life.

[@austinwagner22]

how are you doing now?? I have been taking zoloft 50mg but just now adding Wellbutrin xl 150mg. Also, check out @charlierocketofficial it will help with feeling overwhelmed with not knowing what path to take

[@inkstain7193]

I noticed high anxiety on Wellbutrin for the first 2 weeks. And tinnitus.

[@milanic7267]

I have a buzzing in my head non stop and I'm afraid it won't stop :((

[@soliloquylove2115]

Thank you for this video. Wellbutrin was just added to my regimen to go with the sertraline and trazadone. SAD is still rearing its ugly head.

[@puupgo9553]

What are your thoughts on recommended doses for this combination? I'm taking 50mg zoloft, interested in adding some wellbutrin for general ..'tentative' effect Has been working with the combination in trials right now by axsome pharmaceuticals asx-05 of 45mg dextromethorphan with 100mg sr 2x day, and it was really effective. ..I'm currently "in the system" right now so unable to work with that at the moment , so thinking the 'Welloft' route for a bit.. Thanks pgõ

[@ShrinksInSneakers]

I would talk with your doctor about the plan, but in general this would be my approach to something like this. I would optimize the Zoloft first and see where you are at before adding another medication. 50 mg/day is the lowest effective dose, and RCTs indicate the optimum dose is somewhere between 100 mg/day and 150 mg/day. If there are still residual symptoms despite optimizing treatment, then you can consider augmenting with something like bupropion. Hope this helps, thanks for checking out the channel

[@piscea0229]

I just started on this combo!

[@ShrinksInSneakers]

Great, hope this video helped any other questions I’m happy to answer them

[@stevieg2536]

Same

[@jackmason7466]

How did this mix work out for you? My son is starting this combo today?

[@andreawilliams8763]

I just started two days ago

[@Maharddhika]

I just started. How are you feeling so far?

[@cheyennerose7199]

Question to only those who have tried the combo: I have been on wellbutrin for a month now and experience tachycardia and heart palpitations, but doc prescribed me 50mg zoloft to help counteract the side effects on wellbutrin. I've seen some placesthat zoloft can cause tachycardia as well and obviously I don't want to do that to myself lol. I know the side effects like that are typically rare and not happen to everyone, I just need to make sure I'm doing whats best for my body. Thanks in advance :)

[@nanananatalied]

I've not had that problem on either. I'm not having that problem on both combined. Probably not helpful. If I had to give up one just to deal with anxiety, it would be welbutrin. Welbutrin feels speedy. Zolof leaves you a bit numb. My anxiety will give me palpitations, so I would choose to stay on the drug that takes life down a notch or two in intensity.

[@chrisinglett3704]

Is Paxil and Wellbutrin a good combination? Im about to start them together (have been on Paxil for many years) and I’m nervous about any interactions or side effects.

[@alberthoffman5297]

it's also an ssri like zoloft, so it should work the same or very similar

[@atousay1365]

I have been taking bupropion immediate release for over 8 years now, 300 mg a day. When I had the "Mylan" Brand, it was so effective in treating my depression and gave me tons of energy. Mylan stopped production of this med, it has been awful since. I tried all brands, even extended and suspended release, they did not work with me, made me dizzy and like a zombie. I use heritabe brand, its like doing minimal to nothing for me. I have zoloft, 25 mg, but scared to add it to the mix.. any thoughts? I shouldn't say "scared", I mean I don't think it will do much as i've tried it for a couple of weeks in the past, and was no help. I am looking for something to give me better energy, that is a big problem for me...

[@bastirauchful]

I take Sulpiride as Antidepressant but I had a lot of weight gain, can I change to Wellbutrin?

[@ShrinksInSneakers]

Always check with your doctor when it comes to medication changes and switches. If weight gain or sexual side effects are an issue a switch to Wellbutrin can help provided there are no contraindications to using the medication. I have a video on seizure risk and Wellbutrin. I appreciate the comment

[@MrCupcakes13]

These videos are incredible! What do you think about Wellbutrin and Lexapro? I'm currently taking Lexapro, was on Zoloft for years before making the switch as it was effective for MDD but not anxiety. I've noticed no difference on Lexapro, to be honest. I'm interested in adding Wellbutrin to help out with executive function (suspecting ADHD and waiting to see a psychiatrist).

[@ShrinksInSneakers]

This is not medical advice, it’s for educational purposes only. Always talk to your doctor prior to making any changes.This is a common addition for people who do fully respond to a single medication. Looking forward to hearing about your results. If you haven’t subscribed to the channel please do and spread the word about what we are doing here. We also have daily content on Instagram @Shrinks_In_Sneakers

[@courtneyjade726]

Ashleigh did the lexapro improve your anxiety? I’m on 150mg of wellbutrin and 25mg of sertraline and doesn’t seem to work for me

[@Motive_Humèn]

Wt u think pristiq and welbutrin combo?

[@Yahman1969]

Is it good for ptsd

[@honestyquality3565]

I’m on 150xl Wellbutrin and 50mg Zoloft. I feel great but I sleep alot

[@ShrinksInSneakers]

At the end of the day all we intend to do is attempt to make people’s lives a little better. I’m glad the combination is working for you, and there is plenty of room to make adjustments along the way. Appreciate the comment

[@honestyquality3565]

@@ShrinksInSneakers if I drop down to a 25mg Zoloft from 50mg will I not sleep as much????

[@ShrinksInSneakers]

@@honestyquality3565 It’s difficult to say, Zoloft is not known to be all that sedating although some find it to be. 25 mg/day is below the lowest effective dose so I would talk with your doctor before making any changes.

[@kateavrith]

I guess that means these medications make you more tired ? Like do u have a loss of energy?

[@ShrinksInSneakers]

@@kateavrith It's difficult to predict responses to medications, it really is a case by case basis. Some people find bupropion to be more activating and feel like it helps with energy and motivation. Depression in general can often present with low energy and fatigue as well. If you have a more specific question I will try to provide a more detailed answer, appreciate the comment

[@GymRatCrypto]

I take Zoloft and Buroprion. It works great. I’m worried about long term. I also am on hrt all together I am a tank. Wish I new more Bout Buroprion and long term sides

[@ifyoudontworkyoudonteat7644]

Sometimes I frown and laugh at the same time 😾😂

[@makkhan-jg7vf]

GYMRatcrypto you still on this combo what about sexual and weight side effects?

[@profet1385]

Hey Man, if I've "fried" my dopamine receptors through 8 years of hardcore iv stimulant drug use, would adding an antidepressant that works on DA receptors help with things like motivation, concentration, experiencing pleasure, joy, etc? I'm on venlafaxine right now, I've read it does have some weak DA action in very high doses (300mg+),although I'm on 150mg right now (recently started) and "weak DA activity" doesn't sound very promising to be honest...

[@ShrinksInSneakers]

This is a difficult question but I'll do my best here. At 150 mg from the literature this is a solid dose and the benefits about this dose are mostly related to norepinephrine. Below 225 mg the norepinephrine effect is minimal (mostly a serotonin based medication) but at or above 225 mg the response increases but side effects seem to be worse. It does have an effect on dopamine in the prefrontal cortex because dopamine is primarily cleared from the synapse by NE transporters. I do think venlafaxine is a little better than SSRIs at treating symptoms of depression. I would consult with your doctor about the concerns but I hope this helps a little in understanding how the medication works

[@edenwinter9055]

I'm going through the same issue!!! In the process of finding the right combination. Wellbutrin is amazing for quitting drinking and smoking and appetite suppression (packed on the weight). Still struggling with motivation, energy, and focus.

[@faheykj]

@@ShrinksInSneakers I started taking cipralex last summer for anxiety, thr anxiety was also making me feel depressed. This is my first time taking an antidepressant. I found I was still having anxiety. I switched to Pristiq last November 150mg per day. It seems to help with anxiety. But I've found I get daily acid reflux and I've gained 20lbs. I'm active and exercise regularly. I feel like this medication blunts emotions, dulls sexual desire. I don't feel overly motivated. I'm wondering if Wellbutrin might be a better option for anxiety as it doesn't cause weight gain or acid reflux? I wonder if this medication would be more uplifting rather than bunting emotions?

[@ShrinksInSneakers]

@@faheykj This is not medical advice and it’s for educational purposes only. I will usually switch to Remeron or bupropion. I think bupropion could be a good option when there are issues with concentration, motivation, focus, energy, and sexual side effects. There is the added benefit of no weight gain and possibly weight loss when combined with naltrexone. Emotional blunting may also be better with Wellbutrin. Hope this helps

[@faheykj]

@@ShrinksInSneakers thank you!

[@JoshDTech]

Doctors don't use MAOI because of risk imbalance. Doctors only have to face the risk of patient harm from the medication. Patients have to factor in not only the harms of medication but the failure rate as well.

[@ivanivan-zw8qx]

Which antidepressant is better (sertraline or escitalopram)?Tnx

[@ShrinksInSneakers]

This is a difficult question given they all have similar efficacy. We often make medication choices based on side effect profiles and clinical experience. Either of those medications are first line options in my practice, but clinically I lean more towards escitalopram because it has few drug interactions, is generally well tolerated, is dosed once daily, and is as close as we have to a pure serotonin reuptake inhibitor. Hope this helps

[@EE-ie9gm]

@@ShrinksInSneakers thoughts on remeron and does it have less sexual sides than Zoloft or lexapro

[@ShrinksInSneakers]

@@EE-ie9gm It does have less sexual side effects which is a good thing for sure

[@iKam1Kaz1]

Just a question I have about wellbutrin where it has SR and XL forms are they just extented release forms and if so is there a reason they are named different?

[@ShrinksInSneakers]

There are actually 3 formulations, immediate release (IR), sustained release (SR) and extended release (XL). With the IR you want to dose it more often usually 3 times a day because the half-life is short, and it leads to faster peak blood levels. With SR it is dosed 2 times per day. XL is nice for two reasons its once daily dosing, compliance with medication is reduced significantly for patients taking medication 2-3 times daily, and the XL formulation does not result in rapid increase in blood levels which is usually the cause of side effects. You want to watch for people with seizure disorder and avoid going over 450 mg/day. Also, people without seizure disorder can have a seizure if they abuse the drug (e.g. taking too much or shorting the medication)

[@iKam1Kaz1]

@@ShrinksInSneakers thanks for the reply and when you mention the abuse as wellbutrin is that a large issue? Just asking as I never knew a drug marketed as a anti depessent which has then turned into some kinda drug of dependence/abuse. Dr

[@ShrinksInSneakers]

@@iKam1Kaz1 I’ve had a few cases of accidental overdose resulting in seizure. In most prison systems they do not allow you to prescribe bupropion. Another example would be quetiapine which is usually not available in the prison system for risk of abuse. Bupropion differs from other antidepressants with respect to the stimulant like effect, it has also been studied in ADHD and can be used off label for ADHD treatment in adults, that is where the abuse potential comes from. Although this is still not very common.

[@iKam1Kaz1]

@@ShrinksInSneakers Im not sure if you have seem the documentary yet about I believe meth addicts injecting wellbuttrin as a way to i assume fight off withdrawls? Is there much merit to this or more so just people abusing drugs for some type of "high"? P.s thanks for the information you provide. I can see it hellping people understand certain medication that they may be prescribed but need for information.

[@ShrinksInSneakers]

@@iKam1Kaz1 There is no FDA approved treatment for amphetamine use disorder. If you are a gun slinger you could use a stimulant like methylphenidate or amphetamine/dextroamphetamine with the theory that it acts like a “replacement.” There isn’t really good evidence for this, and it would be considered off label. Bupropion has not proven to be effective, although there are some trials. If a person had a depressive disorder and methamphetamine use disorder, then maybe you make an argument for this medication. I’m linking a 2019 meta-analysis for reference. onlinelibrary.wiley.com/doi/abs/10.1111/add.14755

[@hasibulrafi9574]

Does welloft is good for reward defecite syndrome???

[@foodie4128]

I am on Zoloft now for 3 months, it seems to control the anxiety but I can't sleep 😥 my pain doctor will not allow me to be on Ambien or benzodionazepines for sleep and those two medicines was the only thing that helped me sleep 😥 furthermore The Zoloft as soon as I try to fall asleep my leg or something else twitches or moves. Doctor told me to keep my dose at 50 mg. And he recently wants me to add Wellbutrin.. But I fear Wellbutrin because I'm already on hydrocodone and I believe that can cost too much dopamine? For an example I'm on tramadol but I don't take it because I'm scared I'll have serotonin syndrome since I'm on Zoloft. Any input on this please????????????

[@ShrinksInSneakers]

This is not medical advice it's only for educational purposes and you should talk with your doctor before making any changes. There is a lot to unpack here, first opioids and benzodiazepines can causes severe respiratory depression and death with combined. It's very dangerous thats why the doctor will not do it. For sleep I would start with sleep hygiene and learn about all the behavioral things you can do to improve sleep right now without medication. I would also consider melatonin low dose 3-6 mg and cognitive behavioral therapy for insomnia. There is an app called CBTi-coach you can check out. You need to be careful with zoloft and tramadol but I have seen them combined in the past I would talk to your doctor about this. I would say consider continuing to work with the zoloft for possibly switch to bupropion. At 50 mg zoloft is underdosed so it's difficult to say if it's working. For the sleep I would explore my video on sleep hygiene here on the channel and CBTi. Hope this helps if you haven't subscribed to the channel please do and spread the word about what we are doing here.

[@foodie4128]

@@ShrinksInSneakers well thank you so much I want to address some of the stuff... I used to take benzodiazepine and hydrocodone for close to 10 years with no issues. I just wish they would stop treating me like a number even my primary doctor said to hydrocodone a day and one benzodynazepine only when needed.. is very unlikely to cause any issues. But I can't go over my pain doctor's head. Ambien sleeping medicine worked wonders for me didn't sleep walk wasn't drowsy got a good deep sleep and woke up ultra-refreshed! Pain doctor will not allow me to take that either since I'm on hydrocodone. I know 50 mg is not much on the Zoloft but it's when I went up I started to get those uncontrollable muscle movements as soon as I felt my body going into sleep. That was when I went up over 50 mg. But I'm glad you mentioned the tramadol because tramadol increases serotonin... I definitely don't want to get serotonin syndrome. The odd thing is sometimes in the past I would take tramadol and hydrocodone within a few hours apart and I would get those same uncontrollable muscle movements but if I waited 4 hours or more it wouldn't happen only if I took it within one to two and a half 3 hours. I am concerned about the Wellbutrin and hydrocodone because they both work on dopamine. I tried probably 30 different kinds of brands of melatonin at different strengths it does absolutely nothing for me. I can't take old-fashioned antihistamines for sleep because I have prostate issues (enlargement of the prostate gland) Doctor did put me on mirtazapine 7.5 mg but I took a half of a half of a half... And slept for over 20 hours and felt like I was hungover!!! About a month later I tried it again and took a full half and didn't sleep at all. The doctor wants me to try doxepin instead for sleep but I'm just worried because the doxepin Plus realbutrin plus Zoloft that's a total of three antidepressants 🙄! Does Zoloft also hasn't done much for my depression but it has helped curb my anxiety... But I think you're right that 50 mg may not be enough because not only has not the depression went away but it's only curbed my anxiety about 45 % to 60%.... And something I've been taking I think the Zoloft has also made me have this "I don't care attitude" which is kind of a nice break versus my worrying anxiety but I'm just not used to this being kind of Spacey throughout the day I guess I just got used to worrying about everything. Also since Zoloft also works on dopamine is it a good idea to be on Wellbutrin since it also works on dopamine? (Could have too much dopamine something similar when you have too much serotonin and get serotonin syndrome) Anymore comments back to me over what I just said would be greatly appreciated. 👍✌️😃 I'll be sure to tell people in my Facebook group about you 👍👍👍👍❤️

[@keyliving3071]

​@@foodie4128 I would get new Drs who treat you with respect and treat you as an individual and not a number. There are alot of wonderful Drs. Find the ones who fit your needs best.

[@shoshanafox727]

Have you looked into the spect brain imaging by Dr Amen? Seems interesting.

[@ShrinksInSneakers]

SPECT and PET scans are great but they are limited because of the difficulty of finding a place that can do them, cost for the patient, and it's still not fully diagnostic for mental illness. There is utility in these studies and it can help in the research setting, I do not think it's something most patients should get outside of a research study setting. If you haven't subscribed to the channel please do, and spread the word about the community we are building here

[@Danasmagicalplans]

I take Bupropion 300xl. I’ve been taking it for years. Recently my physician prescribed Zoloft to take as well. I take Bupropion in the morning. He told me take the Zoloft at night. Is this normal? I’ve had medication a week but I’m too scared to add it…

[@BeautyRepublicUnited]

how is it going? please answer!

[@Erica-mm3cz]

Yes it's okay I have been doing that for a while now and it works

[@bic2102]

I've been on xanax for years and just started wellbutrin. Going to see about zoloft too! I no longer like nicotine, drink at all, feel awkward, feel anxious, and my sex drive is through the roof. Is zoloft going to ruin my libido?

[@ShrinksInSneakers]

In combination with Wellbutrin it's less likely but you would have to see. When libido is a major concern I like Wellbutrin best and would optimize the dose before adding another medication. This is my approach in general but I would talk with your doctor and see. I think the response you described sounds very positive. Best of luck with everything

[@bic2102]

@@ShrinksInSneakers thanks man!

[@joanamarques4749]

Hello. Can you update? I want to do well+zol combo but I'm afraid for libido

[@suns1457]

amazing video as always! well done!

[@normsoule4564]

what about Lexapro and Welbutrin zolof has too many side effect

[@montea5390]

And really getting to the root of the problem is key . 90% of seratonin resides on the gut. Feeding yourself food that has tryptophan a precursor to seratonin can theoretically help raise serstonin lvls . It's kinda complex . 🤔

[@KrossFire330]

Im on 300mg Wellbutrin and 25mg zoloft, but im not sure I'm really noticing any differences. Not sure if its the substances themselves or if its too small of doses

[@ShrinksInSneakers]

The wellbutrin dose should be adequate and I would expect some results at doses of 300 mg or more per day. The sertraline is very low, 25 mg is a starting dose for an older patient or someone you want to avoid GI side effects in. This is not medical advice please talk with your doctor about the dosing before making any changes. If you have not subscribed to the channel please, do and spread the word about what we are doing here

[@matinastsauveur9551]

Is the combination of paxil and Wellbutrin the same type? Or really is sertraline better in this combo then Paxil.?

[@ShrinksInSneakers]

It's similar, I'm not a big fan of Paxil and I made a video on why I largely stay away from it. There is very little evidence for selecting one SSRI over another when it comes to efficacy. kzbin.info/www/bejne/qWGzfpSFbL2tkJI

[@FrewSlinger]

Im on 250mg sertraline for a few months now, now up to 300mg welbutrin, hopefully it works out for me

[@ShrinksInSneakers]

I hope so too, those are adequate doses of both medication I would expect some results

[@estherdushime8258]

Damn same 200mg Of setraline and 150mg burpropion

[@FrewSlinger]

@@estherdushime8258 im now on 450mg welbutrin, 250mg sertraline

[@omz6313]

I was on 200mg Zoloft with 100mg pregabalin. Been 7 days since Zoloft was increased to 250mg and added 37.5 mg Wellbrutin as a starting does. Felt pretty bad this week, nausea, headaches etc. Although its gotten better, I still feel pretty badd. Did you have the same kind of issues? If so, how long did it take to feel better?

[@FrewSlinger]

@@omz6313 sorry no, i might of had a headache for a while but nothing that bad.

[@kristenkelley9837]

Can this be used for anxiety and can Wellbutrin counter weight gain from zoloft

[@Dave-if5qj]

Zoloft is supposed to have a faster faster onset

[@doctorweathers]

In a sequel to this video, you mentioned another drug that you thought worked better than Zoloft. I can't find that video. What was the name of that drug? Or, can you give me a link to that video?

[@ShrinksInSneakers]

It's escitalopram

[@nistra81]

@@ShrinksInSneakers hi, so you recommend escilopram over zoloft?

[@kimkardashianjong-un6299]

I have been taking Zoloft for 5 months and my psych DR. Prescribed me wellbutrin to take with my Zoloft to relieve my ADHD symptoms and i am like scared but i just started today with the wellbutrin

[@ShrinksInSneakers]

It’s good that you are communicating with your doctor about the plan and making shared decisions. There is more evidence for Wellbutrin in the treatment of depression although some have looked into it as a treatment for ADHD and use it off label for that reason. I would use a screening scale to assess the progress towards your ADHD symptoms to give you an objective measure of the benefits. Best of luck and I’m happy to answer additional questions.

[@kimkardashianjong-un6299]

@@ShrinksInSneakers thank you !

[@ShrinksInSneakers]

@@kimkardashianjong-un6299 no problem

[@stars4jae]

Update? How are you doing with the combo?

[@andrewz5011]

I’ve been on Zoloft for 4 years and was just added 150 xl mg of Wellbutrin. Started snooping around online about Wellbutrin about a week after starting and came across the seizure stuff. I think I’m gonna come off the Wellbutrin and just stick to the sertraline lol

[@ShrinksInSneakers]

Talk to your doctor before doing anything, this is general information not in the context of physician patient relationship. I want to clarify a few things about seizure risk and Wellbutrin. The risk is more relevant for people who have had previous seizures (e.g., epilepsy or alcohol withdrawal). The risk of seizure with bupropion SR up to 300 mg/day is about 0.1% (one in a thousand) which is exactly the same as the risk with SSRIs (sertraline). Up to 300 mg/day there is lower risk. The risk of seizure in the general population is 0.08%, so there is not much increased risk at doses 300 mg/day and under. Above 450 mg/day the risk of seizures increases ten-fold to 4% which is high. Bottom line the risk is dose dependent and up to 450 mg/day there is some risk but not much more than with SSRIs. Hope this helps

[@andrewz5011]

@@ShrinksInSneakers All good. Thanks for the reply. Just wish the process wasn’t so trial and error and frustrating on the patients end of things.

[@ShrinksInSneakers]

@@andrewz5011 It’s true there is a trial-and-error component to treatment in all medicine. Psychiatry a little more so because we do not fully understand the pathophysiology of depression. I can say combination of medications tends to work better than switching. I would like to also share the power of lifestyle modification in mental health. Diets, specifically a Mediterranean style diet have improved depression in clinical trials. Also, daily exercise is important, the more you move your body the better you will feel. I like to start simple just 30 minutes of walking per day. The next thing is psychotherapy, we undervalue the benefits of this treatment and overvalue medications which often disappoint or do not completely solve the problem. The hard part is sifting through all the so-called therapists and finding someone who is actually good and you can form a good therapeutic alliance with.

[@andrewz5011]

@@ShrinksInSneakers I found that running and weight lifting helps tremendously. I’d say I’m now addicted haha. The hard part is getting that momentum going.

[@ShrinksInSneakers]

​@@andrewz5011

[@allieragsdale7460]

Can you start both Wellbutrin and Zoloft on the same day?

[@ShrinksInSneakers]

You could, I usually prefer to start with one and work it up to an effective dose. Then if things aren't working out you can consider combination therapy with bupropion or augmentation with something like aripiprazole, Hope this helps, if you haven't subscribed to the channel please do and spread the word about what we are doing here

[@drzacanova5349]

I never used anything all my life for my OCD and panic and anxiety and slight depression and ADHD. In the last 2 years I had a nervous breakdown and finally gave in and seeked help. At first I was taking Klonopin 2 to 3 times a day and it helped and as the Zoloft started to kick in , I started using Klonopin less and now only use it at night or as needed. I went all the way up to 200 mg of Zoloft and was on that for the last year and that was the only dose that even remotely helped the ocd and intrusive thoughts and panic but I was entirely nonproductive and cared less and could do nothing but sleep. I asked my phychiatrist about Adderall and it turns out by my response to it and the fact my son also has it that I have adhd as well as it helps me focus but also I can sleep all day after even taking 30mg of it and sometimes it even causes me to sleep more. I also have an underactive thyroid but my levels are okay right now. The first "Adderall" I took was dextroamphetamine and it helped a little with energy but not nearly enough but it has some unpleasant side effects like sweating tons like I never have. I also lost weight on that which I didn't mind lol.... But because of the side effects, I switched to name brand Adderall and then Teva, both of which somewhat expand my vocabulary and help me focus a little but do nothing for my energy levels and I sleep all day some days. I used to take Adderall twice daily 15mg each and then switched to 30 mg once a day after dropping Zoloft down to 150mg where it's still helping but some instrusive thoughts have come back again and a month or so ago after dropping down to 150mg Zoloft, I also started Wellbutrin 150mg. I take the Zoloft and one Klonopin at night as well as a 0.25 ropinirole for the most brutal thing I'm now suffering with because of the setraline and Adderall and I had this condition before as well but it's gotten a million times worse on these meds to the point where I'm truly suffering and that is restless legs syndrome. That combined with how I'm always so tired is pure torture. I hate how unproductive I've become. I also have phisical pain from other conditions and a car accident 2 years ago. I was an electrician ik construction but I have not been able to work in a couple of years now. I'm a family man and a very active father in my kids lives as they are my world although it's Definitely been tougher the last couple of years. I'm trying to find the right combination of these 6 medications including my hypothyroidism/hashimotos but I also am very afraid because of the chance of seizures which I've never had one but I keep increasing and adding more meds and so we will see what happens but I definitely do not want to have a seizure. I also have asthma and IBS and most likely rheumatoid arthritis as well and who knows what else. One more thing I'll add is that 5 hour energy drinks used to help me at work when tired some days and so every now and then I will take that as well or some other form of caffeine and I've ever tried all types of vitamin's as well at times which gets expensive when struggling financially. My situation is very complex as you can see. I know the 300 mg in a caffeine energy shot drink probably increases dangers but I am so desperate to feel more energy and sometimes that even makes me sleep and other times it gives me a slight boost. I also have 2 special needs children out of my 3 kids and one way worse then the other and he has the ocd but way worse then I did as a child with the thoughts etc. And he has a low IQ so it's hard for him to comprehend it and know how to deal with it. I'm seeing a new phychiatrist for the first time tonight (the one my 7 and 9 year old son's see for ADHD etc) and am going to discuss this all with him but he's a much much older gentleman and not what he once was probably but I will see what he says. I was seeing a psychologist for a while too until recently. I loved this video though and you seem so very knowledgeable so I'd love to hear what you would have to say about my very long comment which I apologize for but like I said my situation is very complex unfortunately. I forgot to mention that the caffeine also makes the RLS much worse and at times even if I'm not sleeping, I still can't get up because rubbing my feet together or against the sheets or anything really is addicting because it's the only relief I feel from the RLS and so I'm still nonproductive even then 🤦.... The RLS is all day nonstop even while moving at times and I will grind my legs and feet so hard into the sheets I will get cuts or bruises or even put holes in the sheets. I'm not as crazy as it sounds here as if you met me , I can definitely have a normal conversation no problem but I'm suffering in many ways. I almost want to get off of all of it when hopefully soon the magic mushrooms become legal in my state as a treatment for anxiety and depression and I've been reading so much about that and how it helps dramatically but without the side effects but it's not legal in my state yet. I am praying you reply because I'd love to read or listen and again , I am sorry for writing you a book. Thank you 🙏

[@Maharddhika]

Excellent video! Thank you for making it. Listened to it while working out. I started on this combo (for MDD) and I feel like I’m “floating” all the time. I don’t know if anyone else feels this way.

[@ShrinksInSneakers]

Sounds like it's working well for you. Appreciate the comment and the support

[@QPT808]

Do you still feel that way ?

[@amandaa898]

YES! I just started this and I felt like I was on a cloud above everything that normally bugs me

[@eleusis7778]

-Hi, Thank you for your vids! Can you do this with prozac (fluoxetine) as well? (wellxetine=?) ? Im on on 40 mg of fluoxetine a day ( It has improved my mood and reactivity as well as intrusive thoughts) ,but I feel emotional blunting, lack of motivation and low libido, so I was wondering if bupropion is an option as an add on therapy. My doctor would just say: lets go ahead .. but ive found several cautions against it online . I`d appreciate any thoughts on the subject, Once again , thank you .

[@mieero]

I got same emotional blunting from prozac and low libido and yes i also get know Wellbutrin is option to recover emotional blunting Can i get your what's app number

[@TheLadyKaylah]

I was on Welbutrin for a bit and it gave me more energy but what was the point if I stick didn't want to do anything? When zoloft was introduced I got violently ill so I took half. Now I'm happier and energetic. I can DO things!

[@ShrinksInSneakers]

Sounds good I'm glad things worked out, let me know if I can help in any other way

[@makkhan-jg7vf]

The lady Kayla what about weight ? You gain weight or lose on this combo?

[@carolgrill]

Can either one of these drugs cause night terrors? I have terrible night terrors.

[@SeaCryptWeave]

Wellbutrin raises my heart rate during sleep. I would assume that would coincide with inducing night terrors if you are already prone.

[@feverdream__9]

Hey, can I ask you something?

[@nymetsfan912]

Yea, go ahead there nipsey

[@CC12398]

I recently started Zoloft/ Wellbutrin combo. I'm experiencing hot flash type symptoms all day and night. Is the dose too high maybe?zoloft 200 Wellbutrin 100. I could have sworn my doctor said 100 Zoloft and 100 Wellbutrin ,, but the bottle on Zoloft said 200. He suggested the Zoloft was helpful in a fungal allergy(immediate release Wellbutrin 50 mg twice a day

[@missdenim6590]

I believe the highest zoloft recommendation is 200 MG. Seems like that high dose is usually for people who have been on it for a long time. I'm sure there are exceptions tho.

[@Erica-mm3cz]

Maybe you can take the Zoloft at night and Wellbutrin in the morning that might help.

[@beccah7643]

Hi, I’ve been on sertraline at 75mg for about 10 months for depression and PMDD, it has helped a lot however I feel like my motivation for doing things I enjoy has really gone since being on the Medicare and i have also put weight on but have no drive to exercise. It’s very frustrating. Do you think adding Wellbutrine could help with this?

[@ShrinksInSneakers]

That is a reasonable strategy to target the low motivation, and decreased energy levels. The pharmacology is complementary, and Wellbutrin has been known to decrease appetite. I would talk to your doctor about options. There is also the possibility of optimizing the sertraline. Hope this helps

[@dannyK757]

You sound like me up until about 2 months ago. I was on 75mg sert, helped with my irritability and anger but after about just over a year, I started to feel pretty much depressed . No motivation, couldn't even think about work. Was prescribed 150mg Wellbutrin, and in about a week I started to feel like a kid again. It's like I was given a confidence pill. Try it if you haven't.

[@beccah7643]

@@dannyK757 I spoke with my GP about this but unfortunately here in the UK they don’t tend to prescribe it 🙄. It’s so frustrating as I’m certain it would help me. We have to go through our GP’s for everything and they just aren’t interested 😤

[@dannyK757]

@@beccah7643 that is super frustrating, Becca! Now Wellbutrin would be the brand name I believe but did they look into the generic name of bupropion or whatever it's called? Would that make any difference?

[@dannyK757]

@@beccah7643 also, if that's not an option maybe looking at the category of meds (I believe it's an ndri- norepinephrine dopamine reuptake inhibitors but look it up to verify first). This combo has been a game-changer for me.

[@zaffranali]

Is wellbutrin prescribed in the UK

[@ShrinksInSneakers]

good question, I'm not sure the generic name is bupropion

[@sarahbartlett9870]

@@ShrinksInSneakers it is but only as Zyban.

[@Tzippi]

Hello, Doc! Will adding 25 mg of Zoloft to 150 Welly XL cause weight gain? I’m on a plant based diet because of cholesterol, but in the past year I’ve lost 30 pounds and I want to keep it off. I have social anxiety, and panic disorder. I took my first dose of Zoloft last night, 12.5 and did not take the Welly because I thought that was causing my anxiety and panic attacks. I was doing great on the Welly alone, I’m but one day SHAZAM! I could not leave the house. Thank you for making this video.

[@ShrinksInSneakers]

I would not expect that to cause weight gain at 25 mg. Sounds like you are already following a good diet and exercise program so I would not expect a problem.

[@Tzippi]

@@ShrinksInSneakers Thank you, but I decided to come off both. I’m doing super well and feel like my old self. Thank you for responding!

[@vgshortsandvideos4576]

@@Tzippi ....how many months did u take to recover from depression dear?

[@Tzippi]

@@vgshortsandvideos4576 I microdose THC and I’m cool. Depression is not the issue, It’s anxiety.

[@Tzippi]

@@vgshortsandvideos4576 I’m off all my meds! ❤️ THC FTW!!!!

[@lex5016]

The side effects of these two meds together for me are awful and idk if anyone else feels the same?

[@ShrinksInSneakers]

Ideally, we should always try to use monotherapy if possible. I believe in maximizing the utility of one medication before adding augmentation. I also do not believe in medicating away all symptoms, it’s unrealistic and results in polypharmacy. Love to hear what others think.

[@TheCoolOwen]

It may be the brand of generic causing adverse side effects? Generics of Wellbutrin have fillers and side effects may be exacerbated or not work as well as name brand therapeutically

[@ShrinksInSneakers]

@@TheCoolOwen For patients who prefer the brand name, we will prescribe it. However, generic medications must meet a certain standard to be approved for use. They have the same active ingredient and must establish the same standards of quality, dosage, strength, and route of administration as the brand name. I have not found generic medications to be less effective in clinical practice and often cost is a major issue for patients which generic medication can help offset. There were some contamination issues with metformin and losartan manufactured in select facilities over the last couple of years. I’m not aware of significant issues with bupropion contamination but I’ll look into it

[@TheCoolOwen]

@@ShrinksInSneakers generic Wellbutrin (bupropion) was the first generic that was found not to be effective as name brand. Lots of articles written on the topic when Wellbutrin was allowed to be manufactured generically. It is because the generics may not have the same extended release mechanism as name brand Wellbutrin. Many people complained when switching to generic it didn’t work as well.

[@ShrinksInSneakers]

@@TheCoolOwen Appreciate the comment. I investigated it and found the FDA update. With bupropion there are three versions of the medication immediate release formulation, and sustained release formulation, and an extended-release formulation called Bupropion XL. The FDA investigated only the generic formulations of the XL medications and found specifically that some of the manufactures of the 300 mg ER tablets were NOT therapeutically equivalent (specifically Watson’s product). The other manufactures WERE therapeutically equivalent, and the products were withdrawn from the market. It looks like those taking the 300 mg ER release tab only by the specific manufacture were affected. For patients taking immediate release, sustained release, or the 150 mg XL version they were largely unaffected by this. I still feel like generic medication is reasonable to prescribe, I always leave the choice to the patient if they want brand name we will prescribe it. A quick search on Good Rx revealed Wellbutrin XL 150 mg Tab 30 day supply costs $1,569 per month, while the same 150 mg XL Tab for 30 days costs $10.94. We have to consider these things when prescribing medication. Good discussion. www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/update-bupropion-hydrochloride-extended-release-300-mg-bioequivalence-studies

[@chr_sta]

Will this combo give me weight gain/loss?

[@ShrinksInSneakers]

Wellbutrin is established as a medication that can result in weight loss. It's used in combination with naltrexone marketed under the name Contrave for management of chronic obesity. I have not had patients gain weight on this combination but I cannot say for sure as all cases are unique. My clinical experience tells me at the very least it's weight neutral, meaning you will not gain weight on the combination. It may result in some weight loss as well. Appreciate the comment

[@Sailboat.Planta_Electra]

Thank you for your videos! I would give anything to have a therapist like you. GOOD mental healthcare in far east Tennessee...well, I think I'll find the FLUXCAPACITOR first.

[@ShrinksInSneakers]

I appreciate the love and support.

[@michealjohn7793]

will zoloft dopamine inhibitor interfere with wellbutrin dopamine inhibitor since both act on the same thing

[@ShrinksInSneakers]

Nope should work synergistically both will increase dopamine. If you haven't subscribed to the channel please do and spread the word about what we are doing here.

[@craigronald]

What are your thoughts on the concern that mixing these two drugs can cause serotonin syndrome? Do you think the maximum dosage for each individual drug changes when combining the two?

[@ShrinksInSneakers]

This is not medical advice and is for educational purposes only, please consult your doctor before making any changes. They are different mechanisms of action, Wellbutrin is a norepinephrine and dopamine reuptake inhibitor and sertraline is a serotonin reuptake inhibitor creating the fabled triple reuptake inhibitor, The mechanisms compliment each other, Clinically they can be combined safely without significant risk of serotonin syndrome, although any SSRI can increase the risk of serotonin syndrome in general. You also need to be mindful of other medications like tramadol that can increase serotonin. Bupropion is an inhibitor CYP 2D6 and sertraline also inhibits 2D6 at doses of 150 mg and above and is a substrate for 2D6 as well, so inhibition may raise levels of sertraline. Bupropion is metabolized by CYP 2B6 so it should not be effected. Hope this helps

[@craigronald]

@@ShrinksInSneakers Appreciate your response, thank you!

[@ShrinksInSneakers]

no problem, best of luck

[@wearesimulated1579]

Is this a ridiculous amount of meds? I could really use some feedback, especially from a professional. Will seek a 2nd opinion as well tomorrow. Was just put on Bupropion 2 days ago. This is what I am prescribed: * 200mg Sertaline * 150mg Bupropion * 15mg Buspirone (x3) * 300mg Quetiapine at night before bed.

[@ShrinksInSneakers]

It's a lot of medications from different classes. I think in this case what matters is the diagnosis. whenever I see a medication list like this you have to question the diagnosis and if it's correct. That would be my starting point. If you haven’t subscribed already, please do, and spread the word about what we are doing here.

[@montea5390]

All of this assuming both are lacking. .. there needs to be better test to see exactly which chemical you are missing.

[@ShrinksInSneakers]

unfortunately, I do not think that would help at all. At this point no good psychiatrist subscribes to a "chemical imbalance theory" for depression. Look out for a post today explaining why or check out the instagram page I explained it there.

[@psyclotronxx3083]

I just added Wellbutrin to my Zoloft today. God I hope it helps. I can't live like this any longer

[@dnlsrv12345]

I hope so too. How have you been feeling now that it's been about 12 days?

[@psyclotronxx3083]

@@dnlsrv12345 surprisingly much better! I'm cautiously optimistic

[@pricasfontes]

Hi there! Still good?

[@psyclotronxx3083]

@@pricasfontes I'm just ok. My doctor had to resort to Klonopin for me. I truly only take it on an as needed basis

[@Dave-if5qj]

Thats one ive not heard of Wellbutrin on is own coused me Me actually couse my hands To shake

[@ShrinksInSneakers]

Hope this helps, yes I have seen tremors with antidepressants

[@sillywhale]

“Reduced sexual desire for women” but I’m already gay, doc. Lol

[@expe808]

You should avoid this combination, risking serotonin syndrome

[@ShrinksInSneakers]

This is theoretically a possibility but is not common. You should always be mindful but in general these can be combined safely and I’ve only found one case report in the literature with this combination and serotonin syndrome. Bupropion does not increase serotonin it’s a dopamine and norepinephrine reuptake inhibitor.

[@ashleylyng8355]

@@ShrinksInSneakers I'm giving myself panic attacks.about this.right now. I just need someone to tell me I'm ok. 150mg welbutrin and 50mg zoloft. Just started this combo 6 days ago. My anxiety is worse than ever. Just feel awful. Please help!!!! Is this.normal?

[@onerepublicrox]

@@ashleylyng8355 did you take Zoloft previously?

[@ashleylyng8355]

@@onerepublicrox yes I took 200mg at one point. I think the 50mg just isn't working.

[@onerepublicrox]

@@ashleylyng8355 I think you should wait to increase the dose. Every time I do my anxiety gets worse for a couple of weeks. Give yourself some time to get use to the Wellbutrin as I’ve heard it may increase anxiety at first. I’m about to try this combination myself next week.

[@Ooooia]

🫣 i cant pay attention im tired help