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Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4058
Experience:  BSN, MSN, CNS
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I a few weeks back was swithched from Zoloft to Paxil by my

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I a few weeks back was swithched from Zoloft to Paxil by my primary care physician. I have neuropathy and RLS. After doing some research I found that some studies showing Paxil to help with the symptoms and Zoloft to occasionally worsen the symptoms. That was the reason I asked for the switch. My question comes here. I have had major depression temper and anxiety issues for years. Today I saw a psychiatrist and he added Wellbutrin in addition to the Paxil, stating that it may help with my motivation as well as depression and temper outbursts. I am just wondering what your thought on the two being taken together is. He also recommended taking the Paxil in the evening due to sleep benefits and the Wellbutin in the morning due to minor stimulant effects. Any info would help ease my mind on this treatment.
Hello, and thank you for using JustAnswer and requesting me.

What your psychiatrist has suggested is not uncommon.

Generally Paxil tends to be one of the best SSRI's for anxiety combined with depression. And for most individuals it is sedating (although some patients report an initial stimulating effect in the hour or two after taking Paxil, then the sedating effects kick in. For this reason, Paxil is sometimes prescribed a few hours before sleep (such as at 7 pm if you plan on sleeping around 10 or 11). This is just something to keep in mind, as you may or may not notice this effect.

While Wellbutrin has some effects on Seretonin, it's effects are mostly on the neurotransmitter Norepinephrine, and it results in increased alertness and arousal.

So, indeed you should find yourself more alert in the day after taking the Wellbutrin, and hopefully you will feel more motivated, while at night your anxiety should be decreased and this should assist you with sleeping.

I personally am not familiar with using Paxil to help with RLS, but, it is logical that anxiety might increase the symptoms of RLS, and thus an SSRI like Paxil that is very helpful with anxiety and known to be more sedating might be more helpful with RLS than an SSRI that is not as sedating.

Side effects of Wellbutrin can include increased blood pressure, but if that is not a problem, then you should not worry about it, but it would not hurt to monitor your blood pressure a little more frequently.

Please let me know if you have any further questions about your treatment.

I will look to see if you have any follow up questions.
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