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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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Ive been on wellbutrin for several months - going up in mg

Resolved Question:

I've been on wellbutrin for several months - going up in mg to 450 mg now. My dr. raised it slowly but I don't feel significantly better. When should I say it isn't working and gave it enough time. I've been on the 450 for about a month now. Before that I was on lower dosage. Should I give the wellbutrin more time? I am concerned about weight gain- on the wellbutrin I've lost about 10 pounds and feel good. I am overweight
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Vikas replied 5 years ago.

Hello Madam,

We usually tell our patients to wait for at least 4 -6 weeks after a change in medicine or change in its dose. Since you have waited for almost 4 weeks, you may wait for 1 or 2 weeks more and after that it is time to ask your doctor about changing the medicine or augmenting it with another antidepressant probably an SSRI antidepressant such as Zoloft.

Wellbutrin usually does not cause weight gain, in fact, some patients report weight loss while on this medicine so there in no need to worry about weight gain while taking this medicine.

I hope this helps.

Best wishes,

Vikas


Please feel free to ask if you need clarification/more information. Kindly click the GREEN ACCEPT BUTTON if you are satisfied with the answer. POSITIVE FEEDBACK and BONUS are warmly appreciated
Customer: replied 5 years ago.
Relist: Answer quality.
I would like more information
Expert:  Dr. Vikas replied 5 years ago.

Hello,

If you want me to answer your question, please do let me know what exactly you want to know in detail?

Thanks

Vikas
Customer: replied 5 years ago.
I'd like more detail- would you suggest changing to another antidepressant or adding one- I don't want to gain weight and so I am concerned about the other SSRI's- I've read they cause weight gain.
Expert:  Dr. Vikas replied 5 years ago.

Thanks for your reply.

The normal daily dose of Wellbutrin is from 225 -450 mg per day. 450 mg is the maximum dose and you are currently on the maximum dose but still not responding fully so in my view, adding another antidepressant to Wellbutrin could be a good idea.

Wellbutrin
mainly acts on two neurotransmitter namely dopamine and norepinephrine and adding another antidepressant which acts on a different neurotransmitter serotonin will augment the antidepressant effect of this medicine.

Now, SSRI antidepressants are those antidepressant which mainly act on serotonin neurotransmitter so adding a SSRI antidepressant to Wellbutrin should be useful in your case.

Fluoxetine (Prozac) is an SSRI antidepressant which does not cause weight gain, in fact in some patients, it may cause lack of appetite and hence weight loss. Sertraline (Zoloft) and Escitalopram (Lexapro) are another two SSRI antidepressants which also does not cause weight gain.

Wellbutrin it self does not cause weight gain so a combination of Wellbutrin along with Prozac should not cause weight gain.

Therefore to summarize, adding a SSRI antidepressant such as Prozac to Wellbutrin will augment the antidepressant effect of Wellbutrin. Since Prozac is also an effective antianxiety medicine it will also help in controlling anxiety symptoms if you have any.

Since both Wellbutrin and Prozac are weight neutral therefore there should be no problem related to weight gain also.

I hope this helps.

Please feel free to ask any related query.

Best wishes,

Vikas


Please feel free to ask if you need clarification/more information. Kindly click the GREEN ACCEPT BUTTON if you are satisfied with the answer. POSITIVE FEEDBACK and BONUS are warmly appreciated
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