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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4509
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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can I take Lexapro, wellbutrin, Abilify and elavil togethe

Resolved Question:

can I take Lexapro, wellbutrin, Abilify and elavil together? All take care of a problem: wellbutrin and abilify for depression and mood disorder, elavil helps with headache and sleep, lexapro helps with anxiety/depression

Submitted: 9 months ago.
Category: Mental Health
Expert:  Dr. Z replied 9 months ago.

Dr. Z :

Hello, I believe I can help you with your question. By combining the Wellbutrin, Abilify, and Elavil together, you can have an increased risk of seizures (even more so if you have a seizure disorder). Now if these medications are at a moderate doses then most likely your risk for these seizures are at a minimum, but I wanted to let you know of this possible interaction risk. Now combining the Lexapro and Elavil together can also cause a syndrome called Serotonin Syndrome, which can be very severe (I will post a link of it at the end of my explanation on Serotonin Syndrome for your benefit). Now if both medications are at a high dose than your risk of Serotonin Syndrome can be very severe, if one is at a high dose and the other is at a low or moderate dose than you should be fine and your risk for Serotonin Syndrome is low. In addition there are moderate effects of combining the Lexapro and Abilify that can cause drowsiness, seizure, Parkinson-like symptoms, abnormal muscle movements, and low blood pressure. And lastly combining the Abilify and Elavil can cause moderate effects of drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Here is a link of all the medication interactions I have listed for you to back up what I just wrote and also the second link will have information on Serotonin Syndrome for you

Dr. Z :

My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Dr. Z :

So you can take these medications together, but be wary of the interaction effects and the dosages as they will have to be minimal to moderate to avoid these interaction effects.

Dr. Z :

It would be the least dangerous for you possibly to go to the Wellbutrin and Abilify, but Lexapro and Abilify (at a low dose) has been combined for years with little reports of side effects. So if you take the Lexapro, Wellbutin (at a low or moderate dose), and the Abilify (at a low dose) then you should be fine with the least chance of interaction effects. I feel that the Elavil may be superfluous though as you already have two antidepressants in the Lexapro and Wellbutrin working for you.

Dr. Z :

Do you have any other questions or concerns?

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4509
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and 2 other Mental Health Specialists are ready to help you
Customer: replied 9 months ago.

That all makes since. So after going through the side effects of these medicines in combination would it be best to take Wellbutrin and Abilify, seems like that would be least dangerous. But then I would still have the anxiety problem

Expert:  Dr. Z replied 9 months ago.
It would be the least dangerous for you possibly to go to the Wellbutrin and Abilify, but Lexapro and Abilify (at a low dose) has been combined for years with little reports of side effects. So if you take the Lexapro, Wellbutin (at a low or moderate dose), and the Abilify (at a low dose) then you should be fine with the least chance of interaction effects. I feel that the Elavil may be superfluous though as you already have two antidepressants in the Lexapro and Wellbutrin working for you. Please let me know if you have any other questions or concerns that I can help you with
Expert:  Dr. Z replied 9 months ago.
In addition to treating your anxiety, I would also like to recommend the use of Cognitive Behavioral Therapy (CBT) as this in combination with the medication is the most effective treatment for anxiety then just using therapy and medication separately. CBT has a premise that your symptoms are caused by negative thoughts, so if we change your thought process to be more positive and objective as well, then your symptoms will lessen.

So this link may help you, it contains a technique I use with patients called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more objective and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

http://www.psychologytools.org/assets/files/Worksheets/CBT_Thought_Record.pdf

In addition, these two worksheets are very good at helping lessen anxiety symptoms. It can help you focus on the big picture and the objective/positive thoughts and outcomes.

http://media.psychologytools.org/Worksheets/English/Decatastrophising.pdf

http://media.psychologytools.org/Worksheets/English/What_If.pdf


Also individuals with severe anxiety have a poor coping mechanism, so this worksheet will help you develop a better coping strategy to manage your symptoms better.

http://media.psychologytools.org/Worksheets/English/TRAP_TRAC.pdf

These two books are also really effective in helping manage anxiety as well.

http://www.amazon.com/T he-Anxiety-Worry-Workbook-Behavioral/dp/160623918X/ref=sr_1_2?ie=UTF8&qid=1378939072&sr=8-2&keywords=cbt+anxiety

http://www.amazon.com/Cognitive-Behavioral-Workbook-Anxiety-Step-/dp/1572245727/ref=sr_1_1?ie=UTF8&qid=1378939064&sr=8-1&keywords=cbt+anxiety

This is a link for something called Progressive Muscle Relaxation that can help you create a long term calm by using muscle tension and release techniques; it can help manage your anxiety and is very similar to a style of meditation.

http://prtl.uhcl.edu/portal/page/portal/COS/Self_Help_and_Handouts/Files_and_Documents/Progressive%20Muscle%20Relaxation.pdf

I am not sure if you are already using CBT techniques or not, but I wanted to mention these for you as well to help relieve your symptoms in the most effective way by using both CBT and medication. Please if you have any questions or concerns, feel free to contact me at anytime.

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