Wellbutrin and Vyvanse: Can you take them together?

Wellbutrin (bupropion) is an antidepressant medication that is approved by the U.S. Food and Drug Administration (FDA) to treat mental health conditions like depression and seasonal affective disorder in adults. It’s also approved to help adults stop smoking. Wellbutrin is often prescribed off-label to treat sexual dysfunction, obesity, bipolar disorder, and attention-deficit/hyperactivity disorder (ADHD). On the other hand, Vyvanse (lisdexamfetamine dimesylate) is a central nervous system(CNS) stimulant that’s FDA-approved to treat ADHD in adults and kids ages six years and older, as well as binge eating disorder in adults.

If you are someone who lives with both depression and ADHD, you might be wondering if you can take Wellbutrin and Vyvanse together. The answer to this question is — it depends. The combination of these two drugs isn’t well-researched, so healthcare professionals will usually assess this question on a case-by-case basis and base their recommendation on each unique person’s health and mental health conditions.

 The experts we spoke to said that Wellbutrin and Vyvanse together work well for most people and can help them manage their depression and ADHD. At the same time, for some people, the combination of Wellbutrin and Vyvanse may have negative side effects. It may also increase the risk of health conditions like seizures. Some people may experience addictive effects when combining Wellbutrin and Vyvanse.

 Here, we’ll look closer at Wellbutrin and Vyvanse and whether taking them together is advisable.

Can you take Wellbutrin and Vyvanse together?

For the most part, you can take Wellbutrin and Vyvanse together. “Many patients can safely take Wellbutrin and Vyvanse together under medical supervision to treat both their depression symptoms and ADHD,” says Desiree Matthews, Psychiatric-Mental Health Nurse Practitioner (PMHNP), clinical director at Different Mental Health.

You might consider taking Wellbutrin and Vyvanse together if you have both ADHD and a comorbid depressive disorder or anxiety disorder that requires the use of medications, according to Matthews. Often, someone might be interested in using Wellbutrin rather than a different antidepressant because of the desire to avoid certain antidepressant side effects. Cost may also be a concern.

 “Antidepressants like Wellbutrin can be an appropriate choice for patients, especially those patients that are concerned about weight gain or sexual side effects and would prefer a generic medication due to cost or limitations on coverage for their insurance,” Matthews says.

 Because this combination is not well-studied at this time, psychiatric healthcare providers will usually only recommend these two medications together on an individual basis after a thorough assessment.

 “It is important to understand the patient’s unique medical and psychiatric needs and other medications they may be taking,” Matthews says. “As with any discussion about medication treatment options, reviewing the patient’s medical and psychiatric history, allergies, current prescriptions, and over-the-counter medications/supplements is important to make a treatment decision.”

 Chris Pagnani, MD, psychiatrist, medical director, and founder at Rittenhouse Psychiatric Associates, says that psychiatrists often prescribe Wellbutrin and Vyvanse together. “It is not uncommon for Vyvanse to be prescribed for a patient with ADHD, who may have comorbid depression,” he says. 

Still, Dr. Pagnani cautions that Wellbutrin and Vyvanse should only be prescribed together by an experienced psychiatric provider. “Mental health care needs to be tailored to the individual, and as such, I have had many patients do quite well with this combination,” he says. However, he’s also found that this combination is not tolerable in some patients. In other patients, he deemed that Wellbutrin and Vyvanse together were simply not safe to try at all due to underlying medical vulnerabilities.

Wellbutrin and Vyvanse interactions

Although the combination of Wellbutrin and Vyvanse is safe and effective for most people, certain side effects are possible. In addition, people with certain medical conditions may be more vulnerable to adverse effects when taking Wellbutrin and Vyvanse together. Let’s take a look at some of those concerns.

Addiction

Research has found that Wellbutrin and Vyvanse have addictive qualities and can increase the risk of abuse. For example, Wellbutrin shares some qualities of amphetamines, which are known to be addictive. Additionally, the main ingredient in Vyvanse, lisdexamfetamine dimesylate, is known to be habit-forming.

Addiction is one main concern that Dr. Pagnani has about taking Wellbutrin and Vyvanse together. “Both Wellbutrin and Vyvanse increase the availability of norepinephrine and dopamine (these medications work on similar pathways in the central nervous system), so there could be additive effects with taking these medications together,” he says.

Increased risk of seizures

Research has found that Wellbutrin may increase the risk of seizures, and the FDA warns that anyone with a history of a seizure disorder should not take Wellbutrin. In addition, some links have been found between central nervous system stimulants like Vyvanse and increased seizure activity.

Dr. Pagnani recommends that anyone with a history of seizures should not take Wellbutrin and Vyvanse together. “Wellbutrin and Vyvanse can increase an individual’s risk of having seizures,” he says. “When you add these medications, that risk only becomes greater.”

Additional potential side effects

Wellbutrin and Vyvanse can cause side effects, and some of these common side effects overlap. If you are taking these two medications together, you want to monitor yourself for these side effects.

“Both medications have potential side effects of tachycardia (fast heart rate), hypertension (elevated blood pressure), constipation, dry mouth, insomnia, increased anxiety, increased irritability, and others, so risks of these side effects also increase when taken together,” Dr. Pagnani says.

A rare but potentially very serious side effect to watch out for while taking these two medications together is serotonin syndrome, which occurs when the medication causes elevated levels of serotonin in your brain. “I would monitor for signs of serotonin syndrome, including muscle rigidity, sweating, shivering, dizziness, overactive reflexes, agitation, tremors, dilated pupils, and abnormal vital signs,” Matthews recommends.

Other drug interactions

If you are taking Wellbutrin or Vyvanse, you might want to know what other drugs you can safely take with these drugs. Here’s what to know.

Wellbutrin drug interactions

Dr. Pagnani says that certain medications should not be taken with Wellbutrin. “As Wellbutrin slows down the liver from breaking down certain medications (medications broken down by the CYP2D6 enzyme), it may not be appropriate to take Wellbutrin with Strattera (atomoxetine, also utilized in ADHD), various antidepressants [Prozac (fluoxetine), Paxil (paroxetine), and Effexor ( venlafaxine)], and even several cardiovascular medications,” he recommends.

RELATED: Bupropion interactions to avoid

Vyvanse drug interactions

Medications that shouldn’t be taken with Vyvanse include monoamine oxidase inhibitor (MAOI) antidepressants, such as Marplan, Nardil, and Parnate. Matthews recommends stopping a MAOI antidepressant at least 14 days before starting Vyvanse. She also recommends not taking Vyvanse with serotonergic drugs, including selective serotonin reuptake inhibitors (SSRIs) like Zoloft (sertraline) and Lexapro (escitalopram), serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants, due to the heightened risk of serotonin syndrome. Matthews particularly cautions that medications like paroxetine and fluoxetine should be approached with even greater care, recommending lower doses to mitigate potential drug interactions.

How to take Wellbutrin and Vyvanse together

Anytime you take Wellbutrin and Vyvanse together, you should do so under the careful watch of a healthcare professional. Your provider will likely watch you closely when you start taking these medications and may not give you a full dose. Your provider usually starts you on a low dose before moving to higher doses. “In general, it is recommended to start at a low dose and gradually increase the antidepressants,” says Matthews. You should be monitored for side effects as you increase your dose, which may need to be adjusted. In some cases, you may need to consider other medication combinations to treat your depression and ADHD.