Can you take trazodone and Wellbutrin?

In this article:

• Trazodone and Wellbutrin
• Side effects
• Timing
• Safety

In this article

• Trazodone and Wellbutrin
• Side effects
• Timing
• Safety

Wellbutrin (bupropion) is a prescription antidepressant that treats major depressive disorders and seasonal affective disorders (SAD). Trazodone is another prescription medication that belongs to the medication class selective serotonin reuptake inhibitor (SSRI). It is used for the treatment of depression and is commonly prescribed off-label for anxiety and sleep problems, such as insomnia. According to medical experts, it can be safe to take these two medicines together depending on your health.

Can you take trazodone with Wellbutrin?

According to medical experts, depending on your health, using Wellbutrin and trazodone together may offer some benefits under a healthcare provider’s supervision. Jahan Khan, MD, a psychiatrist and medical director at the Neuro Wellness Spa in Pasadena, California, affirms the combined use, saying, “[The] combination of this drug interaction is very helpful at regulating dopamine and norepinephrine for energy and serotonin levels for a healthy sleep cycle,” he says. “Often, Wellbutrin and trazodone are taken together to create an adjunct treatment response as modulation of the main neurotransmitters starts to occur, which are responsible for major depressive disorders and anxiety. ”

If your healthcare provider suggests you take Wellbutrin and trazodone together, they’ll likely start both medications at starting doses and adjust the individual dose of each medication based on efficacy and tolerability. While there are no specific dosing guidelines for this drug combination, Dr. Jahan advises that the doses be adjusted or medications stopped if you have trouble tolerating them.

What happens if you take trazodone and Wellbutrin together?

People who take Wellbutrin and trazodone together do so to help ease their insomniac sleep patterns and improve the regulation of dopamine neurotransmitters in the brain. The medication combination also helps regulate mood and aids in smoking cessation. 

According to James Hook, MD, a wellness professional and MD at Neurogan Health in San Diego, California, taking these medications together could benefit some people. “The stimulant antidepressant Wellbutrin and the sedative trazodone can work in synergy for mood stabilization during the day and better sleep at night,” he says. “The dual strategy is usually recommended as over 65% of those using antidepressants have trouble sleeping.”

While it seems fairly safe to take both Wellbutrin and trazodone together to treat mental health conditions and sleep-related issues, it’s important to consider the potential risks as well. 

According to Dr. Jahan, people with liver or heart problems may want to avoid this drug combination. “If the liver is not fully functional or compromised, caution should be exercised as levels of each individual medication can be affected to create subtherapeutic (low efficacy) or supratherapeutic (toxic) effects. As the liver metabolizes both medications through a similar process, the liver may prioritize the metabolism of Wellbutrin over trazodone. If the liver is busy metabolizing Wellbutrin, then the trazodone cannot go through that process. This can result in the dose of trazodone to be greater and/or longer than what the expectation should be, leading to supratherapeutic effects.”

Dr. Jahan also explains that taking Wellbutrin and trazodone may be unsafe for people with heart problems. “The heart can be affected with this combination, so cardiac monitoring is preferred,” he says. “Both medications individually can increase risk of QT prolongation, cardiac arrhythmias, hypotension, orthostasis, and syncope, so a combination of these medications would increase the risk of above-mentioned adverse effects further.”

In addition to heart or liver problems, Dr. Jahan advises against mixing Wellbutrin and trazodone if you’re already taking other antidepressants, such as selective serotonin reuptake inhibitors (SSRIs). “Such combinations can induce a hypertensive crisis or cause serotonin syndrome,” he says.

A hypertensive crisis is a sudden, severe increase in blood pressure. The blood pressure reading for this condition is 180/120 millimeters of mercury (mm Hg) or greater. It is a very serious medical emergency that could lead to a heart attack, stroke, or other potentially life-threatening health problems.

Serotonin syndrome is another severe drug reaction that occurs if there’s too much serotonin in your body. It typically happens when two or more medicines that affect your serotonin levels are taken together. 

Symptoms of serotonin syndrome can range from mild to severe, which include:

• Shivering
• Diarrhea
• Muscle rigidity
• Fever
• Seizures 

If left untreated, serotonin syndrome could lead to death.

Additionally, Dr. Jahan says that mixing these medications could lead to an increased risk of developing neuroleptic malignant syndrome (NMS). NMS is a rare but potentially life-threatening condition that can happen when using medications that block dopamine receptors in the body or when suddenly stopping dopaminergic medications. 

Symptoms of neuroleptic malignant syndrome can include:

• Fever
• Muscle rigidity
• Arrhythmia (irregular heartbeat)
• Tachycardia (fast heart rate)
• Rapid breathing
• Altered mental status
• Dysautonomia (autonomic nervous system dysfunction)

“Despite it being a rare occurrence, it’s worth noting that it is potentially lethal as well,” Dr. Jahan says. “It’s similar to serotonin syndrome in terms of process and manifestation of symptoms—however, it doesn’t occur due to serotonin, but rather dopamine.”

It’s important to consider the potential adverse effects of taking both medications and their individual side effects.

Possible side effects of Wellbutrin include:

• Headaches
• Dry mouth
• Nausea
• Weight changes
• Agitation
• Constipation
• Troubled sleep
• Migraine
• Tremor
• Blurred vision

Serious side effects can include worsened depression, suicidal thoughts and behaviors, seizures, and severe allergic reactions.

Additionally, the most common side effects of trazodone can include:

• Weight gain
• Sexual dysfunction
• Urinary incontinence
• Drowsiness
• Heart problems
• Low blood pressure
• Tremors
• Troubled sleep
• Confusion
• Abdominal pain
• Headache
• Nausea or vomiting

In rare cases, trazodone can cause adverse effects, such as:

• Suicidal thoughts 
• Serotonin syndrome
• Heart problems

If you’re experiencing any adverse side effects from trazodone and Wellbutrin interactions, please seek medical advice immediately. Avoid discontinuing these medications without guidance from your healthcare provider, as tapering may be necessary to prevent side effects. Be sure to inform your provider if you have any liver or heart conditions or if you’re on other antidepressants before starting Wellbutrin and trazodone. 

Can I take Wellbutrin in the morning and trazodone at night?

Yes, according to Dr. Hook, you can take Wellbutrin first thing in the morning for mood stabilization and an energy boost and take trazodone at night for a better night’s rest for its sedating properties.

 . If you have questions about dosage, please contact your healthcare provider for guidance. 

Is it safe to mix Wellbutrin and trazodone?

Taking Wellbutrin and trazodone together may be safe and beneficial for some individuals. According to research and medical experts,  taking these medications together can provide more energy, stabilize mood, and improve sleep quality for people dealing with mental health conditions and sleeping problems. 

However, with the many benefits that can come with taking these medications together, it’s important to be aware of the potential risks. If you have liver or heart problems or are already taking antidepressants, please speak with your healthcare provider before starting these medications. Taking multiple antidepressants can increase your risk of developing life-threatening conditions like serotonin syndrome or neuroleptic malignant syndrome.

While there are no specific dosing guidelines for Wellbutrin and trazodone, it seems best to take Wellbutrin in the morning and trazodone near bedtime. Always check with your healthcare provider or pharmacist for personalized medication management recommendations. Each response may differ, making professional guidance essential for safe and effective treatment.