Can I take Venlafaxine and Wellbutrin together?

Why this happens

Bupropion can lower the 'seizure threshold', making seizures more likely, especially when combined with other antidepressants like venlafaxine. Furthermore, bupropion blocks a specific liver enzyme (CYP2D6) that your body uses to break down venlafaxine. This causes venlafaxine levels to rise. Both drugs also affect brain chemicals, which can occasionally lead to too much serotonin (serotonin syndrome).

What you should do

You should only take these two medications together if they have been specifically prescribed by a specialist who is monitoring you closely. If you have a history of seizures, head injury, or eating disorders, make sure your doctor knows. Seek immediate medical help if you experience a seizure, extreme agitation, hallucinations, or a very high fever.

Important precautions

Depression and anxiety disorders

Both medicines can cause an increase in suicidal thoughts or self-harm, particularly when first starting treatment or changing doses. Monitor your mood closely and seek urgent medical help if you notice any distressing changes.

Seizure risk (Epilepsy)

Both medicines can lower the seizure threshold. Wellbutrin carries a significant risk of causing fits (seizures), especially at higher doses or in patients with a history of epilepsy or eating disorders.

Bleeding disorders

Venlafaxine can increase your risk of bleeding, especially if you are also taking aspirin, NSAIDs (like ibuprofen), or blood-thinning medicines like warfarin. Seek medical advice if you notice unusual bruising or bleeding.

Serotonin Syndrome

Combining venlafaxine with other medicines that affect serotonin (such as St John's Wort or certain painkillers) can cause a life-threatening condition called serotonin syndrome. Symptoms include agitation, hallucinations, fast heartbeat, and muscle stiffness.

Alcohol or sedative withdrawal

Suddenly stopping alcohol, benzodiazepines, or anti-seizure medication while taking Wellbutrin can trigger severe seizures. Consult your doctor before making changes to your alcohol consumption.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol when taking these medicines. Combining alcohol with venlafaxine or Wellbutrin can increase the risk of side effects like drowsiness, dizziness, and impaired coordination. More importantly, alcohol can increase the risk of seizures when taking Wellbutrin, and both medications can increase the risk of liver damage if combined with heavy drinking.

Caffeine

You should limit your intake of caffeine while taking Wellbutrin. Both caffeine and Wellbutrin can stimulate the central nervous system; combining them may increase the risk of side effects such as anxiety, tremors, palpitations, and insomnia. In rare cases, high levels of caffeine may increase the risk of seizures when taking this medication.

Venlafaxine can sometimes increase your blood pressure or heart rate. Consuming high amounts of caffeine (found in coffee, tea, and energy drinks) may worsen these effects or increase feelings of anxiety and restlessness.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.