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Lexapro combinations and suggestions...

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Okay, this has probably been discussed before, but I couldnt' find it.  I am looking for suggestions and experiences with Wellbutrin-Celexa and/or Wellbutrin-Lexipro interactions... and/or interactions with pot.

From the top, I have suffered from depression most of my life, along with my dad, aunts, uncles, and sister.  In 1998 I started looking into prescription drugs to control/ease the condition.  Prozac was my first and I went crazy, voice in my head and the whole bit.  Wellbutrin made me hostile and short fused.  Effexor was next and I was basically a zombie all day.  Zoloft, I can't remember but I'm sure I didn't like it.  (I may be confusing Effexor and Zoloft... I was extremely confused and out of it for a couple months).  Then came Celexa.

In 2001 I started taking Celexa with small doses of Wellbutrin to counter some of the side effects.  It seemed to be working pretty well, school and relationship problems disappeared and everything smoothed out.

At a party I smoked a little pot, something I hadn't done in several years because I was really sensitive and I would freak out with just one hit.  I had the most amazing experience, very thoughtful and very aware.  I stayed up for hours writing thoughts, feelings, and ideas down.  I continued to smoke pot with similar experiences for 2 years... and still maintained a 3.9 GPA in a MS program.  I was obsessed with learning again.

I stopped smoking pot for several months and still felt pretty good... although a bit lazy when it came to "thinking."  Eventually I stopped taking Celexa just to see where I was without it.  I was off it for a full year and it caused problems with relationships, etc... and the few times I smoked pot were just lame.

I started taking Lexipro 6 months ago and I am doing pretty good but not as good as I was on Celexa... but much better than without medication.  I have not supplemented with Wellbutrin because I'm not really feeling the side-effects.  And pot is not as remarkable as it was on Celexa... but it helps me sleep.

I'm curious if anyone has had similar reactions or interactions with these combinations and if they have found anything that works better and/or things to avoid.  Any input would be great.


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From aidsmeds.com:

Moderate Drug-Drug Interaction:  Celexa (citalopram) and Wellbutrin (bupropion)


ADJUST DOSE: Coadministration with bupropion may increase the plasma concentrations of drugs that are substrates of the CYP450 2D6 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by bupropion, which is expected to occur in patients who are CYP450 2D6 extensive metabolizers (93% or more of the general population). MANAGEMENT: Caution is advised if bupropion must be used concomitantly with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range. Concomitant medications should be initiated at a lower dosage. Clinical and laboratory monitoring may be appropriate for some drugs whenever bupropion is added to or withdrawn from therapy.

Moderate Drug-Drug Interaction:  Wellbutrin (bupropion) and Lexapro (escitalopram)


MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be made aware of the possibility of additive CNS effects (e.g., drowsiness, dizziness, lightheadedness, confusion) and counseled to avoid activities requiring mental alertness until they know how these agents affect them. Patients should also be advised to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

It didn't say anything about the marijuana, so my guess is, as usual for such subtances, effects vary by individual.  With MI folk, things such as pot can *really* vary, and cause nasty NASTY effects.  Especially while on meds.  But, mileade varies etc..

And personally, I would council against using pot to slep.  Aside from the potential ramifications of the interactions, there are safer and less, er...*illegal* things to aid with sleep.

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