Combination Therapy with Strattera and Wellbutrin

Introduction to Combination Therapy

The American College of Obstetricians and Gynecologists and other medical guidelines suggest that Strattera (atomoxetine) and Wellbutrin (bupropion) can be safely taken together, though careful monitoring is recommended due to limited research on this specific combination 1, 2

The combination of Strattera and Wellbutrin follows the principle of targeting different neurotransmitter pathways simultaneously, which can have additive therapeutic effects 3

The initial dose of Strattera is 40 mg orally once daily, with titration every 7-14 days, typically to 60 mg then 80 mg daily, and a maximum dose of the lesser of 1.4 mg/kg/day or 100 mg/day 1, 4
For Bupropion SR formulation, start with 100-150 mg once daily, with a maintenance dose of 100-150 mg twice daily, and for XL formulation, start with 150 mg once daily, with a maintenance dose of 150-300 mg once daily 1
The maximum dose of Bupropion is 450 mg per day 1

Monitor patients for neuropsychiatric effects, as both medications carry warnings about potential mood changes, though these are uncommon 2
Watch for insomnia, which can be a side effect of both medications 2
Monitor for changes in blood pressure and heart rate, as both medications can affect cardiovascular parameters 1
Be alert for signs of seizures, as bupropion has a dose-related seizure risk (contraindicated in patients with seizure disorders) 2

Bupropion is contraindicated in patients with seizure disorders, stroke, brain metastases, or those taking MAO inhibitors 2
Both medications require monitoring for neuropsychiatric effects, though recent studies suggest these risks may be lower than previously thought 2
Patients with cardiovascular conditions should be treated with caution as both medications can affect heart rate and blood pressure 1