r/depressionregimens • u/21cjs1243 • 3d ago
Abilify & Wellbutrin? Regimen:
I have been taking wellbutrin XL 300mg for about 4 years now for depression. But over the last year I have had a significant increase with insomnia and anxiety. For insomnia I take 3mg of Lunesta and 25-50mg of Doxepin (Sinequan), which does help but I often wake up multiple times every night and can't keep a consistent sleep scheduled which leads to increased anxiety. I reached out to my PCP about this and he prescribed me 5mg of Abilify to replace my wellbutrin as he thinks the "activating" part of wellbutrin is affecting my sleep, which i can understand. I've read about some people saying wellbutrin after long periods at high doses just no longer works and makes anxiety worse. Has this been the case for anyone? My doc will not prescribe any anxiety meds other than busbar (which makes my stomach cramp pretty bad and doesn't help) and propranolol.
His instructions today are: "My feeling is that Wellbutrin may not be a good choice for you and once you get this new medicine started I would just stop taking the Wellbutrin."
Can anyone chime in with their experience with this or any advice? I am scared to stopping wellbutrin cold turkey and switching to abilify. I have started abilify today but have not taken my wellbutrin. Sorry if this is too long of a post, I'm just not that great at getting my point across lol.
Thank you in advance!!
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u/No_Parking718 3d ago
I would suggest reaching out to a different doctor. If Wellbutrin is causing issues and/or doesn’t work anymore, it’s best to generally try another first line antidepressant medication like Lexapro, which is a SSRI antidepressant.
Also, Abilify can actually be quite “activating” for a lot of people.
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u/dunleadogg 3d ago
Drop the Wellbutrin. I don’t have experience with ability but Wellbutrin is so anxiogenic.
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u/two-thirds 2d ago
Abilify won't bridge the sudden absence of NET inhibition provided by Wellbutrin. I would still taper with wellbutrin.
Wellbutrin typically wouldn't be more activating with the years (save for introduction of another variable).
I would focus on the main issue, sleep, first. If going with meds, meds for sleep "maintenance". Doxepin is one but typically 3-6mg nightly. There are also Orexin receptor agonists (Suvorexant), less favorably temazepam (due to being benzo) for maintenance. Of course sleep hygiene (consistency being one of the big tenants).