For the last 8 weeks I have been on Amitriptyline 20 mg, Guanficine 1 mg at night, Buspar 10 mg 3xday for anxiety. I have been taking these meds for 2 months now. Buspar just takes the edge off the anxiety. I am struggling with depression and fatigue. The Amitriptyline helps with sleep, Guanficine off label for night terrors, racing heart from anxiety. Still have low level anxiety during the day that wears out and I am sure does not help the depression. I have no joy, motivation or energy. This is no way to live. My PCP wants me to try Lexapro again. I have taken it before and the start up was terrible,it made me nauseous and sleepy, but it did help the anxiety.
I started at 2.5 mg and got up to 5mg. Last time I took it for 2 months and transitioned off all above meds first then the Lexapro and went on Wellbutrin 75 mg only. Did really well for two years then PTSD/depression/anxiety hit again.Had to stop the WB due to increase in anxiety.
Now for some reason I am terrified of starting the Lexapro again?? My PCP also told me I could start the Wellbutrin and not take the Lexapro. He gave me 10 days worth of xanax to help with the Wellbutrin anxiety start up. I do not know what to do?? Any advise or words of wisdom would be appreciated. Thank you for any feed back.
Lexapro or Wellbutrin?
Question posted by janiebme on 2 Feb 2016
Last updated on 1 June 2022
4 Answers
Hi Janie ! I have dealt with anxiety all my life. I have tried many AD's through the years. What I am taking now is Wellbutrin along with Buspar. They keep my anxiety in check, which keeps my anxiety from turning into depression.
Like you, I would quit my meds for a while, then feel the need to go back to them. I've gone off and on for many years.
So I've been down this road a long time. Be patient and just try to give the wellbutrin a chance to work. We are all different, but I disliked lexapro for MANY reasons, and I tried it more than once. This combo I'm taking now has been the most effective for my anxiety with the least amount of side effects.
I did a lot of research on my own, and sharing info on forums like these has helped tremendously. So much of this process is trial and error. Hang in there!
Hi G mc-
I liked both of your answers. You answered another one of my questions I posted.
I also dislike Lexapro for a variety reasons. I tried it twice. I am going to try to wean off the Amitriptyline after my Wellbutrin is stable. Having some side effects from the Wellbutrin, it has only been 5 days. The side effects are tolerable, lack of appetite, a little stomach upset. I also feel a little wired like my mind is racing. Also not sleeping as well. It has lifted me out of that dark space. I agree that it is trial and error. I read so much about how Wellbutrin made people's anxiety increase and did not work for them. It was nice to hear that it is helping you along with Buspar. It gave me the courage to continue with the Wellbutrin as it has helped me in the past.
Thank you so much for your kind advise :)
Hi Janie. Please don't give up on the wellbutrin yet. All the AD's will have initial side effects. But, I think wellbutrin is worth its weight in gold in the long run. It helps me to be more positive. Keep in touch, and we can share ideas. The good thing about these forums is that we're here to support each other.
I wanted to say that I agree that wellbutrin is completely worth the wait... I have been taking it for about 5years. It helped me feel less sluggish, gave me more motivation and definitely helped with anxiety and depression. Ive been prescribed just about every anxiety depression med and wellbutrin is definitely the one that finally worked for me. I hope you're doing well!!! I know I'm a little late with commenting. I saw this and felt like I should give you another persons input :)
Hi Panic-
Thank you for your comment. I still struggle with the anxiety that the Wellbutrin creates. I tried to take the Lexapro but had bad side effects for 2 months, even with the brand name :( I am on WB only right now.
If you don't mind me asking, why did you want to stop taking the med you were on for the racing heart ? Were there any bad side effects that you were getting? Or just wanted to start fresh? Im just curious, I've never heard of that med and one of my biggest struggles with my panic disorder IS the racing heart. Also, did the xanax help you when you did take them in the beginning of getting back on the WB?
Janie; All good information; But it could help until you can get into a pdoc; To use the Wellbutrin and use the Xanax as needed as your going on the Wellbutrin to help with the side effects of the anxiety etc that get worse when you first start it. That last for about 7 to 14 days and then most of the side effects go away prior to the 2 week period; this too is pretty much a weight neutral medication more people lose weight than gain weight with Wellbutrin but it does work very well for the type symptoms you are talking about but it does take like most of these medications from 6 to 8 weeks before you reach the full blood level. Hope you get to feeling better soon and also you may have found a pdoc/by then to work with but your PCP IS NOT far off at all most are not as open minded as he or she is.But I would not start out on Remeron until after I tried the Wellbutrin Hope you get to feeling better soon.
Get moving on it the sooner you get started the better you well be.And try not to read so much into the side effects of the medications like the Topamax etc that rash rarely ever happens and many more things like this don't happen that often and it can shake a lot of people off of taking the drugs the could be their life saver.When these studies are done most of them are with a small amount of people and you look good you well see side effects are very close to many of the people taking Placebo medications. hoping all the best for you. Keep at it you well find the right combination of medication to make life so much better.
Hi Chuck-
Thank you for responding. My primary doctor has dealt with PTSD patients before and I am glad that you said he was not far off. I think I am leary with many of the meds. I appear to have bad side effects with most of the SSRIs. Have tried Paxil, Zoloft, Effexor, Prozac and Celexa. I like the idea of trying the Wellbutrin before Remeron if I could just get past the fear of it increasing the anxiety and messing with my sleep. I just got back to being able to sleep 5-7 hours, before it was 2-3 hrs and I almost went crazy due to the night terrors and lack of sleep. But it is really hard to live with the depression/lack of motivation. I appreciate the motivation push to get started and the encouragement regarding the side effects. Thank you.
I've also been on all these meds in some combination or other. It's taken me years to arrive at a somewhat acceptable place. Unfortunately, I started having psychosomatic seizures January 1st of 2021. I already had severe anxiety disorder panic attacks night terrors flashbacks and PTSD managing all this has been beyond extremely difficult. Dealt with severe migraines since I was 3. Trying to treat all this is no easy feat. I feel like a guinea pig at 51. Clonazepam truly helped me for years w panic attacks and the extreme irritability but my Dr in practice I've gone to for over 10 yrs transferred. I was NEVER addicted and don't have addictive personality. Dcotors today just don't want to prescribe it & others in it's class because of all the negative news about controlled substances. Not everyone is effected by meds the same so such generalized reactions are way off the mark. Meds that work for people w/o problem should be doctors first concern.
They take an oath to help and not harm so if med helps & doesn't harm they should be for it.
I agree with howielinux about going to a psychiatrist. Your primary care Dr. is not qualified to treat you on this level. All the meds you are discussing are quite old, and though older meds are sometimes the right ones (I take Remeron 45 mg 1x/day at night for anxiety which is pretty old, but gave me immediate relief [I started on a lower dose] for sleep and appetite as well as the anxiety) and may be right for you, there are newer generations of antidepressants on the market that a psychiatrist will be more familiar with. I struggle with fatigue and low motivation too, and it's hard to tell if it's the MDD or the meds - most of which cause sleepiness. I take them at night, but when your system is full of them, it carries over into the daytime. I hear that many people get some improvement with Abilify. My Psych.
just started me on the next generation of Abilify, but I doubt if my insurance will cover it, so I may have to switch to Abilify. I do feel a little better in terms of energy. She also told me to not stay up late at night (past midnight), sleep regular hours, and eat a good breakfast, which is hard for me, but makes sense. Hope this helps, and that you get some good informed help soon and feel better!
Hi emarti- Thank you so much for responding it helped. The reason we went with the older meds is because I have a horrible time on SSRIs and other newer meds. I take all my meds at night except for the Buspar. Like you I feel the sleepiness carries into the day. My primary doc had suggested Remeron. Did you put on a lot of weight with it? I read this is one of the major side effects.
If PCP mean your primary Dr you need to see a Psychiatrist. IMO he has no business Px'ing that many psych meds and playing with them or suggesting a drug that you previously tried and give it with Elavil will cause blood levels of both drugs to rise significantly. The Guanficine may be causing your lack of motivation so look into something else and Buspar doesnt do anything for severe anxiety so why not look into a long acting benzo (Klonopin, Tranxene, Valium) if it helps your quality of life who cares about the fact that you will become dependent it just another pill to take, SSRI withdrawal was the worst thing I've ever been through and they hand those out 1st line. Look into something like Zoloft, Lamictal, Tranxene, and a small dose of Adderall or Dexedrine (they do not cause as much anxiety as Wellbutrin and help with motivation) if all else fails add Pramipexole to your Elavil. Just my opinion
Hi howie-
I posted back to you but did not see the post?? Thank you so much for the advise. I agree that I should go see a Psychiatrist to figure out my meds. I am not going to take the Lexapro. I have also been through the SSRI withdrawals it was bad. It is getting harder and harder to get docs to prescribe benzos and or Adderall. I really do not want to go the benzo route unless all else fails. I have tried most of the newer SSRIs including Zoloft, could not tolerate side effects. Lamictal sounds promising except for the rash side effect, but from what I read usually goes away. How do you know so much about meds?
Well IDK if I know a lot but I'm a Psychiatric nurse and work with people in crisis and have to know about meds I work with and I sometimes sometimes work with Psychiatrist, Psychologist, L.C Social Workers, NP's so I ask a lot of questions and read a lot since I suffer from some of the same disorders as we treat I have my own recovery as incentive to be knowledgeable in my field. Lexapro was the only SSRI that didn't give me any SE's but sexual ones. I tried the new drug Viibryd and it was really good except it made me sweat profusely and it isn't exactly an SSRI so might be worth considering.
I had those feelings about Benzo's too but I couldn't live with the severity of my anxiety and nothing else worked, I'm taking Klonopin 1mg QID and haven't had to increase the dose in the 2 years I've been taking it and its especially great for anticipatory anxiety, a Psychiatrist will know if your case is severe enough or treatment resistant to require them IMO stay away from Xanax unless you have Panic Disorder. I used Wellbutrin SR in a way that I didn't have a constant blood level, sort of like a mid morning long acting good mood inducing coffee that worked cause I never got used to it, from my understanding its an antidepressant that works on Nor-epinephrine and some Dopamine so a therapeutic level was something I didn't want. Don't let the fear of SJS keep you from Lamictal I've seen/heard so many wonderful things from people using it. Can I ask if you had anxiety and depression before the triggering of PTSD?
Hi Howie-
I appreciate your knowledge. I had depression before my incident. It was managed by Wellbutrin SR 75 mg. After the incident I developed severe PTSD (2013). It was treated with the same meds I am on now. After 8 months of therapy (EMDR) I weaned off all the meds and was on WB only for 2 years. Just recently had a PTSD relapse. Back on the same meds but struggling with the depression/lack of motivation. I still have low level anxiety and nocturnal panic attacks (early morning upon waking). I am sleeping better 5-7 hours as apposed to 2-3 hrs before I started the meds. I get depressed over being fatigued all the time. That is why I wanted to try the WB again. I have good days once in a while so that gives me hope that I may be coming out of this again. Since the PTSD I worry about everything, have a lot of fear. I get overwhelmed easily. Dislike the anxiety that rules my life. So any help and or advice is appreciated.
Ok this is just my opinion but EMDR is not what should be used for PTSD, Exposure therapy or DBT would work since you have other issues with depression and debilitating anxiety. I think you have GAD and the anxiety isn't necessarily from the PTSD, I couldn't start working on anything until my anxiety was manageable and it took years of meds from Paxil to Seroquel to Tegretol and nothing worked until I took Klonopin not just PRN but a given amount every morning, then my depression, derealization and bouts of rage could be worked on. The Alpha Blocker Minipress works great for PTSD's nightmares and should help with sleep overall and its way safer than what you're taking.
If motivation is your main depressive symptom is lack of motivation or drive I say a Dopamine agonist is a must, Abilify may work but I know the drugs for dopamine agonist for Parkinson's are wonderful for this and so is Provigil and Nuvigil, with the Elavil (increase it) or try Pamelor, it wouldn't be a bunch of changes and may show benefits faster. Just my opinion treat the anxiety as a separate condition and treat it 1st, then depression then go after PTSD with therapy and meds
Howie-
Thanks for the insight. It made sense to tackle the anxiety first. Have felt that my anxiety and depression work against my therapy. I am either caught up in my anxiety or too depressed to put the mental energy into it. It is expensive also. I do not have insurance that covers it. It is also the chicken before the egg and visa versa. Did the anxiety create the depression or depression create the anxiety?? Or did the PTSD trigger it all? I do not know. I just know that I was 2 years of living life just on Wellbutrin SR 75 mg then all hell broke loose. It is a slow climb out of the grips of depression/anxiety and fear. It took 8 months the last time. Unfortunately this time I have knowledge of what is happening and that increase my anxiety. There is a saying, ignorance could be bliss. I am feeling a bit better, not so down that I have thoughts of not being in this world. So that is a step up. Have to look at the positive no matter how small. Grateful for all the good people on this site.
I understand where you are coming from 100%. Since you don't have insurance you should get a savings card IDK if it will be removed if I say names or pay to become a member of a giant grocery chain and sign up for their Pharm and the savings is crazy! Is it hard for you to get out of the house other than motivation wise, like does it cause anxiety?
Hi Howie-
I have insurance for my prescriptions. But not for therapy. You are right when I did not have insurance for my meds the chain Walgreens signed me up for a discount plan. It saved me from having to put out hundreds of $.
To address your question about getting out of the house. It is a push to go anywhere. I make myself get out. When this first started I was unable to leave the house for a week. But I have responsibilities to take care of and others depending on me, so isolating 100% was not an option. I think that was a good thing. I did have some left over xanax .5mg I would take 1/2 of it just so I could get out & grocery shop. I do not have to do that now.
It is nice to know you can relate... thank you.
I honestly can relate and I'm only 31 and its no way to live. You said you are seeing a psychiatrist this month? its important to go in there without a anxiety PRN so they can truly evaluate where your at and advocate for yourself, I used to just agree to everything they said and it wasn't til I started expressing my honest concerns, opinions, research, what they weren't understanding did I get any better, so IMO I wasted years because my anxiety made me second guess myself and the Dr cant help you if you hold back
Hi Howie-
I do try to advocate for myself. It is not always easy when you depression with anxiety. You are young to have so many conditions that affect your life. You are very courageous and have good intentions towards others. I am looking into the meds you mentioned.
Do you know anything about nocturnal anxiety attacks? Night terrors have stopped but have early morning nocturnal anxiety attacks every morning. They wake me up, I am trembling, sweating and my anxiety is high.
Thank you! Not really but I would think it might be your Tenex level dropping and your getting a surge of Nor-adrenaline or Adrenal fatigue (sounds weird I know but I believe it exists on some level) or an issue with your glucose being very low since you haven't eaten for a while and hypoglycemia can cause anxiety, have you had an A1c taken? I will look into it but those are my best guesses
Also is there any chance that your anxiety may be how you express hypomania and have BP2 rapid or ultra rapid cycling with mixed episodes?
Hi Howie-
Did not have anxiety until after my incident that created my PTSD. So I do not think it is bi-polar.
My A1c levels was good, so was my glucose level. What is Tenex level?
Its just your Guanfacine wearing down and allowing your adrenal glands to become more active, its called rebounding and anxiety and tachycardia are common side effects of it those 3 factors could be worth bringing up to your Psychiatrist and I think that it and Clonidine both are bad drugs anyway (just my opinion). If the night terrors are gone I wouldn't bother looking for treatment for them
Hi Howie-
You are probably right about the Guanficine. I do not like being on a blood pressure med since I do not have high blood pressure. I am going to start weaning off of it. It makes me dizzy sometimes. Thanks for your suggestions. I noticed you posted about "the best depression meds". That is a really subjective question. It will be interesting to see what answers you get.
Yea I just want to see what peoples experiences are but in all honesty a lot of answers I read on here aren't really answering the question, they just give advice of going to the Dr which is like duh nobody is here for a diagnosis but people do want informed ideas or answer with its hard to tell because everybody reacts different, when we all already know these things but generally 1 or 2 drugs do work better than others in the same group for a given set of symptoms/lifestyle/health lol sorry just ranting!
Hi Howie-
It is OK to rant. It is a CYA to tell them to check with their doctor. They probably already have or going to. They also may want opinions and feedback to validate their thoughts on any given circumstances.
I am thinking twice about what you said about possible bi-polar. Could be why antidepressants alone have not worked for me. Looking back on symptoms of bi-polar II, there could be a connection. The thought of this scares me a lot. I am still trying to get a referral to a psychiatric doctor. I am down to .5mg of guanfacine & 12.5 mg of amitriptyline. Still taking Buspar 10 mg 2x day. Trying to wait until I see the psych doc. Last couple days have been rough. Could be due to reduction of meds. Had to take 1/2 of a 1mg ativan last night to calm down. I am jittery but tired, hate that feeling.
If you took Lamictal and your NOT bi-polar will you know it's not the right med? I read that it helps with a lot of people even for depression. What are the negatives of antipsychotic meds? Really appreciate your input :) My turn to rant :0
I know this is late... Howie, you have so much medical knowledge!
I just wanted to make sure everybody knew that Buspar will NOT work if you have been on "controlled" anti-anxiety meds, you know, Valium and on... on and on !
I work as a Psychiatric nurse with Psychiatrist, Psychologist and N.P's and deal with the entire spectrum of conditions and medications. Lots of crisis situations and I have to know about the meds my guys are on plus I research meds myself as I have Severe depression, GAD, a mood condition that they cant label (or make it fit) so its changes from PTSD to Atypical Bipolar to IED, so IDK lol what it is, I also am just generally interested in Psycho Pharm.
Even before I ever took a benzo Buspar didn’t do anything but cause brain zaps and make me feel off, its the 5htp 1 activation that can work but now with Viibryd, Brintellix and even Abilify and Latuda out that are so much better I don’t understand why its Rx'd I think its garbage but just my opinion
I've been following the answers and comments on this particular question, of which there has been quite a discussion!!
I feel the need to throw in my two cents. Personally, Howie, even though it might not have worked for you or other people you know of, it has been a very effective and therapeutic medication for me. I'm talking about Buspar, which I think often gets a bad rap. I have also been greatly helped with Wellbutrin SR. Without going into my past, I have taken my share of antidepressants and anti-anxiety/depression meds. I took benzos in the past, but even so, the buspar works wonderfully for me at present in spite of that fact. So maybe I don't quite fit the mold. but I know what has and hasn't worked for me in the past and present. I'm a firm believer at this point that, for myself, sometimes, LESS is MORE.
Yes, everyone is different, and I hope for everyone to get relief, because anyone who hasn't had to live like this is fortunate, but also apathetic in many cases. That's why I love to talk to folks here, because everyone has "been there, done that" when it comes to dealing with day to day feelings of just wanting to wake up and feel normal, not scared to wake up with that "heavy rock on the chest" feeling that anxiety loves to visit on us when we first open our eyes in the morning. Thank goodness I haven't experienced that feeling in quite a while, thanks to my current medications, which have also helped me to feel more self-motivated and worry less.
I've enjoyed exchanging ideas and encouraging each other in these forums, like Janie, WCV, Chuck, and others who show empathy and understanding and knowledge and have shared their experiences. Y'all keep up the great comments!
Thanks!! "G"
Thats good Buspar helped you out! If you had severe anxiety you are the 1st person I've came across that has anything good to say about the med though. What did you mean by less is more? I think Wellbutrin SR is a great medication and found it better than XL
Hi Howie,
We meet again... LOL. I take Buspar 10 mg 2x day it helped. I believe it has helped me. Now that I am experiencing the kick up in anxiety caused by the Wellbutrin 75 mg instant release, day 8. I cannot say for sure it is helping, but not willing to stop to find out. It seems to be a drug without bad side effects and addiction, that is rare on this forum. I am taking the WB because it is the only antidepressant that has worked for my depression with the least side effects.
I found it interesting that you like the Wellbutrin SR better than the XL. My doc gave me a script for Wellbutrin 100 SR generic and I just got it filled, it is manufactured by Actives. I had not heard of them... have you?
Sorry... misspelled the manufacturer it is Actavis... darn auto speller.
Janie, if I remember correctly from my research, the company Activas bought out the company Watson. I took Watson before they merged with Activas. I didn't like Sandoz or Par or Global or Teva. I currently take Mylan brand, and I love it. I take 150 sr only once a day for now.
Howie, I like the SR version of Wellbutrin better than the XL version also, as I see you said in your post. Less side effects for me.
My Less is More comment: I was referring to the comment that you made along the lines that buspar usually wasn't very effective for the people at the hospital where you work. And I've read others say that buspar won't work for people who have taken benzos previously. I think someone should try it first before ruling it out. My doctor suggested buspar to me, and I was surprised, because it had never been suggested to me before. She didn't want to refill my prescription for ativan. And I love it! Unfortunately, buspar takes longer to kick in than benzos, but it is not addictive like the benzos, nor does it have as many side effects as the benzos. So, even though some people might think of buspar as a lesser effective medication, sometimes less is better! If it works for someone, that is. The same for Wellbutrin.
The milder medication (least side effects) a person can take that is effective, the easier it is on our systems, especially if we take it long-term. Starting out mild, then working up to the stronger ones is a good idea. Or, for people who want to titrate down because they aren't feeling well from taking multiple meds., this could be another consideration, Of course, this decision would be made between a patient and the doctor. Just saying, sometimes I've heard people say they feel as if they are over-medicated. So this would be another option. I appreciate your helpful comments, also, Howie. It shows that you really care about other people!
Hi G mc-
Thank you for the information.That is why I like this site. More often than not people seem informed and educated.
Why did you not like Sandoz? I was taking Wellbutrin made by this manufacturer and seem to be having trouble with it being effective about 6 months ago. That is when all the anxiety started up again. Wonder if there is a connection? Glad you are doing well on your meds. :)
Janie, my biggest problem with Sandoz was fatigue. I felt very tired, and I needed to feel more awake and mobilized. I felt more tired with Sandoz, as if I were still taking Lexapro, lol.
But medications affect people different ways. It just wasn't the one for me.
Howie, I'm not ignoring you. I submitted an answer to you, but I received a notification which said, "The answer is currently pending approval". ???
Maybe it will post soon, so you can see my answer, lol! "G"
I honestly have never paid attention to the manufacture other than name brand and generic, I live in a smaller town and use CVS and Risperidone is the only med I can remember getting from more than one maker and I didn't notice a difference. I'm happy Buspar works for you guys, its just I've never heard anybody who takes it other than for mild anxiety say it worked or anything good at all, it was the 1st med I took for anxiety and it made me feel like I was in SSRI withdrawal (looking back that's how I would describe it) then Paxil was added and it got worse. Wellbutrin SR let me sleep and did more for getting me out of the house and going. the XL made it harder to sleep and at 300mg it was too much anxiety, low doses of Dexedrine worked way better and didn't induce my anxiety at all but Nuvigil and Modafinil work even better.
If I could get through my day with less medication believe me I would but as of now I'm not there and I dont have the luxury of waiting for therapy or waiting for the perfect med to come out, I've gotta work and I have a high stress career that doesn't help but I like doing it.
Good comment, Howie... I think it's great that you have found the best formula that has worked for you. That wasn't a slam against you when I said less is more. It's just that some doctors, as I have seen mentioned in these forums, try to "throw pills" at some of their patients. I don't feel like that applies to you or to me. Some people I have known were over-medicated and wanted to take less meds. and still feel better. So that was definitely not meant for you. I am thankful that there are many meds out there so that more people can be helped, as our chemical makeups are all different, and there is a good fit for most of us available. And it helps for us to be aware and keep up to date on what is available to us. I appreciate comments from people like Chuck and Masso, and WildcatVet, and also you, Howie, that keep up with what's current. Thanks! "G"
I've been one of those people that was just given a script or samples and my quality of life or my ability to work didn’t seem to matter to the Psychiatrist and asking questions or suggesting anything was taken as non compliance, so I very much know what you mean lol, glad I found a great Psych now who listens and takes my thoughts into consideration but has no problem telling me when he doesn’t agree and explains why also. Yes I'm glad I signed up because their are wonderful people with tons of knowledge here.
Related topics
buspar, lexapro, wellbutrin, depression, post traumatic stress disorder, anxiety, panic disorder, generalized anxiety disorder, amitriptyline, major depressive disorder, anxiety and stress
Further information
- BuSpar uses and warnings
- Lexapro uses and warnings
- Wellbutrin uses and warnings
- Amitriptyline uses and warnings
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