Patient's Query
Hi doctor,
My psychiatrist has decided for years to use only a combo (SSRI and Wellbutrin XL) to control and manage my chronic GAD and SAD. It is important to note that I cannot deal with anxiety without these medications. I am discussing a new plan with him and would appreciate your feedback. Furthermore, I would like to know which of the next SSRIs can be attached to Wellbutrin XL and has the fewest side effects in terms of weight gain, sexual dysfunctions, especially erections, fatigue, sedation, and tremors. Also, is long-term use safe for the liver, heart, circulation, and brain? Are the combinations Prozac 20 mg with Wellbutrin XL 300 mg or Zoloft 50 mg with Wellbutrin XL 300 mg? Please be specific, avoid theoretical information, and be close to your experiences as much as possible. Please help.
Thank you.
Hello,
Welcome to icliniq.com.
I understand your concern. I have found the tablet Fluoxetine more effective in my practice than the tablet Sertraline, even though textbooks say that is not the case. Also, Fluoxetine helps with weight loss, while Sertraline is supposed to be neutral. There is no sedation with Fluoxetine; it has a long half-life, and patients find it more activating in reducing lethargy. Also, this drug does not have long-term side effects on the body. Problems with erections are also uncommon. Instead, most patients have reported a delay in orgasm compared to erection difficulty.
To help improve erection, you can take L-arginine supplements or PDE5 inhibitors (phosphodiesterase type 5). In addition to these medications, I always advise my patients to practice deep breathing exercises three to four times per day. It also helps to repeat it during times of stress. You could also try yoga, meditation, or a search for progressive muscle relaxation on the internet. Finally, in addition to medications, seeing a clinical psychologist for a few cognitive behavioral therapy sessions can help with anxiety management.
Thank you.
I hope this helps.
Please revert so I can assist you further.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
My specialist prescribed a combination of tablet Prozac 20 mg and tablet Wellbutrin XL 300 mg. This combination works well for me, but one side effect I have noticed is fatigue and hand tremors, which are not as severe. What do you think? Is it safe to continue using this combination while neglecting this side effect and not thinking about it? Do these side effects negatively impact sexual performance, or do they have no effect at all?
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
The tremors are due to tablet Bupropion hydrochloride. So you could either ignore it or take a low dose of tablet Propranolol 10 mg to stop them. Also, I do not think it affects sexual performance. Only if you reduce a little weight your sexual performance will improve. So try focusing on that, and till then, you can try using tablet Sildenafil or tablet Tadalafil to enhance erection.
I hope this helps.
Please revert so I can assist you further.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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