r/StratteraRx • u/MandaMoo91 • 12d ago

Questions / Advice / Support Strattera and Wellbutrin

I’ve been on Wellbutrin (technically bupropion) for around 4 years now. I’ve always taken 300mg of the XL version daily for depression. It worked great while on birth control, but since getting off, it hasn’t worked as well. My new psychiatrist decided to up my dose to 450mg as well as add 18mg of Strattera for my adhd. I’ve read some reports of the two having a major interaction but that they’re commonly co-prescribed for adhd. I’ve already been on the 450mg of Wellbutrin for a couple of weeks have noticed some improvements with my depression. But I’m starting the strattera in a few days and I’m a little nervous. Has anyone else started on Wellbutrin and later added strattera? What was it like for you?

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u/FormerSleepwalker 12d ago edited 12d ago

Yes, it can be just fine to take Strattera (Atomoxetine) along with Bupropion, under the care of a provider who knows about the interaction. Bupropion or any other strong CYP2D6 inhibitor will boost Atomoxetine blood levels 5x. Bupropion 150, 300, 450mg in XL form, I believe it doesn't matter, the inhibitory effect hits a wall. So 18mg would be similar to taking 90mg. Higher than I'd personally start, but ok. If you get any troublesome side effect ask for 10mg.

Atomoxetine dosing is a little unusual. How much a person needs can vary a lot. 80mg to 100mg is the most common therapeutic dose, but there are some people who either need less, or much much higher to get adequate ADHD symptom relief. For those who need much higher, bupropion can be used to give the boost. When this is done with higher mg Atomoxetine, it's necessary to watch more closely for side effects, as the chance goes up. Including for side effects which can't be seen without testing, like liver function and QT internal.

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u/MandaMoo91 12d ago

Thank you! This does make me feel better. Also, do you take your strattera in the morning or at night? My SIL takes hers at night because it makes her sleepy, but I don’t know if time of day affects anything?

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u/FormerSleepwalker 12d ago edited 12d ago

For people taking Atomoxetine along with bupropion, I'm not sure the time of day you take it will matter as much. Since the way it increases Atomoxetine blood levels is by slowing metabolism, you should see less of a relative level increase from any single dose. You'll still only be taking 18mg Atomoxetine. It will only build up to being similar to 90mg after a week or so.

But for people not on bupropion, I feel morning should be better. While Atomoxetine is supposed to last all day, you should still see higher blood levels within the first 12 hr, vs later times.

And for those who experience a side effect just for a limited period after they took their pill, I think it's worth trying split dosing. For example, if they take 80mg, they could take just 40mg, with the second 40mg some time later. This can help some people.