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Ask the Experts

Question:

Can I take Wellbutrin and Celexa together? In what way would doing so help me with my depression?

Answered by: Gregory Sullivan

Citalopram (brand name Celexa) and bupropion (brand name Wellbutrin) work by two different mechanisms. For many years it has been common practice among psychiatrists to use a combination of two antidepressants that act differently as an option when one of them alone does not sufficiently relieve depression.

In the last few years, results of a large, multicenter study sponsored by the National Institute of Mental Health (the "STAR*D" trial) became available. This study looked specifically at next steps when the first antidepressant tried does not work sufficiently. About 4000 individuals enrolled in the study, and all took citalopram as the first medication trial for their depression.

The goal in each case was complete remission from depressive symptoms - something that is often not achieved by most participants in industry sponsored treatment trials. In the STAR*D trial, only 33% achieved remission from citalopram alone.

It was not clear if it was better to switch medication or augment with a second medication as the choice was not made randomly (i.e. the physician and client decided together which method to try). But it was clear that 30% of the non-remitters from the first step achieved remission from depression when bupropion SR was added.