Risks of Mixing Lexapro and Wellbutrin

Lexapro and Wellbutrin are two commonly prescribed antidepressants that many individuals rely on to treat depression, anxiety, and emotional imbalance. While each medication works differently, doctors sometimes combine them to target multiple neurotransmitter systems at once. For many, this can boost energy, stabilize mood, or improve overall symptom relief.

But mixing antidepressants is never something to take lightly. Even medications that are safe on their own can create risks when taken together—especially for adolescents whose brains are still developing, or for individuals who mix medications with alcohol, marijuana, or other substances.

At The Meadowglade in Moorpark, California, we work with teens and young adults navigating mental health challenges, medication management, and co-occurring struggles. This guide explains the potential risks of combining Lexapro and Wellbutrin and helps families understand when to seek professional support.

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What Are Lexapro and Wellbutrin?

Before exploring the risks, it’s helpful to break down what each medication does.

Lexapro (Escitalopram)

Lexapro is an SSRI, or Selective Serotonin Reuptake Inhibitor. It helps increase serotonin levels, which can improve mood and reduce anxiety. Doctors commonly prescribe Lexapro for:

  • Depression
  • Generalized anxiety disorder
  • Panic disorder
  • Social anxiety

Possible side effects include:

  • Insomnia or fatigue
  • Nausea
  • Increased anxiety during the first few weeks
  • Reduced sexual interest

Wellbutrin (Bupropion)

Wellbutrin belongs to the NDRI class: Norepinephrine-Dopamine Reuptake Inhibitors. Instead of serotonin, it boosts norepinephrine and dopamine. This makes it useful for:

  • Depression
  • Seasonal affective disorder
  • ADHD symptoms (off-label)
  • Smoking cessation

Common effects include:

  • Increased energy
  • Better focus
  • Reduced appetite
  • Improved motivation

Notable risks include its potential to lower the seizure threshold.

Why Doctors Sometimes Combine Them

Some people don’t respond fully to one antidepressant. In those cases, doctors may prescribe Lexapro and Wellbutrin together for several reasons.

1. Broader Neurotransmitter Support

Lexapro boosts serotonin; Wellbutrin enhances dopamine and norepinephrine. Together, they may cover more mood-regulation pathways.

2. Reduced Side Effects

Wellbutrin can counteract certain SSRI side effects, such as low energy or decreased libido.

3. Treatment-Resistant Depression

For people who haven’t responded to a single medication, combination therapy may provide more complete symptom relief.

4. Improved Functioning

Teens or adults experiencing emotional flatness on Lexapro may regain motivation with Wellbutrin’s energizing effect.

Even so, the combination must be carefully monitored. More neurotransmitter activity does not always mean better or safer outcomes.

Risks of Mixing Lexapro and Wellbutrin

Even when prescribed together intentionally, combining these medications carries several risks. These risks increase significantly if someone:

  • Misuses the medication
  • Mixes prescriptions with alcohol or recreational substances
  • Changes dosage without supervision
  • Has underlying medical vulnerabilities

Below are the major concerns:

1. Risk of Serotonin Syndrome

Although Wellbutrin doesn’t directly raise serotonin levels, pairing it with an SSRI like Lexapro can create excessive neurotransmitter activity. This raises the risk of serotonin syndrome, a potentially dangerous medical condition.

Warning signs include:

  • Rapid heart rate
  • Fever or sweating
  • Agitation or irritability
  • Muscle stiffness or twitching
  • Shaking or shivering
  • Confusion or disorientation

Serotonin syndrome requires immediate medical care. It becomes more likely when other substances—like MDMA, cocaine, certain supplements, or misused prescriptions—are added to the mix.

2. Increased Seizure Risk

Wellbutrin is known for lowering the seizure threshold. When combined with Lexapro, that risk becomes greater—especially if the individual:

  • Has a history of seizures
  • Has an eating disorder (anorexia or bulimia)
  • Drinks heavily or binge drinks
  • Misses doses or increases doses abruptly
  • Uses stimulants or nicotine products excessively
  • Is withdrawing from alcohol or drugs

Teens experimenting with substances while on Wellbutrin are especially vulnerable, as they may not realize how drastically substances increase seizure likelihood.

3. Worsening Anxiety or Agitation

Both medications can increase anxiety in the early weeks of treatment. Together, this may intensify symptoms such as:

  • Restlessness
  • Racing or intrusive thoughts
  • Inability to sit still
  • Irritability
  • Panic attacks
  • Trouble sleeping

This combination isn’t necessarily unsafe for everyone, but it does require close monitoring—particularly for teens dealing with social anxiety, trauma responses, or ADHD.

4. Stronger Reactions When Mixed with Substances

Combining either medication with alcohol or drugs is risky. Combining both medications with substances amplifies the danger.

Potential problems include:

  • Seizures (especially with alcohol + Wellbutrin)
  • Blackouts or memory gaps
  • Heightened depression
  • Aggression or impulsivity
  • Dangerous behavior
  • Worsening suicidal thoughts
  • Unpredictable mood swings

This is a significant concern for adolescents and young adults who may be exposed to substance use socially or in school environments.

5. Suicidal Thoughts in Teens and Young Adults

Both medications carry an FDA black box warning about increased suicidality in people under 25. Mood fluctuations, increased energy, or emotional volatility during early treatment can increase risk.

Important signs to watch for include:

  • Hopelessness
  • Withdrawal from friends
  • Talking about death
  • Giving away belongings
  • Sudden calmness after intense distress
  • Risk-taking behavior

Any concerning behavioral change should be taken seriously.

6. Emotional Blunting or Emotional Overload

Because Lexapro may cause emotional numbing and Wellbutrin may heighten stimulation, combining them can create a confusing internal experience. Some people feel “flat,” while others feel overstimulated—especially during dose adjustments.

This reaction varies based on the individual’s brain chemistry, age, and mental health history, which is why personalized monitoring is essential.

Signs the Combination Isn’t Working

If you or your teen notices any of the following, it may mean the combination needs to be adjusted or discontinued:

  • Increasing irritability or mood swings
  • Frequent panic attacks
  • Worsening depression
  • Loss of appetite or major weight changes
  • Confusion or dissociation
  • Insomnia that becomes unmanageable
  • Seizure-like symptoms
  • Increased reliance on substances to “feel normal”

These signs do not mean the person is “failing” treatment—they simply mean the treatment needs to be reassessed.

Medication Should Support Healing—Not Replace It

At The Meadowglade, medication is viewed as one tool among many. Teens and adults do best when antidepressants are paired with:

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavior Therapy (DBT)
  • Trauma-informed therapy
  • Holistic practices like yoga or art
  • Emotional regulation skill-building
  • Family therapy and communication support

Medication helps stabilize symptoms—but the deeper work of healing happens through therapy, connection, and learning to understand the emotions beneath the symptoms.

Contact Us For Support

If you’re concerned about the risks of mixing Lexapro and Wellbutrin—or if your teen is struggling with depression, anxiety, or emotional overwhelm—The Meadowglade can help.

We offer a peaceful, restorative environment in Moorpark, California, where adolescents and adults receive comprehensive mental health treatment tailored to their needs.

You don’t have to navigate medication concerns or emotional struggles on your own. Our team is here to guide, support, and empower your family every step of the way.