Lexapro (escitalopram) and Wellbutrin (bupropion) are sometimes prescribed together intentionally to treat depression that does not respond adequately to either drug alone. This combination is generally well-tolerated, though bupropion can increase escitalopram blood levels and there is a slightly elevated seizure risk.
How This Interaction Works (Mechanism)
Bupropion inhibits CYP2D6, one of the enzymes involved in escitalopram metabolism. This can increase escitalopram plasma concentrations by approximately 30 to 40 percent. Bupropion acts primarily on norepinephrine and dopamine reuptake, while escitalopram targets serotonin, so their therapeutic mechanisms are complementary rather than redundant. The seizure threshold may be slightly lowered by the combination.
Source: American Psychiatric Association Practice Guidelines, 2025
This combination is commonly used in clinical practice and is generally considered safe under medical supervision. Your doctor may use lower doses of one or both medications. Report any new or worsening side effects, including tremor, restlessness, or seizures. Do not start or stop either medication without consulting your doctor. Avoid alcohol, which can further lower the seizure threshold.
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Sources and standards behind this page
What a drug interaction does, and how strongly it is supported, is documented in public labeling and federal safety references rather than in any one summary, and the sources below are the primary ones. They are linked so a reader can check a claim without taking this page's word for it.
- DailyMed carries the current FDA labeling for every marketed drug product, including the warnings and drug interaction sections.
- Drugs@FDA is the federal database of approved drug products and their approval documents.
- FDA: Drug interactions, what you should know explains how drug-drug, drug-food and drug-condition interactions are described on labels.
- FDA Drug Safety Communications publishes the agency's safety alerts and label changes as they are issued.
- FDA MedWatch is the program for reporting and reviewing adverse events, including suspected interactions.
- openFDA provides public access to FDA labeling and adverse event data.
- MedlinePlus drug information is the National Library of Medicine's consumer reference for what a medicine is and how it is taken.
- NIAAA: Harmful interactions documents which medicines interact with alcohol and how.
- NCCIH: Herb-drug interactions summarises the evidence on interactions between herbal products and medicines.
- National Library of Medicine maintains the drug and health databases the sources above draw on.
This page describes how this interaction works and where it is documented. It is not medical advice: a prescriber or pharmacist decides what applies to a particular patient and medication.
Frequently Asked Questions
Lexapro and Wellbutrin have a mild interaction. In most cases, they can be taken together with appropriate precautions, but you should discuss the combination with your doctor or pharmacist to ensure safety based on your individual health profile.
Lexapro (escitalopram) and Wellbutrin (bupropion) are sometimes prescribed together intentionally to treat depression that does not respond adequately to either drug alone. This combination is generally well-tolerated, though bupropion can increase escitalopram blood levels and there is a slightly elevated seizure risk.
Yes. Anytime you are taking multiple medications, supplements, or substances, you should inform your doctor and pharmacist. They can evaluate your specific risk factors (age, kidney function, other medications, medical conditions) and determine whether the Lexapro and Wellbutrin combination is safe for you, or whether adjustments are needed.
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