Prescribed Wellbutrin. Suffer Anxiety. On Paxil. Taking Clonazepam. Suggestions?

Posted on Wed, 28 Aug 2013

Question: My doctor prescribed Wellbutrin, 75 mg as a remedy for my lingering generalized anxiety. I haven't had a panic attack in 5 years but my doctor long ago said would probably benefit from "maintenance" medication taken regularly. I was on Paxil back when but I thought it interfered with my sexual functionality and that doc just sighed and said to forget Paxil. Do you know if Wellbutrin or Bupropion will be the same thing all over again?

Also, I take a small Clonazepam tablet at night (I told another doctor about my nagging anxiety and he suggested that and I've been on it for a few years and it does not seem to effect sexuality....

Any comments or ideas? Just stick with Clonazepam or drop it and do bupropion? Both?

Answered by Dr. Jorge Brenes-Salazar (12 minutes later)

Dear patient,

Thanks for your concerns. The ideal management of anxiety disorders with medications states that a long term, maintenance preventive drug, such as bupropion, venlafaxine or similars, is the best strategy and the use of benzodiazepines such as clonazepam should be used only during a crisis or panic attack, because long term use leads to tolerance, potential for addiction and withdrawal; plus, in my patients over the age of 65 I try not to use benzodizepines if I can since they predispose to cognitive dysfunction and falls. I would try bupropion and stick with it if it does not generate sexual side effects, which are less common with it than with paroxetine (Paxil).

Yours truly,

Dr Brenes-Salazar MD
Mayo Clinic MN

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar