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Thread: Zoloft and Wellbutrin fear of Long Qt

  1. #1
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    Zoloft and Wellbutrin fear of Long Qt

    I’m currently taking 150mg of Wellbutrin and have just been reintroduced to 50mg of Zoloft for OCD. I had been prescribed Zoloft before but never took it—yet here I am, back at this stage. I’ve reached a point in my life where I realize I need the medication and plan to stay on it for a while. However, I’m worried about the potential impact of taking both Wellbutrin and Zoloft on my QT interval. Although my previous EKGs were normal, ‘Dr. Google’ has made me anxious about the possible risks

  2. #2
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    Re: Zoloft and Wellbutrin fear of Long Qt

    Quote Originally Posted by Deepseathree View Post
    However, I'm worried about the potential impact of taking both Wellbutrin and Zoloft on my QT interval. Although my previous EKGs were normal, 'Dr. Google' has made me anxious about the possible risks
    Bupropion (Wellbutrin) doesn't affect the QT interval and it is only an issue with sertraline (Zoloft) when it is taken with other medications known to increase the risk. CredibleMeds maintains a searchable register of meds which impact the heart's electrical system on behalf of the FDA (free registration is required to view the data) if you wish more information.

    The only significant interaction between these ADs is that buproprion slows the rate at which sertraline is metabolized which may increase its blood plasma levels. This is likely to only be a problem at near the recommended maximum dose of 200mg/day. However, it may increase the severity of any initial side-effects to some degree so it might be better to start on only 25mg for the first week, however, please discuss this with the prescribing doctor before altering the prescribed dose as there may be factors I'm not aware of.
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  3. #3
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    Re: Zoloft and Wellbutrin fear of Long Qt

    I knew that Zoloft was among the safest when it comes to heart in general, especially in regards to Qt. I just wasn’t aware of combining it with Bupropion would have an added effect. I only take these with an occasional klonopin.

  4. #4
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    Re: Zoloft and Wellbutrin fear of Long Qt

    []I knew that Zoloft was among the safest when it comes to heart in general, especially in regards to Qt. I just wasn’t aware of combining it with Bupropion would have an added effect. I only take these with an occasional klonopin. So Long Qt isn’t something that’s likely to happen just with the two medications named?

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    Re: Zoloft and Wellbutrin fear of Long Qt

    Can it cause low potassium?

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    Re: Zoloft and Wellbutrin fear of Long Qt

    Quote Originally Posted by Deepseathree View Post
    []I knew that Zoloft was among the safest when it comes to heart in general, especially in regards to Qt.
    The only SSRIs with a potentially significant effect on the electrical system of the heart are citalopram and escitalopram though to what extent has been a matter of debate over the years.

    I just wasn't aware of combining it with Bupropion would have an added effect
    It works the other way too with sertraline inhibiting bupropion elimination, however, I doubt it will trigger an increase in side-effects given you've been taking bupropion for some time.

    So Long Qt isn't something that's likely to happen just with the two medications named?
    No. Contrary to what Dr Google may claim long QT is not a significant problem even in overdose of ADs which have a known risk of causing it.

    Can it cause low potassium?
    There is a case report (Izgi C., 2013) which attributed a patient's severe hypokalemia (low potassium) to sertraline, however, studies have found no association, for example: Catalano MC, 2000, so I wouldn't lose sleep over this.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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