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Sertraline apathy issue, need better fix
I am a student with recurrent anxiety and depression. I took escitalopram 10mg from January 2024 to April 2025 and did very well. Eight months after stopping, anxiety returned in December 2025 due to my father falling ill. This second episode was fifty percent milder than my first. I started sertraline 50mg which is working well for anxiety and depression.
However sertraline is causing emotional blunting, apathy, anhedonia and low motivation badly hitting my studies. I have no drive or spark to study despite mood being better.
Two weeks ago aripiprazole 2mg was added. Since then I have worse brain fog, lethargy, apathy, small mood highs and lows daily and poor sleep. Day twenty five now with no improvement.
My questions are One:Stop aripiprazole given poor tolerance at lowest dose after twenty five days. Need tapering?
Two : Is bupropion 150mg better augmentation for my apathy, anhedonia and low motivation with sertraline 50mg?
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Thank you for sharing this in detail. I'm sorry sertraline + aripiprazole is hitting your motivation and sleep like this.
1. **Stopping aripiprazole**: Even at 2mg for 25 days, some people need a short taper due to rebound issues. Don't stop cold turkey — your psychiatrist should guide the safest way based on your history.
2. **Bupropion for apathy**: It's commonly used off-label with SSRIs to target low energy, apathy, and anhedonia, since it works on dopamine/norepinephrine. But it can worsen anxiety in some people, so the risk/benefit is very individual.
Flagging this with your prescribing psychiatrist ASAP is key, especially since sleep and mood swings are new since adding aripiprazole. Hope you get relief soon.
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