Wellbutrin/Remeron and Xanax

Hi there.  I am a 26 year old female and have been on 300 mg of Wellbutrin XL for several years and 15 mg of Remeron for about 10 months; it's been a fantastic combination until very recently.  I have begun having constant low-level and intermittent severe situational anxiety- not quite panic attacks, but getting progressively closer to and worse -for the last week or so.  My psychiatrist moved unexpectedly and I have been unable to find another with an open appointment in the near future-   I've scheduled one for 3 weeks from now, but the anxiety is beginning to become unbearable.  

Prior to being prescribed the Remeron in addition to the Wellbutrin about 10 months ago, my doctor had me taking Xanax as needed for the anxiety. I have a handful of Xanax left over from less than a year ago when I titrated down and added Remeron, and am wondering if it would be safe to take .25 or even .125 of the Xanax with the Wellbutrin and Remeron when the anxiety is severe until I see my new doctor in a few weeks?  I'm really becoming a miserable, anxious wreck and my work and physical health are beginning to suffer.

I was able to find interaction info for the Wellbutrin and Xanax and Remeron and Xanax independently, and both have moderate interaction profiles (increased risk of seizures with excessive use of Xanax for the WBN and CNS and respiratory depression for the Remeron), but haven't been able to find anything on the three together.  Any thoughts?  Thanks SO much!

[Roger Gould, M.D.]

In general, you want to limit the number of medications because sometimes the effects are unpredictable. Taking the small dose of xanax is probably quite safe, but you should limit yourself. You don't want a xanax addiction.  If the Remeron is not working, you might consider eliminating that and taking the xanax instead.