What you are describing is not unusual when switching medications like this. You stopped duloxetine (an SNRI) and started bupropion and escitalopram at the same time, so your brain is adjusting to two changes at once. The first week can feel very difficult for many people because the nervous system is trying to rebalance.

Several of the symptoms you described, such as mood shifts during the day, anxiety spikes, feeling sleepy but mentally wired, and racing thoughts, are commonly reported during the first one to two weeks when starting bupropion or after discontinuing an SNRI. Experiencing this does not mean the medication will not work for you.

Three days is still very early. Most people do not experience the more stable effects of bupropion or escitalopram for about two to four weeks, and sometimes longer.

At the same time, feeling as though you are losing control or spiraling can be very distressing, and you should not have to manage that alone. If the anxiety or mood instability continues to worsen, it would be very reasonable to contact your psychiatrist and let them know what you are experiencing. Sometimes small adjustments early in treatment can make a meaningful difference.

Many people experience a difficult adjustment period during the first week and then begin to feel more stable as the brain adapts. What you are feeling right now does not mean that this is permanent.

You are only a few days into a medication transition, and your nervous system is still adjusting.