Doctors' Answers to "Frequently Asked Questions" - Wellbutrin

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Eating Disorders and Wellbutrin [posted 1/12/99]
Question: Can you explain the problem with eating disorders and Wellbutrin? I understand it lowers the seizure threshold - why is this? If beginning on l50 mg per day, will this be a problem for a person with an eating disorder?

Answer: Seizures are one of the potential problems with this drug, as to why it is not understood. 150 mg a day would be the usual starting dosage for most patients.

Wellbutrin and Alcohol [posted 1/11/99]
Question: My husband is currently taking Wellbutrin. He has been diagnosed by his counselor as having aggressive depression. He started off taking prozac (took for 1 month) which was working great. However, his sex drive was low and that was a problem for him. His doctor prescribed Wellbutrin for him and he's been on it now for about 2 to 3 weeks. His doctor informed him that he could have an occasional beer on the weekends, but that was it. He was fine at first and now seems to be drinking at least 3 to 4 beers a night. I know alcohol adds to depression. The medication does not appear to be working as he is reverting back to his old habits and bad attitude toward everything. I'm wondering if it's the alcohol or the drug not working. I'm not sure whether to contact his doctor or directly speak with him about this problem. My question is what affect the alcohol has on Wellbutrin?

Answer: The alcohol has some effect on Wellbutrin, but not major. However, the alcohol is a major problem and should be addressed through both the family and his doctor.

Wellbutrin, Zoloft, and Alcohol consumption [posted 1/8/99]
Question: What are the effects on a person taking Wellbutrin and Zoloft 100 mg and continuing to drink approximately 6 to 10 bottles of beer a day?

Answer: Wouldn't be smart, probably only sedation.

Are Hair Loss & Loss of Libido Considered Wellbutrin Side Effects [posted 12/04/98]
Question: I have been taking Wellbutrin for attention deficit disorder and depression. I have been happy with the results but concerned that it might be causing two side effects: I have experienced (1) decreased libido (though not sexual function) and (2) hair loss. Could these symptoms be caused by the drug? If so is there any way to mitigate or stop these side effects? Thank you for your help.

Wellbutrin & Weight Gain [posted 11/3/98]
Question: I just stopped zoloft after 4 yrs because of increased appetite and a lg. wt. gain.I just started 300 mg. wellbutrin and was told no weight gain is associated. What is your knowledge of this? I need to lose about 70 lbs. Thank you

Answer: Well, some do gain weight, although usually less than zoloft. You'll have to try it and see.

Wellbutrin vs. Smoking [posted 11/3/98]
Question: I have been on Wellbutrin SR 150MG for one week now to help me stop smoking. I've been having a lot of sleepless nights, been feeling sort of spaced out, tired, short of breath, and just not myself. Although today was the first day I haven't bought a pack of cigarettes in years. By the way I am a 27 year old male who has been smoking for 12 years. Should I wait this drug out and deal with the way I'm feeling, or get off it now?

Answer: Well, the cigarettes will kill you. You can usually stop the wellbutrin in a couple of weeks, or at least cut it to 75 mg. The wellbutrin won't be a permanent deal, cigarettes usually are.

Wellbutrin & Pregnancy [posted 10/30/98]
Question:I've taken 300mg of Wellbutrin (150 2x/day) for the past five years. I am concerned about pregnancy while on wellbutrin. To my knowledge, there is very little known about the effects of Wellbutrin on the fetus. I have been told that when I decide to try to conceive, I should go off of Wellbutrin and not resume it until after the first trimester if absolutely necessary. Personally, I don't think that I am going to be able to go off of it, please advise.

Answer: Wellbutrin is a Class B drug. There have been some problems in rat studies, but nothing alarming. This seems a low risk pregnancy drug;but, it hasn't been available all that long to know in humans. I'd discuss this with a high risk pregnancy expert to balance the need for the two.

Mixing Wellbutrin & Alcohol [posted 10/28/98]
Question:What effects does Wellbutrin have on a Blood Alcohol Level reading. After for 4-5 glasses of wine in a 6 hour period, I had blood drawn with a result of .299. Is this possible?

Answer: Yes. Depends on your weight, any food taken with/prior to the alcohol. This is too much alcohol to take with an antidepressant.

Unanticipated Effects While on Wellbutrin [posted 10/22/98]
Question: Recently I tried to quit smoking using wellbutrin 150 sr tablets. It made things worse, not better, and I had a very difficult week until I quit the regime. I called my M.D. ,who hasn't got back to me yet, but when I told his appointment secretary why I wanted to talk to him she volunteered that her husband had the same experience and that he went into "something like a road rage" which pretty well describes my experience. In this state I alienated many people and may lose my job because of it. Is this a common experience? Is there any way I can document it's occurrence? Thank you

Answer: Well, the antidepressants do change the chemical balance in your nervous system. For most, this is well tolerated and helps. But, some experience the opposite effect. Already documented in medical texts.

Wellbutrin for Fragile X [posted 10/14/98]
Question: My son 22 years old is fragile X and is taking 450 mg. of wellbutrin daily. What if any are the risks of increasing the dosage. He seems to do well on this drug and doesn't have side effects.

Answer: Don't seem to be a lot except sedation, constipation and occasional urinary hesitation. Withdrawal could be a problem at this dosage;but, I suspect he'll be on it for a long duration if it is working.

Wellbutrin and Weight Gain [posted 8/14/98]
Question: I am on 300 mg of Wellbutrin per day and have gained a lot of weight. How common is this and how much can a 200 lb. man expect to gain just due to the medication?

Answer: Well, it varies. Most of my patients 60% or so gain weight. This varies a lot by patient and is not predictable (some will lose weight).

Wellbutrin and Alcohol [posted 8/12/98]
Question: I am taking 75 mg of wellbutrin 2 times a day. I like to have 2 or 3 12 oz cans of beer a day. is there any interactions with this amount of beer and wellbutrin that you know of? I am not prone to seizures of any kind.

Answer: I'd limit it to one or two. There should be little interaction, however, alcohol is by nature a depressant substance.

Wellbutrin’s Effect on Athletic Performance [posted 8/12/98]
Question: I am a competitive athlete (cyclist) and consequently, I physically train and ride at very high cardiovascular stress levels for long periods of time. I've noticed a significantly elevated (resting) heart rate among several less important side effects. It seems as if my cycling performance has suffered - I fatigue more rapidly and am less able to successfully achieve peaks/bursts of strength required for climbing, etc. I am taking Wellbutrin SR (100 mg in the morning and 100 mg at noon). Is the additional cardio stress the drug seems to create responsible for deterioration of my performance? Am I doing (cardio) damage to myself and what are the long-term effects? The medicine does offer significant relief to my problems despite the attendant nervousness. I'd like to continue its use, but I am very concerned with the above.

Answer: There doesn't seem to be any known cardio-toxic effects of this drug. This does not mean that your performance is not impaired. The effects of a serotonin releasing inhibitor are probably not confined to the nerves in the brain. High levels of performance may show other effects. However, there is no known cardio-toxicity to this drug currently.

Wellbutrin [posted 7/30/98]
Question: I have been taking Wellbutrin now for a little over one week. The doctor told me I wouldn't notice a change for a while, but I think I do. I have been trying to get all the information I can about this drug. A couple of things I've been noticing is an eye twitch. Sounds funny, but ever since I've been on this my left eye twitches. I've been reading that it might cause seizures. That in itself worries me the most. Also, I have the worst taste in my mouth constantly. Will that go away? The doctor put me on this for depression and also he said to help me with cocaine cravings. Does it help with that particular craving cause I've been reading how it helps with nicotine. It seems to be helping and so far with exception of what I mentioned above, I think Wellbutrin is a wonder drug. I feel wonderful. No craving for anything and I've been a smoker for years. If I think I feel it this early, what should I expect later on? As for weight loss, bring it on. One more thing I'm curious about. I've been having these bad I migraines. Both sides of my temples throb to the point where you can see my vessels throb. Is that serious enough to worry about and how will Wellbutrin effect my problem? I take 150 ml twice a day. Also, something is going on with my hearing and vision. My hearing sounds faded. Usually I've been feeling real sharp because of Wellbutrin, but today I'm having trouble thinking of words and I'm not really with it. I have worries about this drug because I've never been one that likes to take anything or be on anything like anti-depressants.

Answer: The headaches are fairly common and one of the reasons patients cannot tolerate the drug. As to the altered taste, I don't know, but would suspect the drug. This one I would wait and see what happens. The altered sensory response is fairly common and usually will persist, but not worsen.

Taking Wellbutrin with Estrace [posted 7/30/98]
Question: I am curious about the effects of wellbutrin. I have been on prozac for 2 years, and still have symptoms of depression. I also take 2 mg of Estrace and .075 mg of synthroid. Is this a good mix? Do you have a better suggestion?

Answer: Wellbutrin is a different class and has different side effects. If the prozac is not working, you either need a different dosage (higher) or a different class of drug. Wellbutrin and/or Effexor would be the class I would switch you to. They both are relatively well tolerated. However, some patients absolutely cannot stand the side effects of these drugs (as opposed to SRI drugs). So, don't be too surprised if you cannot tolerate the side effects. It is difficult to predict who will have trouble with these two. In general, the side effects are either very minimal or intolerable.

Wellbutrin - Effects on the Heart [posted 7/24/98]
Question: I have been on wellbutrin for the past five months. I have read and researched on this medication so that I would be aware of its side effects. I have overcome a lot of those side effects, but I am concerned about its side effects on the heart.

Answer: Appears minimal at this point.

Wellbutrin and Zoloft [posted 7/24/98]
Question: I am taking Wellbutrin (100 mg twice daily) and Zoloft (100 mg once daily), seemingly with little positive effect. Recently, a pharmacist expressed surprise that I was ingesting the two concurrently in the morning, as instructed. She is of the opinion that the two are probably "canceling each other out." Is information available on this? It is recommended that I try other medication because these do not seem to have effect, but I prefer to postpone the switch if a change in how the medication is taken may bring better results. If I experiment by spacing these dosages out over the day, how soon might I expect to see results?

Answer: Unlikely to have any different effect if "spread out" and I know of no cancellation effect. You might try different times, but I doubt you will see any difference.

Wellbutrin and Urinary Problems [posted 7/22/98]
Question: Can wellbutrin cause any kind of urinary problems. I am a 47 year old man with no known prostate problems.

Answer: Occasional patients will experience urinary hesitancy - about 1 to 2%.

Wellbutrin [posted 7/17/98]
Question: I have been taking Wellbutrin for 2 weeks now. My mild to moderate depression has not yet responded to the drug. Last night I experienced 2 muscle spasms in my tongue and one in my upper lip. Afterward my tongue felt very sore. It now feels tense and sore. Do I need to be concerned?

Answer: It’s probably not the wellbutrin.

Wellbutrin
Question: Can you give me your opinion of wellbutrin and the effects of quitting smoking? My doctor just prescribed 150 mg of Wellbutrin to help with the agitation and irritability associated with nicotine withdrawal. However, all I keep reading about Wellbutrin is the restless and agitated side effects.

Answer: I've used several drugs to help people addicted to drugs, but never Wellbutrin. Clonidine(usually a blood pressure pill), which is an alpha blocker is helpful in blocking withdrawal symptoms(sweats, cramps, etc.). Antidepressants have recently been used in alcoholic centers and some drug centers to help different types of addicts. I'm not familiar with Wellbutrin in these situations. Wellbutrin is an antidepressant in a class of its own. The mode of action is not known, but thought to be centered around Serotonin. This might be useful because of this effect.

Wellbutrin
Question: I have been on Wellbutrin for 4 weeks to treat depression. While my depression is subsiding, my moods seem quite erratic. I go from anger to happy to giggles. It is not fun for my family to be around this rollercoaster personality. My doctor says it takes about 6 weeks for this drug to take effect. Do you think these mood swings are part of my body coming into balance emotionally? Do you have any other information on Wellbutrin?

Answer: Wellbutrin (buproprion hydrochloride) is an antidepressant in a class all of its own. The method of action of wellbutrin is not clear, but appears to be related to serotonin. This drug does not belong to the SRI group, however. Side effects include occasional seizures, agitation and insomnia, psychosis or mania, and altered appetite. It can be a very effective drug, but in my experience, has less predictable side effects than other classes of drugs. I'd try a couple more weeks and see if you stabilize.

Wellbutrin
Question: I just started taking Wellbutrin (generic name Bupropion) for moderate depression. Could you tell me whether taking this drug could cause me to test positive on an employee drug screen for any of the following: Marijuana, cocaine, opiates, phencyclidine, or amphetamines?

Answer: There are different types of drug screens. Some are very specific and some are not. The type of drug screen will dictate whether there is any cross reactivity. Lists of cross reacting substances can be obtained from the company. Disclosure of the drugs you are taking (in this instance Wellbutrin) will allow them to check potential cross reactivity. However, in general this should not be a problem with Wellbutrin and the drugs you have listed.

Wellbutrin
Question: My daughter, age 19, has just been prescribed Wellbutrin by a psychiatrist. He says that it is being used to treat ADD symptoms, although it is an anti-depressant. She has never been diagnosed to have ADD, although she has many of the criteria for the syndrome. She also exhibits many of the symptoms listed as the criteria for ODD. I would like to find out more about the drug Wellbutrin and what affects it may have. I also understand that it may take several weeks before we see results. Is the doctor treating her for ADD or for depression?

Answer: Wellbutrin (bupropion hydrochloride) is an antidepressant that belongs to the class of drugs called aminoketones. Although wellbutrin is a treatment for depression, we currently do not understand its mechanism of action However, it appears to not be related to the MAO inhibitors, SRI drugs, or tri-cyclics. It should not be used in individuals with a history of seizures, bulimia, or anorexia nervosa. General side effects usually include increased restlessness, agitation, occasional mania, edema, nocturia (urinating at night), stomatitis (oral sores), flu like symptoms, and muscle pains. The usual dosage is 100 mg twice a day increased to 300 mg t.i.d.(3 times a day). I have not seen this drug used for ADD, but you'll know pretty quickly whether it is effective or not. If it does work I would personally prefer it to Ritalin.

Wellbutrin
Question: I have been mildly depressed of late. My therapist suggested that I seek a psychologist and try a mild dose of an anti-depressant. I did this and was given wellbutrin. My question concerns side effects. I have been taking the drug, 150 mg per day, for about three weeks, and with increasing frequency. I have feelings of anxiety, nervousness, panic, anger, etc. Are these possible side-effects of the drug?

Answer: Wellbutrin (bupropion hydrochloride) is an antidepressant that belongs to the class of drugs called aminoketones Although wellbutrin is a treatment for depression, we currently do not understand its mechanism of action. However, it appears to not be related to the MAO inhibitors, SRI drugs, or tri-cyclics. It should not be used in individuals with a history of seizures, bulimia, or anorexia nervosa. General side effects usually include increased restlessness, agitation, occasional mania, edema. Nocturia (urinating at night), stomatitis(oral sores), flu like symptoms, and muscle pains. The usual dosage is 100 mg twice a day increased to 300 mg t.i.d (3 times per day).

Wellbutrin
Question: I am currently taking 100 mg tid of Wellbutrin for severe postpartum depression. After the first 14 days my depression was gone. My initial antidepressant was Prozac (10 weeks) followed by Effexor (1 week). I had a severe reaction to these medications and have been told not to take any SSRI. I am worried that if I go off of Wellbutrin and need to take it again that it will no longer work and that I will have no alternatives. Are there any other antipressants like Wellbutrin or ones that are currently in Research and Development? Could you also explain how Wellbutrin differs from SSRIs as far as its action on brain chemicals?

Answer: Wellbutlin(bupropion hydrochloride) is an anti-depressant in the class of drugs called aminoketones. These are unrelated to tricyclics, SRls, or other classes. The reason for action for this class of drugs remains completly unknown although it is being researched. It should not be used in individuals with seizure disorders. Common side effects include difficulty sleeping and agitation, delusions, confusion and other neuropsychiatric side effects, weight gain, and dry mouth. There does not seem to be any tolerance that develops to Wellbutrin.

Wellbutrin
Question: After taking Wellbutrin for about a year, following Serzone and Prozac, my GGT liver enzyme is now elevated to 90. Is this a side-effect of Wellbutrin or should I be concerned?

Answer: Wellbutrin is a drug that can affect liver function. Whether this is due to the Wellbutrin or a radon elevation due to other numerous factors which can elevate liver function needs to be checked. This is usually accomplished by stopping the Wellbutrin and seeing if the liver enzymes return to normal. Restarting the Wellbutrin and rechecking the liver functions will answer the question. There are so many different causes of elevated liver functions that I would be reluctant to stop a drug - if it is working - without establishing that it is the cause of the elevated liver functions.

Wellbutrin & Smoking
Question: I have been informed by my doctor that a known side effect of wellbutrin is a decrease or cessation of smoking, somehow the patient simply no longer wants or craves cigarettes.

Answer: It has been used for this as well as alcoholism. There are patients who clearly are better; but, it does not eliminate the craving completely-just an assist. It seems to work about 60% of patients.

Wellbutrin For ADD
Question: My son was prescribed Wellbutrin for ADD 3 years ago. Last Feb. he refused to take it. In short- he went ballistic, became depressed. He has been on 100mg. 3X Wellbutrin for 5 weeks, although he shows signs of improvement he is still moody and complains that the "meds aren't working as they used to". Could he have developed a tolerance? Any suggestions welcomed.

Answer: Not likely, especially after a hiatus. He may need to increase his medications or try a different combo. One's brain does change with aging and sexual maturity I suspect that is the answer. It doesn't have anything to do with the drug; but, with the situation requiring him to take it. The military is very conservative and also a risk avoider. They will avoid situations where they have difficulty predicting behavior. A report from his physician might help. Also, try a different service and "forget" about the prozac.

Situational Anxiety
Question: I have been prescribed wellbutrin for moderately severe situational anxiety, but all the information I've seen on it suggests that this drug is used for depression. Is this an appropriate drug for this condition?

Answer: The SRI class of antidepressants(prozac, etc.) and Wellbutrin started as being used in depression. However, with widespread use it became fairly clear that they are very useful in anxiety and panic disorders. Most physicians use one of these drugs as initial treatment for chronic anxiety, situational anxiety, and panic disorders since they usually work and are not addicting physically.

General Information
Question: My daughter was just prescribed to take (75 mm) “Wellbutrin”. Could you please give me any information with respect to this medication. I am unfamiliar with this medication. All I am aware of is that it supposedly will help her combat her depression. Please forward any and all information to me as soon as possible.

Answer: Wellbutrin is the brand name of a generic medication known as Bupropion. This medication is used to treat depression, and more recently, has also been used to help patients with smoking cessation. This medication should only be used under the supervision o a physician. The typical dose of this medication starts at 1 00mg twice a day, and can be increased to 100mg three times a day. The increase should be done slowly and only on the advice of your physician. There are side effects related to this medication, as is the case with any medication. Bupropion can cause seizures in a very small number of patients, but individuals with an underlying seizure disorder should not use this medication. The risk of seizure can also be reduced with slow dosage increases, and by using the minimal amount of medication needed to provide relief of depression. Other uncommon side effects include agitation, insomnia, weight gain or loss, leg or groin swelling, rash, increases in night time urination, muscle aches, blood pressure changes, and allergic reactions to the medication. Note that side effects can be seen with every and any medication in use today. Any concerns about the use of this or any medication should be expressed to your physician, who can go into further detail about the benefits and side effects of any medication you are taking.



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