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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Staci on February 12, 2001, at 20:51:23
I have a six year old who has been diagnosed ADD and "mood disorder". She is taking 1/2 of a 5mg tablet once in the morning and 1/2 of Wellbutrin 75mg once a day in the morning. From what I understand, Wellbutrin has not been approved for a child under 18. Is there any research or info. about prescribing this to a young child? Also, If I decide to take her off this medication, do I have to taper off as you would for a drug like Zoloft, or can I just stop? Any information that you could give me in this regard would be greatly appreciated. Thanks!
Posted by Cam W. on February 12, 2001, at 21:43:25
In reply to Wellbutrin for a 6 year old? Not FDA approved?, posted by Staci on February 12, 2001, at 20:51:23
Staci - Wellbutrin has been shown to work in about 50% of children and adults with ADHD. The reason that it is unapproved for those under 18 yrs of age is that it is sort of unethical to do large, randomized placebo-controlled trials in children. Most of the evidence for efficacy comes from case reports and (I believe) a case-series. I was reading about it last night in this month's American Journal of Psychiatry (an article on a clinical trial of Wellbutrin use in adult ADHD).
I have the article at work, but any major university should have the journal in it's stacks. You could also buy the article online, but I refuse to pay good money when it is much cheaper to photocopy.
Do not take your child off of the Wellbutrin without the doc's approval. It would be a shame to stop a potentially effective treatment. True, Wellbutrin is used as a second-line agent (and unapproved), but more and more child psychiatrists are using it successfully. Discuss the risk/benefit ratio of the use of this drug with your child's doctor before doing anything rash.
I have personally seen a "night and day" difference in a child who had worked his way through all of the stimulants, only to be controlled by a moderate dose of Wellbutrin SR (100mg twice daily). This child is older, but still preteen.
Again, talk it over with the doctor.
I hope this is of some help - Cam
Posted by dennis on February 12, 2001, at 22:04:32
In reply to Wellbutrin for a 6 year old? Not FDA approved?, posted by Staci on February 12, 2001, at 20:51:23
Your child is 6 years old and your giving her wellbutrin?!!!! this does not sound good to me! Children need to be free from drugs like these so there brains can grow and develop correctly, if I had a child I would not give him or her wellbutrin even if my child was diagnosed with ADD or anything else. That is absolutly amazing that a doctor will have a 6 year old girl taking wellbutrin! I am shocked. Actually I dont know very much about wellbutrin aka (zyban) if I am not mistaken, so I could be wrong to be concerned, but I want to make it clear that I am not saying your a bad parent to give your child this drug, you are simply doing what the doctor tells you. All I am saying is your post makes me concerned for the wellbeing of your child. But like I said I could be way out of line with my concern and I could be totally wrong.
Posted by willow on February 12, 2001, at 23:12:11
In reply to Re: Wellbutrin for a 6 year old? Not FDA approved?, posted by dennis on February 12, 2001, at 22:04:32
*if I had a child
*I want to make it clear that I am not saying your a bad parent
*I could be way out of line with my concern and I could be totally wrong.Imagine having a child who isn't healthy. Now add a mental illness into the picture. Now add healthy children into the picture. I hate to say this but children can be cruel. If you look at adults behaviour towards others who don't fit the norm and give them childish behaviour, well you get the picture probably.
Believe me as a parent Staci is as concerned as you, but please don't add to the guilt she may be already feeling. Perhaps another thread may be appropriate for the discussion of meds and children. Cam is a pharmascist I believe and thus can probably provide a more intelligent response than us.
PS I know you mean well : )
Posted by JackD on February 12, 2001, at 23:41:33
In reply to Wellbutrin for a 6 year old? Not FDA approved?, posted by Staci on February 12, 2001, at 20:51:23
Listen, I was an ADD child as well, and I didn't even consider taking meds (neither did my parents consider giving them) till i was at least 16. ADD is one of the most misdiagnosed ailments out there, and it doesn't necessarily need treatment. I would really really suggest waiting until your child is much older, and then maybe consider giving them something. For all they know Wellbutrin could have serious impacts on the developing brain of your youngster. I know that I wouldn't even have been able to tell you if the meds were helping really until a more adult age. You're probably an overprotective parent, and rightfully so, but don't go drugging your kid up needlessly. Grades don't even matter anyway until at least high school.
Posted by Sulpicia on February 13, 2001, at 14:54:25
In reply to Re: Wellbutrin for a 6 year old? Not FDA approved?, posted by JackD on February 12, 2001, at 23:41:33
> I'm not sure that we are reading the original post correctly -- in addition to
ADD/HD this child has a mood disorder. Obviously a mood disorder needs to be stabilized so the child can function.
If Wellbutrin works on ADD/HD as well, more's the better.And Jack D, I have ADD and I cannot begin to tell you what lack of diagnosis and proper treatment
did to my self-esteem. I knew that I was as smart or even smarter than my peers,
yet the fact that I had so much difficulty learning because my ability to focus
was not under my control really did a number on me. During college I really can't
figure out how I justified all the extra time I had to spend to get the work done.
Of course in grad school it became nearly life-threatening. I am very greatful for dx and tx with
adderall. If there is a way to prevent a child from losing their sense of self-esteem and
their enjoyment in learning and interacting with the world and the people within it,
IMHO, they should be given that opportunity. ADD is much more
than just not being able to focus. Early effective treatment is crucial.
S.
Posted by JackD on February 13, 2001, at 16:07:03
In reply to Re: Wellbutrin for a 6 year old? Not FDA approved?, posted by Sulpicia on February 13, 2001, at 14:54:25
You don't have to tell me, I know what it was like. And you're talking about having to work harder in college and such, and I agree, at that point psychoactive medications are definitely a wise option. All I'm saying is at the age of 6 God knows if ANYTHING is wrong with her child. How many little kids do you know that were extremely moody, inattentive, hyperactive, impulsive, or just expressed bizarre behavior? These can be symptoms of a mental disorder or just that of early youth. I'm simply suggesting this woman wait at least until the child is a little further developed to make a proper diagnosis and apply medical treatment. That's all.
> > I'm not sure that we are reading the original post correctly -- in addition to
> ADD/HD this child has a mood disorder. Obviously a mood disorder needs to be stabilized so the child can function.
> If Wellbutrin works on ADD/HD as well, more's the better.
>
> And Jack D, I have ADD and I cannot begin to tell you what lack of diagnosis and proper treatment
> did to my self-esteem. I knew that I was as smart or even smarter than my peers,
> yet the fact that I had so much difficulty learning because my ability to focus
> was not under my control really did a number on me. During college I really can't
> figure out how I justified all the extra time I had to spend to get the work done.
> Of course in grad school it became nearly life-threatening. I am very greatful for dx and tx with
> adderall. If there is a way to prevent a child from losing their sense of self-esteem and
> their enjoyment in learning and interacting with the world and the people within it,
> IMHO, they should be given that opportunity. ADD is much more
> than just not being able to focus. Early effective treatment is crucial.
> S.
Posted by Cam W. on February 13, 2001, at 16:48:26
In reply to Re: Wellbutrin for a 6 year old? Not FDA approved?, posted by JackD on February 13, 2001, at 16:07:03
Jack - Since we are not clinicians and do not know the full medical history of the child, using Wellbutrin may be one of the safer alternatives. Psychiatrists do not give medications to children who do not need them. Medications do sometimes need to be used so that a child's brain is able to develop in a more "normal" way.
The mother, in this case Staci, should not be made to feel as if she is harming her child. I am sure that the psychiatrist has weighed the options available and has decided to use a medication in which the potential benefits vastly outweigh the potential risks of treatment.
Staci needs support, not "what ifs". The current literature shows that Wellbutrin is a safer drug in the treatment of ADD & ADHD than many others. Unfortunately, sometimes hopes and comfort are not enough. Sometimes psychopharmaceuticals are needed and in this case a trained psychiatrist, in his/her professional opinion, has decided (and I am sure, not lightly) that medication is needed.
To Staci - Talk to your child's doc about this again and tell him your apprehensions. I'm sure he/she will be able to help alleviate your fears.
Sincerely - Cam
Posted by dennis on February 13, 2001, at 17:02:57
In reply to Re: Wellbutrin for a 6 year old? Not FDA approved? » JackD, posted by Cam W. on February 13, 2001, at 16:48:26
Doesnt wellbutrin cause seizures?
Posted by Cam W. on February 13, 2001, at 19:58:20
In reply to Re: I totally agree with Jack on this issue(np), posted by dennis on February 13, 2001, at 17:02:57
> Doesnt wellbutrin cause seizures?
Yes, at a very low rate in those not predisposed to seizures. The spontaneous seizures seen with Wellbutrin are not age-related. - Cam
Posted by Staci on February 13, 2001, at 20:54:28
In reply to Re: WB and seizures » dennis, posted by Cam W. on February 13, 2001, at 19:58:20
> > Doesnt wellbutrin cause seizures?
>
> Yes, at a very low rate in those not predisposed to seizures. The spontaneous seizures seen with Wellbutrin are not age-related. - CamI find this all so frustrating. My main goal as a parent is to raise a child who can feel successful, loved and confident in herself. I cannot change the fact that she has this disorder, nor can she. So what are our options? Do we "wait it out" until she's older to prescribe medication because of fears expressed by several of the responders (brain development, etc) or do we treat now? these are things I don't know about. What I do know is that since my daughter has been taking her medication, she is happier, she is better able to handle frustration which makes her feel more confident, she is beginning to make friends and is actual popular among her peers (before she was verbally and physically aggressive to the extreme , you would call her a "bully", the kind of child who was constanly causing fights) I see that she likes school, and feels pride in what she has accomplished. I see many positives since she began medication, where as before she took these drugs, she was constantly tearful, angry, frustrated and struggling to develop relationships with her peers. As a parent I have the same fears that most poeple have; is this medication going to do long term harm to her physical and mental health, is this the right thing to do? I don't know. This is why I am asking for any information that I can find about Wellbutrin usage for a child of six, testimonials are great, I like to hear about other peoples experiences. Since this is not an "exact" science so to speak, I have been going on my intuition as her mother and praying that I am doing the right thing. I get so many comments like the ones posted by Dennis and Jack that it proves to me there is not enough information available to the general public about these types of disorders. We have three children in the family that all have some aspect of Autism. One has Apergers Syndrom, the other two are Autistic as well, but in varying degrees. The same applies to this disorder as well, not enough information and a lot of guesswork on the parents part to decide what is the best course of action for the child. On the surface it can be said that parents are over-reacting, teachers are looking for an easy way out with difficult kids and the easiest thing to do is to medicate (or "drug the kids up" as most people put it). I can assure anyone that the decision to medicate is NOT taking the "easy way out". This decision is an agonizing one and one not made to "make things easier" for the parent. My doctor has prescribed Wellbutrin to help with my daughters mood disorder (bi-polar). Without this medication I am fearful that her developing self-esteem would be horribly compromised. I do know that these early formative years are vital in developing ones "sence of self". I want her to be happy with who she is, not confused and hurt. I wish this was an disorder that was better understood and that there was a standard course of treatment, but there isn't. If anyone knows of any research that has been done on this medication, or any info. at all that sounds like it may be helpful to me, I would appreciate it and so would my daughter. Thank you Cam for your understanding, and as far as the posts from Dennis and Jack, I know you have good intention, the more people to look-out for my daughters well being the better and I thank you for taking the time to share your comments.
Posted by Cam W. on February 13, 2001, at 21:42:30
In reply to Re: WB and seizures, posted by Staci on February 13, 2001, at 20:54:28
Staci - I will find you some of the case studies of Wellbutrin being used in children. It may take me a couple of days to accumlate the references, but I know that I have at least one or two of the articles and I know that I can find a few more references in the current literature.
Your daughter has a wonderful mom. I am impressed with the lengths that you are going to ensure the safety of a medication for your daughter. Therefore, I am willing to do the extra work it takes to track down these articles (or at least their references).
Give me a few days to a week to find the references and I may be able to find some abstracts that can be read on the internet. As for the articles themselves, you may have to either buy them from the Journal from which I find them or, if you are near a major University with a medical library, you should be able to look up and photocopy the actual articles.
From what I have read, Wellbutrin appears to be safe and effective in young children.
Sincerely - Cam (the father of a wonderful five and a half year old)
Posted by Sulpicia on February 13, 2001, at 22:25:13
In reply to Re: WB and seizures, posted by Staci on February 13, 2001, at 20:54:28
Staci -- I too think that your kids are very lucky -- especially that you're right on top of how
important self-esteem is for kids.
This board has been wonderful for me. My daughter [15 y/o] has bipolar II and is on lamictal and wellbutrin.
If the lack of data on Wellbutrin gave you pause, lemme tell ya... You haven't sweated until
you've read the lamictal product info. But the bottom line was that my daughter had
crapped out on every other mood stabilizer. There are no guidelines for lamictal for kids either
and there are [very rare] side effects. But the drug worked and it gave her a chance to live.
Her other options were death or institutionalization. She DID get the bad side effect, but with
much research and soul-searching, we restarted her on it again. I too wish I could wait things out
or believe this was some teenage behavior problem. In fact her life was at risk from bipolar II.
I will also ask our pdoc for some references on Wellbutrin use in children. We see him on Saturday.
He is generally a walking bibliography!Good luck to you and your family.
S.
Posted by Cam W. on February 14, 2001, at 0:07:14
In reply to Wellbutrin for a 6 year old? Not FDA approved?, posted by Staci on February 12, 2001, at 20:51:23
Staci - There is far more information on the use of bupropion in children than I ever thought online. Surprizingly, almost all I found was from reputable sources. I will post a few of the better links below and will then show you how to look up more online.
1) Virtual Hospital had an article (updated Nov./2000) entitled:
"Attention-Deficit Hyperactivity Disorder Pharmacology" at:http://www.vh.org/Providers/Conferences/CPS/39.html
-scroll 3/4 the way down the page to "bupropion". Also has lists of studies in children with ADHD.
2) The website About.com had a good article:
"Pharmacotherapy of Attention-Deficit Hyperactivity Disorder: Nonstimulant Treatments" at:http://add.about.com/health/add/library/weekly/aa1119k.htm
3) WebMD also had a good article:
"ADD and it's Treatment with Peter Jensen" at:http://my.webmd.com/content/article/1700.50592
4) A Psychiatric Times News Brief from June, 1995:
"Bupropion Reported to be Effective Treatment for ADHD" (which shows that it has been used for a good 6 years and there have been no serious problems reported with Wellbutrin to date) at:http://www.mhsource.com/pt/p950638.html
5) Online Dictionary of Mental Health is a general site with many links at:
http://human-nature.com/odmh/adhd.html
==============================================================
There were many more sites that came up, but I'll let you decide what you want to read - go to:
and type in "Attention Deficit Disorder"(in parentheses) and click on 'Google Search'. Then scroll to the bottom of the page and click on 'Search Within Results'. This brings ups a page with a box. Type in 'bupropion' (no parentheses) and click on 'Google Search'. The go to the bottom of the page again and click on 'Search Within Results' again and type in 'children' (no parentheses). Then start clicking on links to your heart's content. I only went through the first 4 pages.
If you need any help with my directions, just post.
Hope this is of some help - Cam
Posted by Bill L on February 14, 2001, at 7:44:03
In reply to Re: Wellbutrin for a 6 year old? - Info » Staci, posted by Cam W. on February 14, 2001, at 0:07:14
Staci - I think that you are doing the right thing to investigate studies such as the ones that Cam is sending. I have done a lot of reading over the years of Wellbutrin, Ritalin, and other psychotropic medications. Wellbutrin seems to be extremely safe. It generally has less side effects than Zoloft or Prozac and even these 2 drugs are safe as far as medications go.
Of course you don't want to use these drugs unless it's necessary, but it seems from your post that it is helping your daughter a lot. I think that you will find that the incidence of seizures is extremely low, and is really only a risk at high doses of Wellbutrin.
All in all, Wellbutrin is very safe. Based on what I have read in your posts, I think that there is absolutely no doubt at all that you should keep her on her medications!
Posted by Staci on February 14, 2001, at 8:45:53
In reply to Re: WB and seizures » Staci, posted by Cam W. on February 13, 2001, at 21:42:30
> Staci - I will find you some of the case studies of Wellbutrin being used in children. It may take me a couple of days to accumlate the references, but I know that I have at least one or two of the articles and I know that I can find a few more references in the current literature.
>
> Your daughter has a wonderful mom. I am impressed with the lengths that you are going to ensure the safety of a medication for your daughter. Therefore, I am willing to do the extra work it takes to track down these articles (or at least their references).
>
> Give me a few days to a week to find the references and I may be able to find some abstracts that can be read on the internet. As for the articles themselves, you may have to either buy them from the Journal from which I find them or, if you are near a major University with a medical library, you should be able to look up and photocopy the actual articles.
>
> From what I have read, Wellbutrin appears to be safe and effective in young children.
>
> Sincerely - Cam (the father of a wonderful five
and a half year old)Cam,
Thank you so much for your help, I'm really touched that you are doing this for us. Thank you agian, we really do appreciate your efforts.
Staci
Posted by Staci on February 14, 2001, at 8:58:44
In reply to Re: WB and seizures » Staci, posted by Sulpicia on February 13, 2001, at 22:25:13
> Staci -- I too think that your kids are very lucky -- especially that you're right on top of how
> important self-esteem is for kids.
> This board has been wonderful for me. My daughter [15 y/o] has bipolar II and is on lamictal and wellbutrin.
> If the lack of data on Wellbutrin gave you pause, lemme tell ya... You haven't sweated until
> you've read the lamictal product info. But the bottom line was that my daughter had
> crapped out on every other mood stabilizer. There are no guidelines for lamictal for kids either
> and there are [very rare] side effects. But the drug worked and it gave her a chance to live.
> Her other options were death or institutionalization. She DID get the bad side effect, but with
> much research and soul-searching, we restarted her on it again. I too wish I could wait things out
> or believe this was some teenage behavior problem. In fact her life was at risk from bipolar II.S.
> I will also ask our pdoc for some references on Wellbutrin use in children. We see him on Saturday.
He is generally a walking bibliography!
>
> Good luck to you and your family.
> S.
Thank you for your encouraging response, it's a morale booster to know that there are others out there who care. Good luck with your daughter, sounds like she's in the best of care. The strength that parents find in themselves in order to help their children really amazes me!
Staci
This is the end of the thread.
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