Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Joe Schmoe on July 4, 2001, at 19:53:52
I am now starting on Wellbutrin. This drug seems to have gotten a lot of bad press due to risk of seizures and the information that comes with it always mentions seizures, e.g. don't drink any alcohol because it can lower the seizure threshold, don't use short-acting benzos like xanax because they lower the seizure threshold, etc. etc.
But when I looked into it closer, it appears that it actually has the same seizure rate as SSRIs like Prozac and Paxil, and actually less risk than the other SSRIs! Zoloft has a higher seizure risk than Wellbutrin for example.
Here is an article:
http://www.salon.com/sex/feature/2000/09/26/wellbutrin/I don't understand why seizures are never discussed with regard to SSRIs. Are people on Paxil at risk for a seizure if they drink alcohol or take xanax? If so, nobody told me when I was given Paxil. What is going on here?
I am willing to give up all alcohol while on Wellbutrin if it is necessary to avoid seizures, but it sure seems odd that the guy sitting next to me can be putting away a few beers when he is on Paxil or Zoloft, when he is at the same risk as I am. Does anybody have the facts on seizures with these drugs? Is it really necessary to never have a glass of wine while on Wellbutrin? If so, why aren't similar warnings handed out with the SSRIs? The only warnings I hear about alcohol with SSRIs, Serzone etc. is "Alcohol is a depressant so it can defeat the purpose of the AD" not "Alcohol will give you a seizure!"
Posted by SalArmy4me on July 4, 2001, at 20:04:28
In reply to ADs and seizures, posted by Joe Schmoe on July 4, 2001, at 19:53:52
Oke, A.. Adhiyaman, V.. Aziz, K.. Ross, A.. Dose-dependent seizure activity associated with fluoxetine therapy. QJM. 94(2):113-114, Feb 2001:
"...Antidepressants may display both convulsant and anti-convulsant properties, and the most important determining factor is drug dosage.4 Mostly seizure associated with antidepressant therapy is seen after an acute overdose. Dose-dependent seizure activity has been well recognized with imipramine, amitriptyline, clomipramine and maprotiline. Less commonly, seizures can occur at therapeutic doses and there are two case reports of seizure associated with fluoxetine at a dose of 20 mg.5,6
Apart from the dose, duration of the treatment is also thought to be an important factor in assessing the risk of seizures. Life-table analysis has been used to estimate the cumulative risk of seizure activity for drugs such as clomipramine (data on file, Ciba-Geigy) and bupropion.7 Whether such a risk exists for SSRIs is not known. Other predisposing factors for the development of seizures are family history, underlying neurological problems, concurrent medications, substance abuse and rapid increments in the dose.3 With the exception of overdose, seizures associated with antidepressants are likely to occur during the first few weeks of treatment or after an increase in dose, as in our case..."
Posted by Elizabeth on July 4, 2001, at 22:12:08
In reply to ADs and seizures, posted by Joe Schmoe on July 4, 2001, at 19:53:52
> I don't understand why seizures are never discussed with regard to SSRIs. Are people on Paxil at risk for a seizure if they drink alcohol or take xanax? If so, nobody told me when I was given Paxil. What is going on here?
The labelling for Wellbutrin stresses that the dose should not exceed 450mg/day. When you go higher than that, the seizure risk starts to increase.
It's fine to take Xanax with Paxil or Wellbutrin. Alcohol is less predictable, and some people have bad reactions (never heard of anyone having a seizure, but some people, on SSRIs at least, get sick from drinking alcohol).
> Is it really necessary to never have a glass of wine while on Wellbutrin?
No, that's silly. Unless you find that even a small amount of alcohol makes you sick (or drunk) when you're taking the AD, drinking in true moderation (e.g., a glass of wine here and there) is fine.
> The only warnings I hear about alcohol with SSRIs, Serzone etc. is "Alcohol is a depressant so it can defeat the purpose of the AD" not "Alcohol will give you a seizure!"
That's so annoying when people misuse the word "depressant" that way. Alcohol (especially in moderate amounts) doesn't cause depression (although alcoholism can). It causes central nervous system (CNS) depression (meaning it inhibits neuronal firing).
-elizabeth
Posted by Else on July 4, 2001, at 22:19:04
In reply to ADs and seizures, posted by Joe Schmoe on July 4, 2001, at 19:53:52
> I am now starting on Wellbutrin. This drug seems to have gotten a lot of bad press due to risk of seizures and the information that comes with it always mentions seizures, e.g. don't drink any alcohol because it can lower the seizure threshold, don't use short-acting benzos like xanax because they lower the seizure threshold, etc. etc.
>
> But when I looked into it closer, it appears that it actually has the same seizure rate as SSRIs like Prozac and Paxil, and actually less risk than the other SSRIs! Zoloft has a higher seizure risk than Wellbutrin for example.
>
> Here is an article:
> http://www.salon.com/sex/feature/2000/09/26/wellbutrin/
>
> I don't understand why seizures are never discussed with regard to SSRIs. Are people on Paxil at risk for a seizure if they drink alcohol or take xanax? If so, nobody told me when I was given Paxil. What is going on here?
>
> I am willing to give up all alcohol while on Wellbutrin if it is necessary to avoid seizures, but it sure seems odd that the guy sitting next to me can be putting away a few beers when he is on Paxil or Zoloft, when he is at the same risk as I am. Does anybody have the facts on seizures with these drugs? Is it really necessary to never have a glass of wine while on Wellbutrin? If so, why aren't similar warnings handed out with the SSRIs? The only warnings I hear about alcohol with SSRIs, Serzone etc. is "Alcohol is a depressant so it can defeat the purpose of the AD" not "Alcohol will give you a seizure!"This is a personnal account. Wellbutrin WILL probably give you a seizure if taken in overdose. I know because I have done it twice. I don't reconmend it (projectile vomitting, visual hallucinations, convulsions, delirium, etc...). I've now been on it for two month and no longer do stupid self-destructive things. I have had drinks but have never gone on a bender, I've taken Xanax with no dire consequences. If you're not epileptic I don't *personnally* see why you should avoid alcohol. Anyway, I think the main difference is that SSRIs are not as likely to give you seizures if you take the whole bottle as Wellbutrin is. If you don't plan on doing that (and once again I don't recommend it) I think you will be o.k.. I have been and I have a low convulsive threshold.
And besides, that warning is probably aimed at alcoholics who indeed have an increased chance of seizure when they stop drinking. The Wellbutrin would probably compound that. But I don't think it's aimed at social drinkers, really.
Posted by judy1 on July 5, 2001, at 7:04:57
In reply to ADs and seizures, posted by Joe Schmoe on July 4, 2001, at 19:53:52
are people at risk if they drink alcohol or take xanax?
Xanax and all benzos are anticonvulsants- judy
Posted by sl on July 7, 2001, at 19:50:16
In reply to ADs and seizures, posted by Joe Schmoe on July 4, 2001, at 19:53:52
>do stupid self-destructive things. I have had drinks but have never gone on a bender,
I've gone on a "bender" for a night or two, at least. While on 300mg of Wellbutrin every day. While I can see now where it was probably indicative of problems not alleviated by Wellbutrin, the combination never caused additional probs. I may have gotten drunker faster, but that's about it. (and it was never so fast it was OBVIOUS it was from Wb)
But my family history has NO predisposition to seizures. I'd suggest if you've so much as HEARD the word "seizure" regarding a family member, you avoid alcohol and seriously consider a different AD. That's not something you want to play with.
One other thing....
I'd been thinking about going back on Wellbutrin (after the 2-3 months I've been off) and asking to add something else, like perhaps Klonopin. So I'm very curious how this combination is affecting you. If you'd be willing to email me once or twice once you're stable on it, I'd really appreciate it. You could post instead of you wanted, but I'd be less likely to see it...
Anyway, I wanna know how it turns out!Luck...
sl
PS Sorry to double this, it was supposed to be to Joe not Else! :(
Posted by Rick on July 8, 2001, at 2:23:07
In reply to ADs and seizures, posted by Joe Schmoe on July 4, 2001, at 19:53:52
Curiously, Medscape's profile of Wellbutrin SR(bupropion SR) says that it actually wipes out the cognitive deficits caused by alcohol (text attached). Yet the manufacturer still suggests avoiding this combo because of increased seizure risk. I wonder if some of the strong seizure warnings with Wellbutrin SR are leftover baggage from the non-sustained-release version. My understanding was that SR carried less seizure risk, presumably because the drug gets into the bloodstream more gradually.
Also with regard to Wellbutrin and alcohol, this newly released study of Wellbutrin for dysthmia suggests the med is quite effective (and quite tolerable), but a lot less so in patients with a history of alcohol or chemical abuse:
From Medscape:
While subjective assessment indicated impaired mental status (e.g., muzzy versus clearheaded, dreamy versus attentive, mentally slow versus quick-witted) with alcohol alone, such impairment was abolished generally with the combination of alcohol and bupropion. However, because of concerns that excessive use of alcohol or abrupt withdrawal from alcohol may be associated with an increased risk of seizures during bupropion therapy, the manufacturer states that patients receiving the drug should be advised to minimize or, if possible, avoid alcohol consumption.Rick
This is the end of the thread.
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