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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by pav on November 7, 2001, at 22:53:23
I just started Wellbutrin a week and a half ago (for ADHD). I have some questions:
1. I had bulimia for a few years in college (about 5 years ago). Should I NOT be taking this medication? My doctor, I guess, forgot to ask me about this.
2. The last three days I've felt teary and very depressed/down. Is this typical in the beginning? Will this get better after I up the dose?and
3. Is there a possiblity that this medication could change my brain chemistry forever, even after I stop it?
Thanks
Posted by Bill L on November 8, 2001, at 9:10:15
In reply to Wellbutrin questions/bulimia, posted by pav on November 7, 2001, at 22:53:23
I'm personally not aware of any problem taking Wellbutrin for someone who used to have bulimia but who doesn't still have it.
You don't have to worry about a permanent adverse change in brain chemistry. That's not a problem with the antidepressants.
I'm concerned that you feel depressed. You mentioned that you are on Wellbutrin for ADHD. Were you also depressed before starting on Wellbutrin? If not, then call your doctor right away. I do not think that depression is a normal side effect of Wellbutrin. Have you tried Ritalin or Adderal? Those are the typical drugs for ADHD, especially for a person who is not depressed.
> I just started Wellbutrin a week and a half ago (for ADHD). I have some questions:
>
> 1. I had bulimia for a few years in college (about 5 years ago). Should I NOT be taking this medication? My doctor, I guess, forgot to ask me about this.
> 2. The last three days I've felt teary and very depressed/down. Is this typical in the beginning? Will this get better after I up the dose?
>
> and
> 3. Is there a possiblity that this medication could change my brain chemistry forever, even after I stop it?
> Thanks
Posted by paxvox on November 8, 2001, at 9:27:00
In reply to Wellbutrin questions/bulimia, posted by pav on November 7, 2001, at 22:53:23
Typically, WB is not given to people with a history of eating disorders due to its anorexic properties. This, I believe, follows the same logic of avoiding certain doses of WB because of seizure risk. If you ARE CURRENTLY having an eating disorder, WB would be contraindicated for you. Personally, I don't think your past history should exclude you from the positive effects a med may have for you. As far as ADD and related attention disorders, WB works similarly to the amphetamines, with fewer of the negative effects of them.
The sadness and depressive feelings you are having are *probably* NOT an effect of the WB, but a related depressive condition. WB, if anything, greatly improves one's mood and energy level.
WB takes a good 3-4 weeks to reach its peak serum plasma levels. So don't be discouraged, give it some time. I have been using it for almost 3 years. There ARE some issues I have with WB, but none that you mentioned. As with any med, each person will respond differently to some degree or another.
Hope this helps, if not, there are some excellent links available for info on WB.
PAX
Posted by houstongirl on November 8, 2001, at 10:00:09
In reply to Re: Wellbutrin questions/bulimia » pav, posted by paxvox on November 8, 2001, at 9:27:00
It is not given to people with a history of bulimia because of the (very!) high rate of seizures it has caused in studies of people with bulimia. I don't know the exact reference (I could probably dig it up eventually) but I think one study showed 4 out of 37 bulimics taking it had seizures. I was bulimic in college and within 38 hours of taking it at age 31 had a grand mal seizure! I would be VERY wary of taking it if you have a history of bulimia!! PLEASE talk to your p-doc about it.
Cristy
> Typically, WB is not given to people with a history of eating disorders due to its anorexic properties. This, I believe, follows the same logic of avoiding certain doses of WB because of seizure risk. If you ARE CURRENTLY having an eating disorder, WB would be contraindicated for you. Personally, I don't think your past history should exclude you from the positive effects a med may have for you. As far as ADD and related attention disorders, WB works similarly to the amphetamines, with fewer of the negative effects of them.
>
> The sadness and depressive feelings you are having are *probably* NOT an effect of the WB, but a related depressive condition. WB, if anything, greatly improves one's mood and energy level.
>
> WB takes a good 3-4 weeks to reach its peak serum plasma levels. So don't be discouraged, give it some time. I have been using it for almost 3 years. There ARE some issues I have with WB, but none that you mentioned. As with any med, each person will respond differently to some degree or another.
>
> Hope this helps, if not, there are some excellent links available for info on WB.
>
> PAX
Posted by pav on November 8, 2001, at 11:59:08
In reply to Re: Wellbutrin questions/bulimia, posted by Bill L on November 8, 2001, at 9:10:15
> I'm concerned that you feel depressed. You mentioned that you are on Wellbutrin for ADHD. Were you also depressed before starting on Wellbutrin? If not, then call your doctor right away. I do not think that depression is a normal side effect of Wellbutrin. Have you tried Ritalin or Adderal? Those are the typical drugs for ADHD, especially for a person who is not depressed.
>No - I wasn't depressed before trying Wellbutrin. In fact, I felt great, except for problems ccaused by ADHD. I'm taking it now because I tried dextroamphetamine, and it actually made my ADHD symptoms worse - I walked in circles like before, only faster. I did tell my doctor about this affect of WEllbutrin -- he said I was having a strange reaction, but it was up to me to continue or not. That's why I'm asking you fine folks. He said to go ahead and up the dosage "If I wanted to." That didn't seem so helpful.
>
Posted by pav on November 8, 2001, at 12:16:01
In reply to Re: Wellbutrin questions/bulimia » pav, posted by paxvox on November 8, 2001, at 9:27:00
Hi Pax - the strange thing is that I wasn't depressed before I got on the Wellbutrin. I ahd more ups than downs, and I was rarely, if ever, depressed for longer than one day without getting some relief from an "up" mood. I must be having a rare reaction to it, or something. I've always reacted to medications in a strange way.
> The sadness and depressive feelings you are having are *probably* NOT an effect of the WB, but a related depressive condition. WB, if anything, greatly improves one's mood and energy level.
>
Could you please tell me what your issues are with this medication? Thanks!>
> PAX
Posted by paxvox on November 8, 2001, at 18:01:07
In reply to Re: Wellbutrin questions/bulimia, posted by pav on November 8, 2001, at 12:16:01
The negative side effects I *personally* attribute to Wellbutrin with me are: extreme weight loss. Tachycardia (pulse over 90 beats per minute) possibly slight anemia (though I am JUST a tad above the bottom for "normal"),chest tightness, ringing in my ears, urinary retention.
As far as I am concerned, all but the tachycardia are acceptable to achieve the AD effects, but I am concerned about the specifics of my blood chemistry, although my Internist said it was basically "normal". The rapid heart beat has not ALWAYS been a problwm with WB, but there is a direct realtion between dose and effect. My Pdoc had me try 200mgSR x 2, but I could not tolerate the chest tightness, and went back to 150 mg SR x 2. I am considering reducing that to 100 mg SR x 2 to see if I can reduce the negative effects I have mentioned, and still keep the AD qualities.
As for the bulimia issue, I think houstongirl's response is atypical. If you were taking amphetamines, they were much more likely to have caused you seizure and eating disorder problems.
WB can certainly "charge you up" like the amphetamines, because it works similarly to them. You can adjust to these effects once you get accustomed what to expect.
You didn't mention what dose YOU are taking. I really would advise against going over 300 mg per day, though I know people on up to 450 mg per day.
Let me know what else you want me to elaborate.
PAX
Posted by gdog on November 9, 2001, at 12:29:36
In reply to Re: Wellbutrin questions/bulimia » pav, posted by paxvox on November 8, 2001, at 18:01:07
hmmmm. this thread is very interesting, as it relates to what i've been thinking a lot about but havent talked with anyone about. i am currently expressing symptoms of my eating disorders (including bullimia) and was when my pdoc's assistant put me on wellbutrin. my pdoc knows about this, and last time i saw him, he asked how the "eating thing" was going - he never expressed concern about the bullimia (although i knew from my own research it was counterindicated). i have worried about seizures on wb, but more because i'm on a fairly high dose (450mg). i have not had any seizure symptoms (are there any others besides. . .well. .. seizing?). if i were to be susceptible to seizures at this dose, with this disorder, would it have already happened? i've been on wb since early june, and in august raised my dose from 300 to 450 mg.
i know that wellbutrin has amplified/triggered some of my disorder behaviors. however, given the nature of the disorder, i am loath to do anything about it. i have lost weight on wb, and it seems to be a combination of the drug's effects, and the increased disorder behaviors, triggered, in part, by the wb. it is beginning to cause secondary health problems.
i have not told my pdoc this yet. as an aside, both my previous therapist and my gp know about the disorders and the wb. . .
gdog.
Posted by paxvox on November 9, 2001, at 13:24:15
In reply to Re: Wellbutrin questions/bulimia, posted by gdog on November 9, 2001, at 12:29:36
gdog, why such a high dose of WB? What is your DX?
I could not tolerate 450 mg per day.That is the "magic threshold" where seizure really CAN become a risk. I think the main reason WB is contraindicated in bulimia has to do with "small bodies" caused by A/N and bulimia. I guess, perhaps, this increases the amount of med in your bloodstream.As to your seizure risk, I would think you would have had one by now if you WERE going to have one. I would base this upon the logic that after a few weeks, the WB would have reached a steady blood serum level in your body. HOWEVER...if you have been taking certain meds, like benzos, or have been a heavy drinker, abrupt discontinuance of them COULD cause a seizure where it "normally" would not. I still think 450 mg is a high dose of WB.
PAX
Posted by gdog on November 9, 2001, at 14:02:52
In reply to Re: Wellbutrin questions/bulimia » gdog, posted by paxvox on November 9, 2001, at 13:24:15
pax,
my dx is bpII, and although i don't really believe it, i don't fight it because it helps with insurance coverage. the dose started out as a self-adjustment from 300 to 450 because i started going into severe decline and couldnt get anyone in pdoc's office to keep an appointment or return my phone calls. so i made the adjustment (which helped within 2 days, like it did when i started wb last spring) and went to see my gp. she said that dosage was alright until i could get another pdoc or a response from mine. (i left him a message telling him i had adjusted my dosage. . .still no response. . .) so, 3 months later and still not able to get in. (i've ranted about this on pbs. . .)anyway, 450 seems fine, and i've had no adverse impacts other than decreased appetite. i do take a small amount of ativan with it. are you saying that abrupt discontinuance of the benzo could cause seizure? and how dangerous is a seizure on it's own (aside from added dangers of driving, etc.)?
> gdog, why such a high dose of WB? What is your DX?
> I could not tolerate 450 mg per day.That is the "magic threshold" where seizure really CAN become a risk. I think the main reason WB is contraindicated in bulimia has to do with "small bodies" caused by A/N and bulimia. I guess, perhaps, this increases the amount of med in your bloodstream.
>
> As to your seizure risk, I would think you would have had one by now if you WERE going to have one. I would base this upon the logic that after a few weeks, the WB would have reached a steady blood serum level in your body. HOWEVER...if you have been taking certain meds, like benzos, or have been a heavy drinker, abrupt discontinuance of them COULD cause a seizure where it "normally" would not. I still think 450 mg is a high dose of WB.
>
>
> PAX
Posted by paxvox on November 9, 2001, at 20:24:21
In reply to Re: Wellbutrin questions/bulimia » paxvox, posted by gdog on November 9, 2001, at 14:02:52
OH YESSSSS!!!!!!
UNDER NO CIRCUMSTANCES SHOULD YOU DISCONTINUE A BENZODIAZEPINE WHILE ON WELLBUTRIN!!!!
That *can* cause a seizure, and is MUCH more likely a scenario.
So, you take WB during your downswing, and maybe Depakote for the manic phases? I really do not know too much about BP diseases, but DO know that the Pdocs like to "stabilize" your mood after they have put you on a med like WB, then are surprised when you can't sleep, and are anxious.My Pdoc changes my DX about every six months, I think he wants to lean toward a BP, since he tried to get me to take Depakote (I couldn't stand it!). But I never have had a manic phase, I have always been depressed, along with a general anxiety disorder. Go figure! I think there is too much emphasis on a DX for insurance purposes, and less as medical treatment.
Anyway, it's good to take a benzo along with WB to smooth it out, but PLEASE don't abruptly stop taking any if you have been on it for any length of time. If you do have to come off, you will have to tapper it down VERY slowly.
PAX
Posted by ivoovi on November 9, 2001, at 23:33:56
In reply to Re: Wellbutrin questions/bulimia » gdog, posted by paxvox on November 9, 2001, at 20:24:21
Can I stop taking mood stabilizers if i'm on WB? I've been on Neurontin 900mg for 2 months, and I just started WB....and I want to stop the neurontin.....is it safe to stop?
Posted by Mitch on November 10, 2001, at 10:10:51
In reply to Re: Wellbutrin questions/bulimia, posted by ivoovi on November 9, 2001, at 23:33:56
> Can I stop taking mood stabilizers if i'm on WB? I've been on Neurontin 900mg for 2 months, and I just started WB....and I want to stop the neurontin.....is it safe to stop?
Neurontin is an anti-epileptic drug (AED). You could run the risk of seizure by suddenly stopping the Neurontin. You would want to taper it down slowly. BTW, Neurontin has a very short half-life, be careful about missing or skipping doses.
Mitch
This is the end of the thread.
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