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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by butternut on October 27, 2006, at 19:35:05
Hi all,
I started 150 mg of Wellbutrin about two weeks ago. This was to try to counteract the sexual side affects of Lexapro, which is otherwise working well for me.On Wednesday morning I woke up with an itchy red rash all over my chest, stomach and neck. I figured it was the Wellbutrin and so didn't take my pill that morning. The rash spread a bit over the course of the day. It's now in my inner and outer thighs and back, and a little on my arms and legs. My pdoc referred me to my family doctor, who said I should come in right away and probably start prednisone. However, his secretary said there were no appointments available. So, I saw my allergist instead. He said that he doesn't see a lot of drug allergies in his practice (he deals mostly with really long-term type allergies) but that he didn't think prednisone was necessary. Just stop the Wellbutrin and the rash will go away.
I was happy not to have to take prednisone, but MY GOD IT ITCHES!! Now it's Friday night, and the rash doesn't look worse, but it doesn't look much better, and it's very very itchy.
Does anyone know if this is normal? Anyone know how long it takes a drug rash to go away? I shudder to think it wasn't the Wellbutrin but the Lexapro I've been taking for 4 1/2 months. I am still taking the Lexapro.
Posted by Phillipa on October 27, 2006, at 22:10:28
In reply to Drug Rash!!, posted by butternut on October 27, 2006, at 19:35:05
Strange. But everyone reacts differently to meds. Love Phillipa
Posted by yxibow on October 28, 2006, at 2:14:46
In reply to Drug Rash!!, posted by butternut on October 27, 2006, at 19:35:05
> Hi all,
> I started 150 mg of Wellbutrin about two weeks ago. This was to try to counteract the sexual side affects of Lexapro, which is otherwise working well for me.
>
> On Wednesday morning I woke up with an itchy red rash all over my chest, stomach and neck. I figured it was the Wellbutrin and so didn't take my pill that morning. The rash spread a bit over the course of the day. It's now in my inner and outer thighs and back, and a little on my arms and legs. My pdoc referred me to my family doctor, who said I should come in right away and probably start prednisone. However, his secretary said there were no appointments available. So, I saw my allergist instead. He said that he doesn't see a lot of drug allergies in his practice (he deals mostly with really long-term type allergies) but that he didn't think prednisone was necessary. Just stop the Wellbutrin and the rash will go away.
>
> I was happy not to have to take prednisone, but MY GOD IT ITCHES!! Now it's Friday night, and the rash doesn't look worse, but it doesn't look much better, and it's very very itchy.
>
> Does anyone know if this is normal? Anyone know how long it takes a drug rash to go away? I shudder to think it wasn't the Wellbutrin but the Lexapro I've been taking for 4 1/2 months. I am still taking the Lexapro.
I would say if you developed a rash after only two weeks on the Wellbutrin that it would be the culprit.From the PI:
"A patient should stop taking WELLBUTRIN XL and consult a doctor if experiencing allergic or anaphylactoid/anaphylactic reactions (e.g., skin rash, pruritus, hives, chest pain, edema, and shortness of breath) during treatment." (XL, SR, and I hope you're not taking the original formulation as it can cause more seizures, are basically similar in those regards.)
Since you're not experiencing anaphylactic (shortness of breath), it is conceivable it could disappear during treatment but I would be wary of that myself.
Definitely prednisone is a medication to avoid at all possible circumstances unless it is medically necessary to have a systemic corticosteroid. It is normally prescribed only for low cortisol conditions, MS, etc. It can cause weight gain, but more importantly, it can increase a chance of infection and cause depression.
What you have is called sebaceous dermatitis. You can get that from poison ivy or any material. Since you have it on more than just your arms, I would say it could take two to four weeks or more to heal.
I once got it on my arm while doing volunteer work in a botanical garden and I thought it was medicine related but in fact it was just something I picked up from something in the gardens. It went away in about a week, but that was on just one arm. So it will take a while unfortunately.
You can use OTC 1% hydrocortisone, judiciously, since it covers an extensive part of your body and can therefore be absorbed internally (like a small dose of prednisone). Or you can see a dermatologist and they may prescribe something like a common somewhat more powerful corticosteroid called fluocinolone acetonide.
Also Benadryl 2% (maximum OTC) cream works too to some extent but there is again a caveat -- you have it all over parts of your body to the point that if you lather on a cream or gel of Benadryl onto large portions of your body you may become drowsy from absorbing Benadryl transdermally as if you took a pill (or 2). So that is also again something to use judiciously.Actually, taking a Benadryl pill (H1 blockade) also could clear up some of it, while making one sleepy. H2 blockers like Zantac may augment it, depending on the allergic response you have.
Discuss this with a dermatologist I think.
So the discontinue idea is a good thing I would imagine and use the above carefully. And it also will just go away, which is true, longer of course untreated, just more uncomfortable and itchy. That part is up to you and your doctor(s).
Just my 2c
-- Jay
Posted by Meri-Tuuli on October 28, 2006, at 3:03:19
In reply to Drug Rash!!, posted by butternut on October 27, 2006, at 19:35:05
You'll be relieved (?) to know I had this happen to me whilst starting up with wellbutrin. Yeah it happened like you say, 2-3 weeks after starting it. My rash was limited to slightly bizarre locations, like my elbows, knuckles, hands and sides of my torso.
Yeah, I read the insert too and panicked (lots and lots and lots) about the severe allergy anaphalytic bit. I think its highly highly highly unlikely this was the case with us. Still, i had a major panic over it and if you search the archives, I posted about this too!
Thing is, it took me a good few days to realise it was the wellbutrin. I thought it was the sheets, like I was allergic to some new washing power or something.
Well I stopped the medication as soon as I realised, and I saw my doc (family doc) who was pretty unhelpful.
Apart from stopping wellbutrin, I have no idea what the solution or cause is. It would be interesting to find out. I mean, is this a true allergy, or is it just some mechanism of the drug stimulating/supressing some part of the brain/synapses etc and so causing the rash. There's a difference, if you see what I mean. Personally, I'm not allergic to *anything* that I know of, except possibly to wellbutrin (but was this a true allergy? and moclebomide (again I got a rash, but who knows?) and it might be just a start up side effect.
Its funny how the rash thing isn't mentioned in the insert, apart from the 'serious' allergic reaction thing, I mean analythic shock part. I would imagine these types of rashes to be relatively uncommon- I mean, both me and you had a reaction to wellbutrin that isn't really mentioned in the insert.
Interesting.
Kind regards
Meri
PS my rash cleared up relatively quickly after stopping the wellbutrin, in like 3-4 days. And yes it did itch like crazy! And as soon as you itch one place, you'd itch another...and another. In fact, I was itchy in places that didn't even have a rash!
Just stop the wellbutrin (which you already have) and the itch/rash disappears relatively quickly and things return to normal.
And don't panic like I did!!!!!!!!!!
Have you ever had any rashes to other things (inc pysch drugs)?
Posted by butternut on October 28, 2006, at 16:30:58
In reply to I had the exact same thing happen to me! » butternut, posted by Meri-Tuuli on October 28, 2006, at 3:03:19
Meri,
Thanks for sharing! It's good to know yours went away fairly quickly. I hope mine does too. But it's day 4 without the drug and it's only slightly less horrible looking than when it started. I read someone's story online who had a similar problem and it took weeks for the rash to heal and nearly 8 mos or so for her skin color to be completely back to normal. Yikes! I am going to be so much more judicious now about taking new/multiple meds.I did a google search on Wellbutrin rash and found a lot of postings from people who got one and also some medical journal articles about it. Some articles seem to say it's the drug itself. I've also seen some that speculate it could be an allergy to the dye or to the sustained release component of the drug. Some people are getting a rash that is not anaphylactic reaction or Stevens Johnson, but it is still a serious form of Erythema Multiforme (sp?) which can affect you internally.
Posted by butternut on October 28, 2006, at 16:35:24
In reply to Re: Drug Rash!!, posted by yxibow on October 28, 2006, at 2:14:46
Thanks for the great ideas yxibow. I think I will try the Benadryl cream. The 1% cort cream didn't really help. The oral Benadryl seems to calm the itching a lot better than Claritin, but it isn't really healing anything. I agree w/you that the pred is a last resort. I don't like the idea of dampening my immune system just as cold and flu season is getting into full swing.
My new update is that I am getting tiny little bumps on my fingers, right under the cuticle area. I saw on crazymeds that it can take 5-8 days for Wellbutrin to clear out of your system, so maybe things aren't going to really calm down until then.
Thanks to everyone who responded.
Posted by Lindenblüte on October 28, 2006, at 17:17:32
In reply to Re: Drug Rash!!, posted by butternut on October 28, 2006, at 16:35:24
Hi butternut,
yes, I think if you were so sensitive to wellbutrin that you got an extensive rash after only 2 doses-- well, it may continue to flare up until you clear the last of it after a few days.I get itchy rashes pretty often- I'm really allergic to poison ivy, and also mango (which is somehow related to poison ivy??). I also got a really bad rash the one time I ever took more than one tablet of St. Johns Wort. It was all over my neck(the WORST) chest, torso and thighs. ugh.
Took about 5 days to clear up.
In the meanwhile- cool showers. You can try bathing with Aveeno or other oatmeal bath products. Something in oats is supposed to be soothing for rashes- perhaps it's an anti-histamine?.
Wear gloves or mittens if you find that you're scratching in your sleep. At one point during the SJW rash incident, I remember having to borrow my husbands fluticasone (prescription steroid cream) and just put a few dabs on my neck and inner elbows.
Hope it clears up FAST.
-Li
Posted by Phillipa on October 28, 2006, at 19:39:53
In reply to Re: Drug Rash!! » butternut, posted by Lindenblüte on October 28, 2006, at 17:17:32
I had no idea you could get a rash to wellbutrin. I honestly thought lamictal was the only one. And you say it's not on the insert? Love Phillipa
Posted by yxibow on October 28, 2006, at 21:27:26
In reply to Re: Drug Rash!!, posted by Phillipa on October 28, 2006, at 19:39:53
> I had no idea you could get a rash to wellbutrin. I honestly thought lamictal was the only one. And you say it's not on the insert? Love Phillipa
Its definately in the PI as well as losing hair (men I think mostly) and other things. Everything you put or brush on your body has a potential for sebaceous dermatitis (if you're lucky) or worse dermatological conditions. Allergies are more understood today than 50 years ago but there is much still to go. For example it is now known that they are modulated by H2 as well as H1, if not other factors.
Claritin is a very targeted H1 drug and while it is fine for those with mild hayfever seasonal allergies it is not as powerful as Benadryl which is also less refined (hence the drowsiness) for allergenic conditions.
Do heed the package inserts about taking Benadryl internally and using the creme (especially extensively on the body) at the same time -- you'll get atropine like symptoms otherwise from too much of it, though.
Hydrocortisone doesn't act immediately, and in general steroids work on the nature of a very small amount of medication percentagewise (fluconilone I think is .1%) to slowly bring things back out of disorder. But indiscriminate use can bring depression.
In the end, either or both are palleatives, which ever works for one. Basically waiting for SD to take its natural course and go away is the ultimate cure. That is if it is not "the ultimate rash" (SJS, or other conditions.) A dermatologist could figure this out better.-- tidings
Jay
This is the end of the thread.
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