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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by dioxinsniffer on July 30, 2001, at 22:02:56
hi,
i feel pretty stupid saying this but i've just figured this out tonight and happened on this message board by chance (or by google if you will.) i tend to get long-winded in most written communications but please bear with me.
i've been taking Wellbutrin SR 2x150/day for about 20 months and have just realized a correlation between it and a worsening acne problem. Since around the time I began taking the Wellbutrin for depression and to cope with the then-recent departure of alcohol from my life >:) , I've noticed a general increase in acne, especially cystic acne. i had almost zero acne in HS or in college (i'm 25)- just one pimple at a time if any. i've also been having some gastrointestinal problems recently but honestly the acne is of more concern to me since it has negatively impacted my self-esteem and affected my desire to be social or see anyone, really.
i have made the connection between the two by observing that over the past few weeks, as I have been forgetting roughly half of my daily doses, my skin has vastly improved while no other factors such as diet, weight, exercise level, what-have-you has changed. however, the past four days i've gone back to the dual dose and now have seen yet another set of these horrible pustules appear on my face. neither i nor anyone even remotely related to me has ever had spots like this.
though i would like to go completely off of Wellbutrin because I feel very confident that it has been seriously impacting my skin condition which in turn has been seriously chipping away at my self-esteem (and it's all downhill from there, believe me), I remain cognizant of the fact that I've been taking this for almost two years and it *has* helped me, so cold turkey is probably the wrong thing to do.
my concern is THIS: Has anyone heard of or seen in themselves a correlation between Wellbutrin usage and acne problems? Especially concerning long-term use of Wellbutrin? I've read some posts about GI issues with it but with about an hour of searching I was unable to find anything here and little elsewhere about the affects of Wellbutrin on the skin (other than extreme reactions such as rash and hives.) This worsening has been so gradual and now this recent deduction so breathtaking that I am at a loss for words and extremely conflicted - part of me wants to remember the positive effects of the drug that got me through some real SHIT-life. the other part of me wants to beat myself up for not seeing the connection sooner and then put a bat through this monitor.Are there any discussion forums devoted to issues with long-term Wellbutrin use? I feel like all the doubt I had at the beginning re: no studies of LT side effects is coming back to kick me in the ass. In case it's too veiled I'm rather angry and need some real data to quell my suspicions.
Any comments or commiserative tales are appreicated, thanks
ds
Posted by SalArmy4me on July 30, 2001, at 22:11:04
In reply to wellbutrin and acne? long-term effects? (LONG), posted by dioxinsniffer on July 30, 2001, at 22:02:56
Paxil and Acne:
Copyright 2001 © American Academy of Child and Adolescent Psychiatry Volume 40(5) May 2001 pp 505-506 "IMPROVEMENT OF ACNE IN DEPRESSED PATIENTS TREATED WITH PAROXETINE":
"When prescribing the antidepressant agent paroxetine, a selective serotonin reuptake inhibitor (SSRI), to patients with depression, I have observed a profound improvement in the facial acne of a number of adolescents and adults.
I first observed the positive effect of paroxetine on acne in 1994, when I treated a white woman in her late 30s for severe depression. The woman also had facial acne, which disappeared after she took paroxetine 20 mg daily for about 1 month.
Another case involved a 27-year-old woman from a Caribbean island whose depression and social anxiety prohibited her from performing the duties of her job in marketing, so she accepted a position as a file clerk at a bank. The woman also had a serious case of facial acne. She responded very well to paroxetine 20 mg daily, and her face became blemish-free. Consequently, her confidence and self-esteem levels increased dramatically and her depression eventually disappeared; she felt more comfortable with her appearance and resumed her career in marketing.
From these two incidental situations, I decided to target paroxetine to the adolescent population and discovered promising results.
One of my first adolescent cases involved a 17-year-old male patient with depression. He had poor socialization skills and inadequate academic performance, and he was absent from school once or twice a week. He also had a severe case of acne. This patient’s depression responded remarkably well to treatment with paroxetine, and he demonstrated an increase in social involvement and an improvement in school attendance and academic performance. After his facial acne disappeared, he developed a positive self-image and expressed contentment with his treatment.
Another case involved a 14-year-old African-American female patient. Approximately 1 year before this report on her case, she was discharged from a hospital and prescribed an SSRI (fluoxetine 10 mg daily) for depression. I began treating her shortly after her discharge and immediately noticed that she was painfully shy, reclusive, and socially uncomfortable. During the initial evaluation, she attempted to conceal her face from me. Because this patient exhibited less than an optimal response to the initial SSRI and reported severe headaches, I discontinued the medication and prescribed paroxetine 10 mg daily. Within 6 to 8 weeks, the changes in her depression and facial acne were remarkable. Her self-confidence improved dramatically, and she now perceives herself as physically beautiful.
I am currently treating three adolescents who have exhibited positive effects of treatment with paroxetine. The first patient is a 13-year-old girl with facial acne. She had reported extremely poor peer relationships; she was frequently derided by her peers because of her appearance. She has responded very well to paroxetine 10 mg daily for the past 6 months, as evidenced by an alleviation of depression, an improvement in self-esteem, and the disappearance of her facial acne. She now takes pride in her appearance and has made new friends. During our last interaction, she disclosed that she is involved in a boyfriend–girlfriend relationship.
The other case involves two African-American siblings whom I have been treating for depression and anxieties over the past several years. Within the past couple of months, the brother and sister (aged 16 and 14 years, respectively) complained about facial acne. Until this point, they had been taking sertraline, another SSRI agent, for more than a year. I switched their medication to paroxetine 10 mg daily and, in my most recent consultation with them, witnessed two acne-free complexions. The siblings and their grandmother, who is their caretaker, expressed extreme delight with the overall improvements.
I have found that paroxetine is the only effective SSRI that improves facial acne while treating depression. Studies show that certain skin diseases may lead to depression and even suicidal ideation (Gupta and Gupta, 1998).
In the cases described in this study, the depressed adolescents were compliant with treatment, especially upon learning that paroxetine reduces breakouts of facial acne. For the most part, the acne improved without the assistance of other medications. I hypothesize that the chemical properties of paroxetine may affect certain agents or receptors that can improve the condition of facial acne."
Hamid Moussavian, M.D.
1. Gupta MA, Gupta AK (1998), Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis"
Posted by Nicole Smith on December 18, 2008, at 11:23:00
In reply to wellbutrin and acne? long-term effects? (LONG), posted by dioxinsniffer on July 30, 2001, at 22:02:56
I have the exact same problem, and am also just making the correlation, (b/c I've forgotten to take my meds for several days in a row and my skin seems to be miraculously clearing up...coincidence?). This terrible cystic acne began about 6 months ago & I did wonder if it could be from the Wellbutrin, but I had already been on it for about 6 months, so really didn't think that could be it. Also, I did ask my doctor & was told that couldn't be it...I think they even laughed me. The acne was bad at first, but has continued to worsen. (I take 300mg/day of WBXL & have been on it about a year now...actually I take the generic Buproprion.) I've been to the dermatologist MANY times & have tried every acne medication & home remedy out there. I was planning to start Accutane next month, (the "last resort" for clearing up bad skin), but now am wondering if I should just try weening off the anti-depressants. But like you, I am hesitant to do so b/c the Wellbutrin was like a god send when I first began taking it...my emotions leveled out, I felt clear headed, had energy again, felt truly happy for the first time I could remember & even lost weight. But this acne is really affecting my self esteem, social life & even career...I avoid every activity I possibly can b/c I am embarrassed to show my face. I'm definitely going to bring this up to my dermatologist again before starting Accutane.
Posted by desolationrower on December 18, 2008, at 11:43:27
In reply to Re: wellbutrin and acne? long-term effects? (LONG) » dioxinsniffer, posted by Nicole Smith on December 18, 2008, at 11:23:00
I wonder if this is the reason.
Acneiform eruption following anti-TNF-alpha treatment: a report of three cases.
Sun G, Wasko CA, Hsu S.Tumor necrosis factor-alpha (TNF-alpha) antagonists are used to treat many autoimmune disorders including Crohn's disease, ulcerative colitis, rheumatoid arthritis, and more recently, psoriasis. The adverse effects of the treatment regimen for psoriasis are not as well documented as those for Crohn's disease and rheumatoid arthritis. We report the development of acne vulgaris in 3 patients with psoriasis after initiating anti-TNF-alpha therapy.
-d/r
Posted by desolationrower on December 18, 2008, at 20:50:51
In reply to Re: wellbutrin and acne? long-term effects? (LONG), posted by desolationrower on December 18, 2008, at 11:43:27
Oh, if you don't know, bupropion reduces TNF-alpha. Also i'd think the connexion w/acne is that by reducing immune sysmtem activation the bacteria that can cause it are better able to take hold. So thats the link i bet. Also welcome to pb.
-d/r
Posted by Orangecat on December 21, 2008, at 0:22:50
In reply to Re: wellbutrin and acne? long-term effects? (LONG) » dioxinsniffer, posted by Nicole Smith on December 18, 2008, at 11:23:00
Hello, I am new here - diagnosed bi-polar about 20 years ago. I use 300 mg. of Wellbutrin XL but find it doesn't really aggravate my acne too much, although when it gets out of hand, I get a rx for one month for Minocycline, an anti-biotic. I get about 5 months of clearer skin out of doing this. Check with your dr. or psydoc first.
Posted by Shamokin92 on January 23, 2009, at 22:44:05
In reply to wellbutrin and acne? long-term effects? (LONG), posted by dioxinsniffer on July 30, 2001, at 22:02:56
I have the same problem. I never had acne before and I couldn't figure out what was causing it. It's changed over time from weird blisters to cysts.
Posted by Ceres on January 28, 2009, at 15:10:57
In reply to wellbutrin and acne? long-term effects? (LONG), posted by dioxinsniffer on July 30, 2001, at 22:02:56
Hi, D-Sniffer, Yes, I got a bad acne-like eruption on my face after my doctor doubled my Welbutrin dose. (A lesson to me to 1st trust my own judgment --I know I have to go up slowly)
For me, it was like a severe Adrenal Response. I was Over-Stimulated, red & sweaty & couldn't cope with my environment. (now that I think of it, my doctor was cavalier about the whole thing -clueless.. --& I know he would have been freaked if his skin broke out, as he was very concerned about his appearance --am having doctor ambivalence)
I say "acne-like", because it was different than usual break outs --was more uniform & widespread. Also, I later read that term in relation to med induced eruptions & am not sure why it's classified differently.Well, that got me to see a dermatologist for the first time & she prescribed both topical & pill treatment. It worked. Meanwhile, I had a friend who was dropping $80 at a cosmetic counter to cover her med break outs. A dermatologist is a good investment if you can swing it (cheap meds online & $60 for my dermatologist apt {just as much education & probably more liability insurance than a psychiatrist, but a fraction of the cost --what's w/ that?})
If I was stable on the Welbutrin, I would have probably stayed on it & just treated the skin problem. Although, I think it permanently enlarged my pores.
Good luck finding a med balance.
Posted by wildebras on May 21, 2013, at 10:26:24
In reply to Re: wellbutrin and acne? long-term effects? (LONG), posted by Orangecat on December 21, 2008, at 0:22:50
Hi all,
Wellbutrin definitely causes cystic acne in some people. Imo mainly in females. Why? because I think it is caused by the increased testosterone (that are in its turn caused by the increased dopamine levels). Comparable to the acne you see on dope addicts (amfetamine/speed/crack).
I've used Wellbutrin several times, and everytime I'm on it I get serious acne on my cheeks/chin. Everytime I quit using it the acne quickly diappears. Normally I don't have acne, only a pimple or 2 when I'm about to get my period. Even in my puberty I didn't have acne as bad as when using Wellbutrin. Actually I hardly had any acne at all at that time. For the rest I'm very positive about Wellbutrin (libido increaser numero uno), so it made me really sad that I had to stop using it because of the acne. I still have a scar from one very bad pimple :(
Best wishes for everybody!
Posted by wildebras on May 21, 2013, at 10:28:02
In reply to wellbutrin and acne? long-term effects? (LONG), posted by dioxinsniffer on July 30, 2001, at 22:02:56
Hi everyone,
I'm from Holland, 34 years old female, and I had the same experience. Actually I've been on and off Wellbutrin a few times, and every time I use it I get terrible cystic acne. I hardly had any acne during my puberty and after that only a pimple or 2 when I was about to get my period. So I'm 100% sure it 'is' the Wellbutrin.
To be more specific: I think it is the heightened testosterone you get from it (through some intricate interaction with dopamine,sorry I forgot the names of the articles that support my theory)
This increase of testosterone does also the incredible increase of my libido I encountered on this med :-) This side-effect was very welcome of course.Bye y'all, greetings from Amsterdam!
This is the end of the thread.
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