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Doctors' Answers to "Frequently Asked Questions" - Wellbutrin

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 08/6/2000]
Question: I have recently begun treatment for depression and am taking wellbutrin sr- 300 mg/ day however I also use imitrex nasal spray 2-3 times a month for migraines. I have heard about seretonin syndrome as a possible side effect and that maybe I should not take this combination? Both my nueroligist and my family doctors don't seem to worried since they hope my migraines will subside with the wellbutrin- should I be concerned with my occasional use of imitrex? THANK-YOU

Answer: There is a potential problem here. Whether you would experience cannot be predicted. But, there is a specific warning in the pdr about this combination.

[posted 08/6/2000]
Question: I've been on Wellbutrin for 7 months. I suffered a burnout six months ago. Socially I became a wreck, I avoided people, I became forgetful, was crying frequently, had palpitations, dizziness, nightmares, in other words I was no longer able to function. Wellbutrin began to kick in 6 weeks later. Emotionally I feel great..... BUT .........., I BEGAN GAINING WEIGHT TO THIS DAY (20 LBS)(I already had a weight problem)...... AND SINCE APRIL I HAVE PAIN IN MY KNEES (JOINTS) AND terrible LEG MUSCLE pain.
My doctor tells me that muscle pain is one of the side effects of the medication, but not weight gain! Will the joint/muscle pain go away once I stop this medication and hopefully lose the weight? I've seen on a certain web site whereby people discuss their reactions to different drugs and I'm quite alarmed at all the different side effects caused by Wellbutrin! Comments please!

Answer: Weight gain is common with most of the newer antidepressants. Muscle pain is distinctly uncommon. I suspect this is really joint pain-possibly caused by the weight gain, possibly not. I would see a specialist if it persists(Rheumatologist). You might need to try another antidepressant to see what effect it has on your weight, also ensure your thyroid has been checked. Sometimes hypothyroidism presents as depression.

[posted 08/4/2000]
Question: I have been taking Wellbutrin for a couple of months, recently I've had the dosage increased to 300mg a day. I am having a lot of problems swallowing. I feel like there is something stuck in the back of my throat but there isn't. This happened once before when I first started taking Wellbutrin and it became almost impossible to swallow but I kept feeling like I had too. It went away faster than it appeared. Is this a temporary side effect? Should I be concerned about it? I also just started taking Celexa - but I thought it was probably the Wellbutrin since it happened once before.

Answer: Probably will last as long as you take the medication, but will go away when you stop the medication.

[posted 07/7/2000]
Question: I would like to know what, if any, type of reactions to taking Wellbutrin. I did not have a blood test done to check my Seratonin level before going on the med. I am experiencing dizziness, fatigue and a sense of detachment from everyday life. Could taking Wellbutrin when not needed cause any symptoms? Thank you.

Answer: Checking the serotonin would not be helpful since the serotonin you are looking to change is at the neurotransmitter area, not blood levels. The side effects are probably the wellbutrin.

[posted 06/24/2000]
Question: I have been taking Wellbutrin and Dyazide for about 3 weeks. 2 days ago I started having problems going to the bathroom. Yesterday I was in pain most of the day and had to use a laxative in order to releave the pain. Is this an issue with WellButrin or Dyazide? What if anything can be done by me or my Dr. to keep this from happening....

Answer: Wellbutrin can cause mild constipation as can any diuretic. The combo is more likely to cause the problem. Fiber, lots of fluid, exercise would be the usual starting point with small daily doses of mom or equivalent to keep one stool every 2-3 days.

[posted 05/24/2000]
Question: My 4 year old is on wellbutrin as a first choice before ritalin. He is adhd and is aggressive. Have you heard of using this medication on a 4 year old?? And does it interact with regular cold medicine or tylenol??
He is so young and Im afraid he cant tell me if hes feeling bad on this med. Its hard , we are ready to try medication as he is completely disrupting all normal situations, but medicating is hard also. We do see some positive changes but the aggressionor outbursts are not subsiding as much as we would like. The doctor wants us to up his medication. He will be taking one regular wellbutrin 75mg morning and a 1/2 at 3pm. So about 118 mg daily. He is ony about 31 lbs. Thanks for your reply.

Answer: I've not used Wellbutrin for either ADD or ADHD, but it is reported. I assume he has been on Ritalin or equivalent? This is usually the first drug used, but this is a hard diagnosis in a four year old.

[posted 05/18/2000]
Question: Effexor--I have just been put on 150mg of effexor, and I was wondering what the consequences to drinking alcohol while taking this medicine?

Answer: Other than sedation, usually pretty minimal, keep it to two-three drinks.

[posted 04/17/2000]
Question: I have been taking wellbutrin 100mg in the a.m. for three weeks and am experiencing a lot of shaking throughout my arms, hands, and legs. It does not produce any anxious feelings, just tremors. This is a problem since I draft architectural designs and am finding that I can't make a straight line even with the help of a straight edge. I also have trouble typing. Is this a common side effect? None of my other meds have changed so I am concluding that it's because of the w. When can I expect it to stop? I see a psychiatrist once a week for chronic depression and extreme anxiety attacks, but he is on vacation for a while. I'd really appeciate your input. Thank you.

Answer: No, but usually persists when it is present until you stop the drug.

[posted 04/16/2000]
Question: I have been taking antidepressants for nearly 8 years. I took Zoloft for about 5 years and then switched to Wellbutrin which I've been taking for about 3 years. I am concerned about the long term effects of taking these drugs. What, if anything, is known about effects of long term usage? Also, what are the withdrawal symptoms for Wellbutrin (if I decide to discontinue taking)?

Answer: There are currently no ominous long term problems with this class of drugs. However, they have only been around 15 years or so, so just starting to see European patients with long term histories. The withdrawal syndrome is best described as "flu like". Headaches, muscle aches, nausea etc. this can last 1-2 weeks. About 30% of patients have a withdrawal syndrome.

[posted 04/9/2000]
Question: i would like to know if wllbutrin and celexa have any adverse effects when used together.

Answer: Not usually, but needs to be monitored by an md.

[posted 04/4/2000]
Question: I have a 17 year old who is on adderal for trauma induced add(car accident) he started off wonderful on the drug with improvement in grades, attitude, self esteem etc. lately tho he is depressed and his grades and attitude are a mess. his doctor is a neurologist and has given him welbutrin to take with the adderal. he has started him off slowly but i am seeing no change at all. is this normal? does it take some time to see a difference? are these two drugs safe together?

Answer: Usually there are no interactional problems with these two. The wellbutrin will take 2-4 weeks before you see any effect.

[posted 04/3/2000]
Question: I am trying to quit smoking, and do have mild asthma. I use an inhaler. I have heard that Wellbutrin has had excellent results for assisting in quitting smoking. Is it okay to take this while using an inhaler?

Answer: There is some risk to seizures with the Wellbutrin and the inhaler, but pretty small if you haven't had problems before.

[posted 03/20/2000]
Question: I have noticed changes in my menstrual cycle (e.g. heavier bleeding, bleeding between periods) since taking Wellbutin SR. The changes appear to worsen as my dosage increases and lessen as the dosage decreases. I've experimented by discontinuing the Wellbutrin to see if my periods would return to normal and they have. Is it possible that Wellbutrin interferes with hormone levels?

Answer: Not to my knowledge, but it is having some effect in your case.

[posted 03/12/2000]

Answer: This is a high dosage, but if you don't have any side effects, it might be more effective. There shouldn't be any major problems with moderate alcohol intake on the wellbutrin. As to stopping the wellbutrin, stop smoking for at least 2 months then taper the wellbutrin and see what your nicotine urge does.

[posted 03/10/2000]
Question: My pharmacist expressed some concern regarding my taking Klonopin along with Wellbutrin. Is there any information on drug interactions with the prescriptions I am currently taking?

Answer: A combo that physicians use all the time, I'm not sure what his/her concern would be. Ask for specifics and get back to me.

[posted 02/28/2000]
Question: While taking Cylert for ADD, (38/male) can Wellbutrin be used to quite smoking, or should the Cylert be stopped for a period.

Answer: Probably no problem.

[posted 02/7/2000]
Question: would like to know use of wellbutrin for peripheral neuropathy, side effects, expected results.

Abrour: Any of the antidepressants can be used to treat the pain of peripheral neuropathy. Side effects would depend on the drug. Wellbutrin would typically have occasional headaches and nausea. Results are extremely variable. We really don't have any one drug to treat neuropathy. When that is the case it is because nothing really works very well.

[posted 02/3/2000]
Question: I know that crack isn't recommended, but the question needs to be asked, so we can assume the warnings against the crack itself are already covered. I am taking 150mg of Wellbutrin per day and I want to know how crack interacts with the drug. I know that both deal with dopamine, but are they both doing the same thing, or are they creating opposite affects? I've only tried crack a couple of times, but when I did, my normally slow and very quiet heartbeats became so strong I could feel it with my hand and literally see it pounding below where my ribcage meets. I also experienced a momentary loss of breath as if the oxygen was taken out of the room. Is this because of the crack itself, or a reaction between the crack and the Wellbutrin? Others didn't seem to have the same reactions. I'm also taking Estratest and Synthroid. My blood pressure is typically low and my pulse, even during exercise, barely gets above 70. I can't seem to find any info on this matter, so any help would be appreciated. Please do not post my email address. Thank you.

Answer: There are no direct studies on the interaction of Wellbutrin and cocaine. Both would increase the risk of seizures. As to which is causing the heart rate, I would assume the cocaine. But, there is no clear way of knowing without taking each independently.

[posted 01/31/2000]
Question: In the last three months my face has gotten incredibly sensitive to the sun. I can not be in the sun for more than 10 minutes without getting sunburn- always on my cheeks in kind of a butterfly shape on either side of my nose. I've been on wellbutrin (300 mg twice/day).

Answer: Rashes are occasionally seen, but I'm not aware of any specific sun sensitivity. I would get a blood check for lupus(ANA) and you might consider a skin biopsy of unexposed skin(your rump is usually the best spot) to ensure that there are not any immune complex depositions. If these are negative, then the Wellbutrin is still the suspect. Other drugs can do this also, are you taking birth control pills or any other medication?

[posted 01/29/2000]
Question: I am taking 100 mg Wellbutrin in the a.m., but have always had terrible nightmares at night with all the antidepressants I have tried. I found that taking a combo of Wellbutrin in the a.m and Fluvox at night diminished the nightmares. Are there any concerns mixing these?

Answer: No, but ensure your doctor knows you're mixing.

[posted 01/11/2000]
Question: I started Wellbutrin for my depression in late November 1999. Since mid-December, I have experienced increasingly bothersome, transient sensations in my brain--not quite painful, but with persistent ideas of my head hitting asphalt or being sliced with razors. It's as if the sensation is a result of my imagining these things. I try to ignore this and explain it away as a mild hallucination, but my willpower is not enough to keep this from disturbing me and interfering with my thoughts. I was on Prozac since 2/98 which worked much better but I finally realized that it was the reason I had gained 40 pounds. I have been on Toprol since 1/98 for IHSS as well. My question is whether my "headaches" are directly related to the Wellbutrin? What exactly would they be classified as? Is my occasional pot-smoking to blame? Also, if it is the Wellbutrin, what antidepressant can I take that won't cause more weight gain and still be safe for my heart?

Answer: Too difficult to know which is the cause. Beta blockers can cause headaches. This would be an uncommon reaction with wellbutrin by itself. You'll need to switch before you know. Try taking the Prozac for a couple of weeks to see if it goes away. If it persists, it is not the wellbutrin.

[posted 11/26/1999]
Question: I have taken wellbutrin for several years. currently take
200 md/day. i would like to stop taking it. how do i taper off it and over what period of time?

Answer: I'd cut it in 1/2 for 10 days to 2 weeks then 1/4 for 10 days then stop. Not all patients have a withdrawal syndrome and you might be able to go faster, but not worth the risk. Even at this rate you may experience withdrawal, usually described as a flu like illness. Headache, nausea, vomiting, diarrhea. I'd let your doctor in on your cut back also.

[posted 11/18/1999]
Question: Should I stop St. John's Wort now that I've started Wellbutrin? I'm on 100 mg SR Wellbutrin (started 2 weeks ago) and the dr said no problem with St. John's Wort, but I'm wary.

Answer: Most physicians would recommend one or the other, not both. However, they don't seem to have much of a problem. We like simplicity and if there is a problem to know which drug caused the problem.

[posted 11/8/1999]
Question: My fifteen year-old son has had ADD since age eight. He used Ritalin for eight years, with good academic results. However, he recently was diagnosed with OCD and it was recommended that he take Adderal and Zoloft. He can not tolerate the side effects of Adderal or the Ritalin, due to severe stomach discomfort. He has not started the Zoloft.
I have been told by a physician that Wellbutrin will work for both of these disorders, with mimimal side effects. I would like other information on this or any others drugs that might be considered for these conditions. He refused to restart the Ritalin or Adderal and the OCD symtoms seem to be prevalent.

Answer: Well, the wellbutrin would be worth a try, but I don't have much experience using it in ADD. It does help in OCD.

[posted 11/9/1999]
Question: I was taking Effexor 75mg for six weeks for depression. I was unable to have an orgasm and had difficulty sleeping so my doctor switched me to Wellbutrin. I have taken Wellbutrin 150 mg for only 2 days and I feel horrible. I am so dizzy and nauseous that I cannot lift my head from the pillow. Also, I am bothered by bright lights and sounds. It feels like I have a hangover. Will this subside? My doctor wants me to hang in there with this drug.

Answer: Usually will persist. Did you try Prozac etc? These can also have sexual depression as a side effect. Celexa is another alternative.

[posted 11/3/1999]
Question: I started taking Wellbutrin after not seeing any effects with Celexa. The wellbutrin has caused the 'common side effects' such as insomnia and decreased appetite. I can deal with the decreased appetite, but getting 4-5 hours of bad sleep a night is making my body exhausted and nausious all day. I take one dose of 150mg in the morning around 8am. I usually take the second dose around 6-8pm and can't fall asleep until 2-3am. My doctor suggested cutting this second dose in half. I also might try taking it earlier. I haven't started doing this yet, but I just wanted to ask if you think that this will help? Will the insomnia ever get any better?

Answer: Unfortunately usually not. Usually, you will need some prescription sleep aid to avoid this problem, a common problem with the class.

[posted 10/30/1999]
Question: My wife is pregnent after IVF, and takes Welbutrin for depression. Any concerns for this med?

Answer: Currently a Class B pregnancy risk drug. This means that animal studies have shown few any mutations or fetal harm. However, like all drugs there are no direct human studies due to ethical reasons. Glaxo has a monitoring number 800-722-9292 if she continues on the medication. This will allow non-controlled monitoring of fetal damage and allow some scientific decisions concerning it's potential fetal harm.

[posted 09/26/1999]
Question: I Was diagnosed with Bipolar Disorder in 11/96 and started treatment w/Lithium. Wellbutrin was added 12/97 for depression. In February 98 I miscarried at 5 weeks. In February 99 I miscarried again at 7 weeks. I feel pretty certain that its not the Lithium since the recent studies I have read show a low number for birth defects and none for miscarriages. I couldn't find anything regarding pregnancy on Wellbutrin so to me it is the culprit. I want to get off Wellbutrin to conceieve and deliver so I thought maybe I could use St Johns Wort. What do the studies show for St Johns Wort and pregnancy? What could I take to help achieve a healthy pregnancy and baby? I am 35 years old so time is of the essence. I have one living child that is 5 years old.

Answer: There are no studies about Wellbutrin and pregnancy in humans -only animals. There will be only anecdotal information since it is a violation of ethics to expose the unborn to drug studies. There does not appear to be specific information about Wellbutrin but it sounds like your mind is made up. St. John's Wort has the same problem. You'll need to balance the complete absence of information against how you feel. Wish I could give you more data.

Eating Disorders and Wellbutrin [posted 1/12/99]
Question: Can you explain the problem with eating disorders and Wellbutrin? I understand it lowers the seizure threshold - why is this? If beginning on l50 mg per day, will this be a problem for a person with an eating disorder?

Answer: Seizures are one of the potential problems with this drug, as to why it is not understood. 150 mg a day would be the usual starting dosage for most patients.

Wellbutrin and Alcohol [posted 1/11/99]
Question: My husband is currently taking Wellbutrin. He has been diagnosed by his counselor as having aggressive depression. He started off taking prozac (took for 1 month) which was working great. However, his sex drive was low and that was a problem for him. His doctor prescribed Wellbutrin for him and he's been on it now for about 2 to 3 weeks. His doctor informed him that he could have an occasional beer on the weekends, but that was it. He was fine at first and now seems to be drinking at least 3 to 4 beers a night. I know alcohol adds to depression. The medication does not appear to be working as he is reverting back to his old habits and bad attitude toward everything. I'm wondering if it's the alcohol or the drug not working. I'm not sure whether to contact his doctor or directly speak with him about this problem. My question is what affect the alcohol has on Wellbutrin?

Answer: The alcohol has some effect on Wellbutrin, but not major. However, the alcohol is a major problem and should be addressed through both the family and his doctor.

Wellbutrin, Zoloft, and Alcohol consumption [posted 1/8/99]
Question: What are the effects on a person taking Wellbutrin and Zoloft 100 mg and continuing to drink approximately 6 to 10 bottles of beer a day?

Answer: Wouldn't be smart, probably only sedation.

Are Hair Loss & Loss of Libido Considered Wellbutrin Side Effects [posted 12/04/98]
Question: I have been taking Wellbutrin for attention deficit disorder and depression. I have been happy with the results but concerned that it might be causing two side effects: I have experienced (1) decreased libido (though not sexual function) and (2) hair loss. Could these symptoms be caused by the drug? If so is there any way to mitigate or stop these side effects? Thank you for your help.

Answer: The libido will be lowered as long as you take Wellbutrin. As to the hair loss, a listed problem, but, not seen commonly.

Wellbutrin & Weight Gain [posted 11/3/98]
Question: I just stopped zoloft after 4 yrs because of increased appetite and a lg. wt. gain.I just started 300 mg. wellbutrin and was told no weight gain is associated. What is your knowledge of this? I need to lose about 70 lbs. Thank you

Answer: Well, some do gain weight, although usually less than zoloft. You'll have to try it and see.

Wellbutrin vs. Smoking [posted 11/3/98]
Question: I have been on Wellbutrin SR 150MG for one week now to help me stop smoking. I've been having a lot of sleepless nights, been feeling sort of spaced out, tired, short of breath, and just not myself. Although today was the first day I haven't bought a pack of cigarettes in years. By the way I am a 27 year old male who has been smoking for 12 years. Should I wait this drug out and deal with the way I'm feeling, or get off it now?

Answer: Well, the cigarettes will kill you. You can usually stop the wellbutrin in a couple of weeks, or at least cut it to 75 mg. The wellbutrin won't be a permanent deal, cigarettes usually are.

Wellbutrin & Pregnancy [posted 10/30/98]
Question:I've taken 300mg of Wellbutrin (150 2x/day) for the past five years. I am concerned about pregnancy while on wellbutrin. To my knowledge, there is very little known about the effects of Wellbutrin on the fetus. I have been told that when I decide to try to conceive, I should go off of Wellbutrin and not resume it until after the first trimester if absolutely necessary. Personally, I don't think that I am going to be able to go off of it, please advise.

Answer: Wellbutrin is a Class B drug. There have been some problems in rat studies, but nothing alarming. This seems a low risk pregnancy drug;but, it hasn't been available all that long to know in humans. I'd discuss this with a high risk pregnancy expert to balance the need for the two.

Mixing Wellbutrin & Alcohol [posted 10/28/98]
Question:What effects does Wellbutrin have on a Blood Alcohol Level reading. After for 4-5 glasses of wine in a 6 hour period, I had blood drawn with a result of .299. Is this possible?

Answer: Yes. Depends on your weight, any food taken with/prior to the alcohol. This is too much alcohol to take with an antidepressant.

Unanticipated Effects While on Wellbutrin [posted 10/22/98]
Question: Recently I tried to quit smoking using wellbutrin 150 sr tablets. It made things worse, not better, and I had a very difficult week until I quit the regime. I called my M.D. ,who hasn't got back to me yet, but when I told his appointment secretary why I wanted to talk to him she volunteered that her husband had the same experience and that he went into "something like a road rage" which pretty well describes my experience. In this state I alienated many people and may lose my job because of it. Is this a common experience? Is there any way I can document it's occurrence? Thank you

Answer: Well, the antidepressants do change the chemical balance in your nervous system. For most, this is well tolerated and helps. But, some experience the opposite effect. Already documented in medical texts.

Wellbutrin for Fragile X [posted 10/14/98]
Question: My son 22 years old is fragile X and is taking 450 mg. of wellbutrin daily. What if any are the risks of increasing the dosage. He seems to do well on this drug and doesn't have side effects.

Answer: Don't seem to be a lot except sedation, constipation and occasional urinary hesitation. Withdrawal could be a problem at this dosage;but, I suspect he'll be on it for a long duration if it is working.

Wellbutrin and Weight Gain [posted 8/14/98]
Question: I am on 300 mg of Wellbutrin per day and have gained a lot of weight. How common is this and how much can a 200 lb. man expect to gain just due to the medication?

Answer: Well, it varies. Most of my patients 60% or so gain weight. This varies a lot by patient and is not predictable (some will lose weight).

Wellbutrin and Alcohol [posted 8/12/98]
Question: I am taking 75 mg of wellbutrin 2 times a day. I like to have 2 or 3 12 oz cans of beer a day. is there any interactions with this amount of beer and wellbutrin that you know of? I am not prone to seizures of any kind.

Answer: I'd limit it to one or two. There should be little interaction, however, alcohol is by nature a depressant substance.

Wellbutrin’s Effect on Athletic Performance [posted 8/12/98]
Question: I am a competitive athlete (cyclist) and consequently, I physically train and ride at very high cardiovascular stress levels for long periods of time. I've noticed a significantly elevated (resting) heart rate among several less important side effects. It seems as if my cycling performance has suffered - I fatigue more rapidly and am less able to successfully achieve peaks/bursts of strength required for climbing, etc. I am taking Wellbutrin SR (100 mg in the morning and 100 mg at noon). Is the additional cardio stress the drug seems to create responsible for deterioration of my performance? Am I doing (cardio) damage to myself and what are the long-term effects? The medicine does offer significant relief to my problems despite the attendant nervousness. I'd like to continue its use, but I am very concerned with the above.

Answer: There doesn't seem to be any known cardio-toxic effects of this drug. This does not mean that your performance is not impaired. The effects of a serotonin releasing inhibitor are probably not confined to the nerves in the brain. High levels of performance may show other effects. However, there is no known cardio-toxicity to this drug currently.

Wellbutrin [posted 7/30/98]
Question: I have been taking Wellbutrin now for a little over one week. The doctor told me I wouldn't notice a change for a while, but I think I do. I have been trying to get all the information I can about this drug. A couple of things I've been noticing is an eye twitch. Sounds funny, but ever since I've been on this my left eye twitches. I've been reading that it might cause seizures. That in itself worries me the most. Also, I have the worst taste in my mouth constantly. Will that go away? The doctor put me on this for depression and also he said to help me with cocaine cravings. Does it help with that particular craving cause I've been reading how it helps with nicotine. It seems to be helping and so far with exception of what I mentioned above, I think Wellbutrin is a wonder drug. I feel wonderful. No craving for anything and I've been a smoker for years. If I think I feel it this early, what should I expect later on? As for weight loss, bring it on. One more thing I'm curious about. I've been having these bad I migraines. Both sides of my temples throb to the point where you can see my vessels throb. Is that serious enough to worry about and how will Wellbutrin effect my problem? I take 150 ml twice a day. Also, something is going on with my hearing and vision. My hearing sounds faded. Usually I've been feeling real sharp because of Wellbutrin, but today I'm having trouble thinking of words and I'm not really with it. I have worries about this drug because I've never been one that likes to take anything or be on anything like anti-depressants.

Answer: The headaches are fairly common and one of the reasons patients cannot tolerate the drug. As to the altered taste, I don't know, but would suspect the drug. This one I would wait and see what happens. The altered sensory response is fairly common and usually will persist, but not worsen.

Taking Wellbutrin with Estrace [posted 7/30/98]
Question: I am curious about the effects of wellbutrin. I have been on prozac for 2 years, and still have symptoms of depression. I also take 2 mg of Estrace and .075 mg of synthroid. Is this a good mix? Do you have a better suggestion?

Answer: Wellbutrin is a different class and has different side effects. If the prozac is not working, you either need a different dosage (higher) or a different class of drug. Wellbutrin and/or Effexor would be the class I would switch you to. They both are relatively well tolerated. However, some patients absolutely cannot stand the side effects of these drugs (as opposed to SRI drugs). So, don't be too surprised if you cannot tolerate the side effects. It is difficult to predict who will have trouble with these two. In general, the side effects are either very minimal or intolerable.

Wellbutrin - Effects on the Heart [posted 7/24/98]
Question: I have been on wellbutrin for the past five months. I have read and researched on this medication so that I would be aware of its side effects. I have overcome a lot of those side effects, but I am concerned about its side effects on the heart.

Answer: Appears minimal at this point.

Wellbutrin and Zoloft [posted 7/24/98]
Question: I am taking Wellbutrin (100 mg twice daily) and Zoloft (100 mg once daily), seemingly with little positive effect. Recently, a pharmacist expressed surprise that I was ingesting the two concurrently in the morning, as instructed. She is of the opinion that the two are probably "canceling each other out." Is information available on this? It is recommended that I try other medication because these do not seem to have effect, but I prefer to postpone the switch if a change in how the medication is taken may bring better results. If I experiment by spacing these dosages out over the day, how soon might I expect to see results?

Answer: Unlikely to have any different effect if "spread out" and I know of no cancellation effect. You might try different times, but I doubt you will see any difference.

Wellbutrin and Urinary Problems [posted 7/22/98]
Question: Can wellbutrin cause any kind of urinary problems. I am a 47 year old man with no known prostate problems.

Answer: Occasional patients will experience urinary hesitancy - about 1 to 2%.

Wellbutrin [posted 7/17/98]
Question: I have been taking Wellbutrin for 2 weeks now. My mild to moderate depression has not yet responded to the drug. Last night I experienced 2 muscle spasms in my tongue and one in my upper lip. Afterward my tongue felt very sore. It now feels tense and sore. Do I need to be concerned?

Answer: It’s probably not the wellbutrin.

Question: Can you give me your opinion of wellbutrin and the effects of quitting smoking? My doctor just prescribed 150 mg of Wellbutrin to help with the agitation and irritability associated with nicotine withdrawal. However, all I keep reading about Wellbutrin is the restless and agitated side effects.

Answer: I've used several drugs to help people addicted to drugs, but never Wellbutrin. Clonidine(usually a blood pressure pill), which is an alpha blocker is helpful in blocking withdrawal symptoms(sweats, cramps, etc.). Antidepressants have recently been used in alcoholic centers and some drug centers to help different types of addicts. I'm not familiar with Wellbutrin in these situations. Wellbutrin is an antidepressant in a class of its own. The mode of action is not known, but thought to be centered around Serotonin. This might be useful because of this effect.

Question: I have been on Wellbutrin for 4 weeks to treat depression. While my depression is subsiding, my moods seem quite erratic. I go from anger to happy to giggles. It is not fun for my family to be around this rollercoaster personality. My doctor says it takes about 6 weeks for this drug to take effect. Do you think these mood swings are part of my body coming into balance emotionally? Do you have any other information on Wellbutrin?

Answer: Wellbutrin (buproprion hydrochloride) is an antidepressant in a class all of its own. The method of action of wellbutrin is not clear, but appears to be related to serotonin. This drug does not belong to the SRI group, however. Side effects include occasional seizures, agitation and insomnia, psychosis or mania, and altered appetite. It can be a very effective drug, but in my experience, has less predictable side effects than other classes of drugs. I'd try a couple more weeks and see if you stabilize.

Question: I just started taking Wellbutrin (generic name Bupropion) for moderate depression. Could you tell me whether taking this drug could cause me to test positive on an employee drug screen for any of the following: Marijuana, cocaine, opiates, phencyclidine, or amphetamines?

Answer: There are different types of drug screens. Some are very specific and some are not. The type of drug screen will dictate whether there is any cross reactivity. Lists of cross reacting substances can be obtained from the company. Disclosure of the drugs you are taking (in this instance Wellbutrin) will allow them to check potential cross reactivity. However, in general this should not be a problem with Wellbutrin and the drugs you have listed.

Question: My daughter, age 19, has just been prescribed Wellbutrin by a psychiatrist. He says that it is being used to treat ADD symptoms, although it is an anti-depressant. She has never been diagnosed to have ADD, although she has many of the criteria for the syndrome. She also exhibits many of the symptoms listed as the criteria for ODD. I would like to find out more about the drug Wellbutrin and what affects it may have. I also understand that it may take several weeks before we see results. Is the doctor treating her for ADD or for depression?

Answer: Wellbutrin (bupropion hydrochloride) is an antidepressant that belongs to the class of drugs called aminoketones. Although wellbutrin is a treatment for depression, we currently do not understand its mechanism of action However, it appears to not be related to the MAO inhibitors, SRI drugs, or tri-cyclics. It should not be used in individuals with a history of seizures, bulimia, or anorexia nervosa. General side effects usually include increased restlessness, agitation, occasional mania, edema, nocturia (urinating at night), stomatitis (oral sores), flu like symptoms, and muscle pains. The usual dosage is 100 mg twice a day increased to 300 mg t.i.d.(3 times a day). I have not seen this drug used for ADD, but you'll know pretty quickly whether it is effective or not. If it does work I would personally prefer it to Ritalin.

Question: I have been mildly depressed of late. My therapist suggested that I seek a psychologist and try a mild dose of an anti-depressant. I did this and was given wellbutrin. My question concerns side effects. I have been taking the drug, 150 mg per day, for about three weeks, and with increasing frequency. I have feelings of anxiety, nervousness, panic, anger, etc. Are these possible side-effects of the drug?

Answer: Wellbutrin (bupropion hydrochloride) is an antidepressant that belongs to the class of drugs called aminoketones Although wellbutrin is a treatment for depression, we currently do not understand its mechanism of action. However, it appears to not be related to the MAO inhibitors, SRI drugs, or tri-cyclics. It should not be used in individuals with a history of seizures, bulimia, or anorexia nervosa. General side effects usually include increased restlessness, agitation, occasional mania, edema. Nocturia (urinating at night), stomatitis(oral sores), flu like symptoms, and muscle pains. The usual dosage is 100 mg twice a day increased to 300 mg t.i.d (3 times per day).

Question: I am currently taking 100 mg tid of Wellbutrin for severe postpartum depression. After the first 14 days my depression was gone. My initial antidepressant was Prozac (10 weeks) followed by Effexor (1 week). I had a severe reaction to these medications and have been told not to take any SSRI. I am worried that if I go off of Wellbutrin and need to take it again that it will no longer work and that I will have no alternatives. Are there any other antipressants like Wellbutrin or ones that are currently in Research and Development? Could you also explain how Wellbutrin differs from SSRIs as far as its action on brain chemicals?

Answer: Wellbutlin(bupropion hydrochloride) is an anti-depressant in the class of drugs called aminoketones. These are unrelated to tricyclics, SRls, or other classes. The reason for action for this class of drugs remains completly unknown although it is being researched. It should not be used in individuals with seizure disorders. Common side effects include difficulty sleeping and agitation, delusions, confusion and other neuropsychiatric side effects, weight gain, and dry mouth. There does not seem to be any tolerance that develops to Wellbutrin.

Question: After taking Wellbutrin for about a year, following Serzone and Prozac, my GGT liver enzyme is now elevated to 90. Is this a side-effect of Wellbutrin or should I be concerned?

Answer: Wellbutrin is a drug that can affect liver function. Whether this is due to the Wellbutrin or a radon elevation due to other numerous factors which can elevate liver function needs to be checked. This is usually accomplished by stopping the Wellbutrin and seeing if the liver enzymes return to normal. Restarting the Wellbutrin and rechecking the liver functions will answer the question. There are so many different causes of elevated liver functions that I would be reluctant to stop a drug - if it is working - without establishing that it is the cause of the elevated liver functions.

Wellbutrin & Smoking
Question: I have been informed by my doctor that a known side effect of wellbutrin is a decrease or cessation of smoking, somehow the patient simply no longer wants or craves cigarettes.

Answer: It has been used for this as well as alcoholism. There are patients who clearly are better; but, it does not eliminate the craving completely-just an assist. It seems to work about 60% of patients.

Wellbutrin For ADD
Question: My son was prescribed Wellbutrin for ADD 3 years ago. Last Feb. he refused to take it. In short- he went ballistic, became depressed. He has been on 100mg. 3X Wellbutrin for 5 weeks, although he shows signs of improvement he is still moody and complains that the "meds aren't working as they used to". Could he have developed a tolerance? Any suggestions welcomed.

Answer: Not likely, especially after a hiatus. He may need to increase his medications or try a different combo. One's brain does change with aging and sexual maturity I suspect that is the answer. It doesn't have anything to do with the drug; but, with the situation requiring him to take it. The military is very conservative and also a risk avoider. They will avoid situations where they have difficulty predicting behavior. A report from his physician might help. Also, try a different service and "forget" about the prozac.

Situational Anxiety
Question: I have been prescribed wellbutrin for moderately severe situational anxiety, but all the information I've seen on it suggests that this drug is used for depression. Is this an appropriate drug for this condition?

Answer: The SRI class of antidepressants(prozac, etc.) and Wellbutrin started as being used in depression. However, with widespread use it became fairly clear that they are very useful in anxiety and panic disorders. Most physicians use one of these drugs as initial treatment for chronic anxiety, situational anxiety, and panic disorders since they usually work and are not addicting physically.

General Information
Question: My daughter was just prescribed to take (75 mm) “Wellbutrin”. Could you please give me any information with respect to this medication. I am unfamiliar with this medication. All I am aware of is that it supposedly will help her combat her depression. Please forward any and all information to me as soon as possible.

Answer: Wellbutrin is the brand name of a generic medication known as Bupropion. This medication is used to treat depression, and more recently, has also been used to help patients with smoking cessation. This medication should only be used under the supervision o a physician. The typical dose of this medication starts at 1 00mg twice a day, and can be increased to 100mg three times a day. The increase should be done slowly and only on the advice of your physician. There are side effects related to this medication, as is the case with any medication. Bupropion can cause seizures in a very small number of patients, but individuals with an underlying seizure disorder should not use this medication. The risk of seizure can also be reduced with slow dosage increases, and by using the minimal amount of medication needed to provide relief of depression. Other uncommon side effects include agitation, insomnia, weight gain or loss, leg or groin swelling, rash, increases in night time urination, muscle aches, blood pressure changes, and allergic reactions to the medication. Note that side effects can be seen with every and any medication in use today. Any concerns about the use of this or any medication should be expressed to your physician, who can go into further detail about the benefits and side effects of any medication you are taking.

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