Has Anyone Heard of Wellbutrin Prescribed for Bipolar Disorder?

[lnichols]

I have been looking everywhere and can't find an answer. Maybe there is someone out there who can answer my question or point me in the right direction. I have a friend who suffers from bipolar disorder. He's been taking Lithium for several months and has had good results. He goes to a local community mental health organization to see a Psychiatrist every 90 days for monitoring. Recently, his doctor prescribed Wellbutrin and took him off the Lithium after my friend had complained about dizziness. I know that Wellbutrin is prescribed for several different things, like depression and to aid in the cessation of smoking, but I have never heard of Wellbutrin prescribed for bipolar disorder. I got on Glaxo Smith Kline's web site and didn't see anything about it. I also tried web MD, and several other sites. I don't want to second guess the doctor, and I realize that new treatments come along all the time.

 

Is there anyone out there who has taken Wellbutrin for the treatment of bipolar disorder? The literature I have read indicated to me that one of the side effects could be mania, which to me is something to be avoided when bipolar! It can also cause agitation and impulsivity. My friend really had a hard time with the manic part of his disorder and does not want to take a medication that might cause this state to return. He doctor is only in on Mondays. No one in the clinic will second guess his orders. Anyone out there? Is there a doctor in the house?

[HokeyReligions]

http://bipolar.about.com/cs/menu_meds/a/meds_wellbutrin.htm

 

It's not that uncommon to use this in the treatment of manic depression / bi-polar disorder. It's usually not a first choice, but if the side-effects of other drugs are too much it is a good one to step to. Here's a link about the drug and use in bi-polar disorder. From the Bipolar Medications Library

 

Wellbutrin / Zyban - Bupropion - Antidepressant Medication Profile

from About Bipolar Disorder

[Matilda]

I did a quick search, and found the following info in these links. I don't have any first hand knowledge of Wellbutrin in the treatment of bipolar, but from what I read in my search, it looks like it is an accepted treatment for the depressive phase of bipolar, and may be the anti-depressant of choice, because there is less of a risk of mania with Wellbutrin than other SSRI's. You read the following links and see what you think. I am definitely NOT an expert about this. (Or anything else for that matter. )

 

 

http://www.whatmeds.com/meds/bupropion.html

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uid10852090

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uid12842303

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uid11893875

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uid10826663

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uid10701483

[lnichols]

Thank you Hokey Religions and Matilda for your quick responses! It was very helpful! Boy! I'm so glad to have you guys!

[lydiamarie]

oh my. where to begin, where to begin!

 

first i better do the I AM NOT A MEDICAL PROFESSIONAL disclaimer.

 

anyone else out there apalled at the fact that they seem to know more about the treatment of their disease than some doctors do?!

 

 

bipolar disorder should FIRST be treated with a MOOD STABILIZER: lithium, tegretol, depakote, etc. SECOND (after the mood stabilizer is well established and an effictive dose established) and only as needed it can be treated with an antidepressant. wellbutrin is generally the first choice (you can't take it if you have an eating disorders) because it has the lowest incidence of induced mania. other drugs that can be added to the regimine are antipsychotics and sleeping aids-serequil, clonazepam (in the valium family this is the drug of choice for the treatment of mood disorders), etc.

 

i THINK that some dizziness can be expected with lithium, but i know that it is also a symptom of toxicity (too high of a dose). lithium is a great drug, but an effective dose is very close to a lethal dose-that is why frequent lithium blood level tests are required.

 

mood stabilizers can help both ends of the spectrum, but antidepressants only help the one end-they shift mood up. this is VERY DANGEROUS for someone with bipolar disorder. if your friend had a hard time dealing with the mania, then he really really shouldn't only be on an antidepressant without a mood stabilizer.

 

have your friend ask about depakote. this is becoming one of the favored drugs for the treatment of manic depression. blood tests are necessary for this drug too-to establish an effective blood level (and the dose that causes it) and to check for signs of liver damage. some people have liver failure because of this drug but a simple blood test can catch the onset of it, and so far it looks like if it's going to happen it will happen at the start of treatment (first six months or so). so blood tests every couple of weeks for the first few months, then once a month to every few months. eventually i think the standard is something like once or twice a year.

 

i wanted to respond to this quickly, so i'm posting this before i find links for you.

 

i hope this helps.

[lydiamarie]

The use of antidepressants alone has been linked to an increase in manic episodes. Antidepressant treatment needs to be monitored closely and always used in combination with other drugs, such as mood stabilizers or antipsychotics, to avoid causing a manic episode.

 

taken from this webmd page on bipolar disorder:

http://my.webmd.com/hw/mental_health/ty1088.asp

 

this is the 'home page' for bipolar disorder on webmd. it has links to more information on the righthand side of the screen. http://my.webmd.com/hw/mental_health/ty1019.asp?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

 

 

here's the medication page for bipolar on webmd. this is just some general info. remember that drug names are the generic, not brand name

http://my.webmd.com/hw/mental_health/ty1147.asp

 

 

Call your doctor if you experience nausea, vomiting, diarrhea, slurred speech, extreme drowsiness, or weakness. These symptoms may be early signs of lithium toxicity.

 

Lithium may cause dizziness or drowsiness. Use caution when driving or performing other hazardous activities until you know how this medication affects you. If you experience dizziness or drowsiness, avoid these activities.

 

taken from the webmd page on lithium:http://my.webmd.com/hw/drug_data/d00061a1.asp?bn=Lithium

 

here's a link to webmd drug info for depakote:http://my.webmd.com/hw/drug_data/d03833a1.asp?bn=Depakote

[tiki]

To answer your post directly, yes, I have heard of it's use for bi-polar.

[lnichols]

When my friend called me and said that the Doc had him on Wellbutrin, I asked him, "Don't you mean Depakote?" I would expect that. I work at the same agency where he is getting treatment, but not on the clinic end of it. I know a little about medications used for treating mental illness because some of my clients are diagnosed with mental disorders. I thought that mood elevators for bipolar wasn't good. Why would a doctor do that? And the community mental health system is not easy to navigate - they make you feel like a number. Most people that come in are not familiar with their own diagnosis, so they just accept whatever they are told. I've tried to advocate for my friend, since I know some of the regulations and some of the staff working there. I'm not a mental health professional, though.

 

Thanks for the information. I'll tell my friend to call the clinic and see if he can schedule another appointment. (Not easy to do, BTW.)

[faux]

The friend of yours who has Bipolar disorder is under the regular care of medical professionals. Why then, are you questioning the judgment of medical professionals in the treatment of your friend? I find it interesting that you believe information that you find on the internet (Most of which is completely unreliable, even from those drug company websites, as they do not get very involved in the actual everyday uses of their medication to any truly great extent) qualifies you to question your friend's treatment, which has nothing to do with yourself.

 

I recommend that you become less concerned in these matters. I am certain that your friend has not been found to be mentally incompetent, and can worry about his or herself. To further answer your question: Wellbutrin has, for some time, been used to treat persons with Bipolar disorder, or in other situations in which mood stabilization is needed.

[lydiamarie]

would it be possible for your friend to see another doctor? if he prescribed wellbutrin for your friend, then his competence should definitely be called into question. that's a mistake that might not be so shocking (but no less serious) if he were a general practitioner and your friend had the type of bipolar that lays more heavily on the depressive end. but he's a psychiatrist. that just isn't acceptable.

 

when i first knew that there was something 'wrong' with me, i called my clinic and it was going to take them months to see me. so i called EVERYWHERE. finally i found somewhere that would see me in about a month.

 

thankfully the clinic that i go to now is at my school-i can be seen in about two to three weeks. when i'm not doing well my doctor tells me when she wants to see me again and says to tell the receptionist that if she doesn't have an opening within that time period that she should make one-schedule a later appointment or one on her lunchbreak or anything-now that's good care!

 

just to make sure we're all clear, your friend is ONLY taking wellbutrin?

[lnichols]

It really frosts me that a doctor would KNOW that they are dealing with someone who maybe isn't a walking PDR (Physician's Desk Reference) and yet fail to tell them 1) WHAT they are prescribing and 2) WHY they are prescribing it! It is like "take this and see me in 90 days". My friend isn't the shaprest knife in the drawer and he isn't going to question a doctor about his medications. I think that a doctor could give him kitty litter and he would ingest it - because that is what the doc told him to do. I think that doctors owe it to their patients to educate them. I personally don't just take anything without having some idea about what it is and how it works.

 

I think that if doctors had to be patients, they might come around.

[lydiamarie]

people who have a mental illness often are not good advicates for themselves. there is nothing wrong with lnichols making sure that his friend is receiving the care that he needs.

 

sometimes doctors are wrong. they have a lot of things to keep track of. sometimes doctors aren't good at what they do. but some people who post on this site (as i'm sure lnichols knows) have had good treatment for their bipolar disorder and have read everything they can get their hands on about their disability.

 

it is possible that there are things that we are not aware of-but i can tell you one thing that i know for certain: people with bipolar should NEVER be on an antidepressant without a mood stabilizer. and lnichols said that his friend has had major problems dealing with mania. antidepressants don't treat mania, they make it worse.

 

faux

Wellbutrin has, for some time, been used to treat persons with Bipolar disorder, or in other situations in which mood stabilization is needed

 

a mood stabilizer is a specific class of medications. wellbutrin is not one.

[lydiamarie]

thank god your friend has you lnichols, we should all be so lucky

[lnichols]

Lydiamarie - He is taking Lithium right now, (a low dose). The doctor wanted to switch him to Wellbutrin. He hasn't started taking it yet because he is afraid of being manic again. He has been on the Lithium for several months, but is complaining because he is dizzy and lethargic.

 

Faux - The situation I am in is not a comfortable one. My friend is not very smart, and I don't mean that in a bad way. I have told him on a number of occasions that while I will assist him in navigating the mental health system, for example, I told him what he needed to do in order to voluntarily commit himself to the state hospital, I tried to tell him what to expect and not to expect in the community mental health system... that I am not a mental health professional. He is not trusting of the system and he feels powerless and overwhelmed at times. I know most of the people who have worked with him! They are overwhelmed, too! And when you are talking about community mental health, you are talking about get 'em in and get'em out treatment. He is eligible for only minimal services, (care management and medication management), and he and others like him fall through the cracks.

 

And doctors make mistakes, too. They prescribe incorrect medications, they misdiagnose, they are humans and prone to the same amount of error as every other human.

 

The last think I want to do is play doctor!!!

[lydiamarie]

i've read up a bit more on lithium and it looks like lethargy and dizziness are pretty normal side effects-but not much fun just the same.

 

i don't think that it is nearly as common for depakote to have these side effects-but as with all medications it takes a couple of weeks or so for your body to get used to them but after that time most side effects should go away.

 

you could try calling a hotline or talking to a pharmacist (bring your friend with you if he feels comfortable) they are usually pretty good sources of information. i'll see what i can find for information lines for you.

[lydiamarie]

all right....

 

so i went online and did some searches...blah blah...a bit frustrating...finally decided to give NAMI a try. I found their main information line and gave it a call. boy were they ever helpful!

 

i explained the situation and asked if being removed from lithium and placed on wellbutrin sounded like a reasonable course of action and the answer i got was no, it did not sound reasonable and that he had a big concern because the mania is not treated with the antidepressant-and we all know how dangerous mania can be (look up the symptoms if you don't already know, they are genuinely frightening!). he also said he thought it very important to know the doctor's reasoning for making this switch and why he hadn't tried other mood stabilizers.

 

i asked if it would be a reasonable request for you to make that you be present during appointments in order to ask questions and help take notes on treatment and options, etc. the answer i got was that it would depend on the doctor, but clinics have confidentiality waivers, so you have a chance at being able to do this.

 

i asked if there were any information lines for you to call and he said that NAMI has local numbers, but since i don't know where you are in northern texas, you'll have to call and ask for that yourself. the main line for NAMI is 1-800-950-NAMI (6264).

 

ask for local numbers for information lines (or you can just ask them whatever questions you have), support groups, online support groups. the man i spoke with was VERY helpful.

 

if you haven't been to the NAMI website, you could give it a try:

http://www.nami.org

 

 

during my search i also found this handy list of questions and answers about bipolar, you might find it helpful: http://www.mhsource.com/expert/consumer.html#Bipolar

[einahpets]

this is kind of unrelated but i took welbutrin a couple years ago for a few weeks to quit smoking. it is the worst thing i have ever put in my body (and i experimented w/every drug known to man when i was younger). i was out of my body the whole time. i had no idea what was going on, i was in a daze. the anxiety and panic attacks were unbearable, i practically lost my mind. i was not the same person while i was on it. my brother had a similar experience. i have talked to doctors that have told me most people they know that were on it liked it so much they never wanted to go off it. ?

 

i thought i would share my experience though i am not bipolar as far as i know.

[lydiamarie]

drug induced mania doesn't automatically mean that you have bipolar-but you can bet that if you are bipolar you are far more prone to it!

 

if you have a family history of mood disorders, alcoholism, 'nervous breakdowns', unemployment, drug abuse, etc. then you've a higher risk of drug induced mania-it seems you're more prone to it.

 

it sounds, einahpets, that since you and your brother reacted the same way (adversely) that you might be genetically vulnerable to manic episodes and you'd do well to remember it. make sure you check the drug info and look to see if mania, paranoia, etc. can be side effects of any drugs you are prescribed and let your doctor know about your experience with wellbutrin. he might want to moniter you more closely during treatment or suggest a different medication. at any rate, it doesn't hurt to be cautious.

[einahpets]

well i have had a history of anxiety (though my brother hasn't), i did read the side effects but i didn't figure they would be as bad as they were. i thought the side effects would we worth the pain to quiting smoking. i had tried everything and nothing had worked, it was really important to me to quit smoking. anyways i lasted two wks on the welbutrin and told my doc about the side effects, she put me on paxil too. i lasted two days on both. my pupils were dialated the whole time and the side effects were magnified. my friends told me i looked like i was on heroin. i stopped both on that second day on the two, nothing was worth what i was feeling. the good thing is i desided that i would not make all of it for nothing, i didn't have another cig after that. it is almost 2 yrs since i have had a cig. also now i am very careful of any meds i take. if it is not a life threatening situation, i prefer not to have it in my system.

[lydiamarie]

Originally posted by einahpets

if it is not a life threatening situation, i prefer not to have it in my system.

 

that's the way i am too. unfortunately, bipolar disorder is such a 'situation' so i take medications daily.

[lnichols]

Lydiamarie, I appreciate the work you have put in this for me. My friend signed a consent to release information about his treatment to me when he first went into services. I want him to be responsible for his own illness and treatment, as I have seen far too many people become dependent on others for their own wellness. I told him this up front - that it was his illness to manage whether or not I was there. (He's threatened my life and his own during the worst part of his illness before he went into the hospital). I will pass this information on to him so that he can question his doctor about other courses of treatment. Maybe you have helped others, too, and that is really great. I appreciate you very much! I'll let you know how it goes. I think that you can never be too well informed.

[kirkyswife]

lnichols

 

Is there anyone out there who has taken Wellbutrin for the treatment of bipolar disorder? The literature I have read indicated to me that one of the side effects could be mania, which to me is something to be avoided when bipolar! It can also cause agitation and impulsivity. My friend really had a hard time with the manic part of his disorder and does not want to take a medication that might cause this state to return. He doctor is only in on Mondays. No one in the clinic will second guess his orders. Anyone out there? Is there a doctor in the house?

 

Hi! I am Bipolar and take Wellbutrin 350mg and Depakote 1500mg per day. Depakote is a mood stabilizer and was prescribed to manage my irritability and severe mood swings. Some of the side effects of Depakote is weight gain so I was prescribed Wellbutrin, an anti-depressant, to manage my "depression" and to curb my weight gain which would have thrown me into severe depression. MY suggestion is to strongly urge your friend to seek the advice of another psychiatrist. Many doctors are hesitant to put people with bipolar disorder on anti-depressants because of possibly cycling into the mania. While doctors treat the manic phase of the mood disorder, they are often remiss in treating the depressive side for fear they will trigger the manic side. My experience with Wellbutrin has been quite challenging I was up to 350mg per day and had the worst dry mouth (and this awful film on my teeth and tongue - I brushed my teeth about 5 times per day to manage that taste) and tremors. I found that I had more anxiety so we decreased my dosage and I feel much better now. Your friend should see a doctor every 15 to 30 days especially since the meds were recently changed. And I'm interested did the doctor prescribe Klonopin to help ease off the Lithium?

[lnichols]

Hey, thanks a lot. I am geting a lot of really helpful feedback, which i am passing along to my friend so that he can manage his illness more independently.

[ladyangel]

Lydiamarie is the resident pro on information about bipolar, in my opinion. I am bipolar and I haven't found a thing she's said that isn't spot on. I've had a lot of personal experience, as well as doing a lot of research on the topic, and I agree with her advice in this thread, if that means anything. Good luck with helping your friend. It's a great thing you're doing.