Has Anyone Heard of Wellbutrin Prescribed for Bipolar Disorder?
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?
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
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. )
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.
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.
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.
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.)
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.
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?
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.
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.
Quote:
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 - 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.
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.
Please note: The suggestions and advice offered on this web site are opinions only and are not to be used in the place of professional psychological counseling or medical advice. If you or someone close to you is currently in crisis or in an emergency situation, contact your local law enforcement agency or emergency number.
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