What is Wellbutrin and it’s benefits, especially in the treatment of bipolar disorder?
First and foremost, Wellbutrin, (generic name bupropion), is NOT your typical antidepressant! It can be considered as a good “helping hands” medication if someone with bipolar disorder is
taking a mood stabilizer and exhibits mainly anti-manic signs.
Many prefer Wellbutrin medicine to a Selective Serotonin Reuptake
Inhibitor (SSRI) such as Zoloft or Prozac because Wellbutrin does NOT
cause sexual dysfunction or weight gain.
This is a huge issue with
consumers, who often stop taking their meds, even during serious
bipolar depression, because of not wanting to be fat and sexless.
Other benefits of Wellbutrin?
It is more than just a good
medication to take if one suffers from bipolar depression. We know from
clinical studies that Wellbutrin is as effective as an
antidepressant as Zoloft, Prozac and Paxil, and is more effective than
However, IN ADDITION, Wellbutrin medicine is effective in
helping compulsive gamblers who also have other bipolar disorder
Further, Wellbutrin is also marketed under the name of Zyban
and is used to help smokers kick the habit.
Wellbutrin is FDA approved for treating major depression but NOT for bipolar disorder.
Wellbutrin may also be effective in treating ADHD.
Wellbutrin for Anxiety?
On the downside, this medication does not appear to have any anti-anxiety effects. However, if a person happens to experience a major depressive episode along with anxiety, then Wellbutrin may be beneficial. Complicating this is another caveat – if it is given in higher doses, the anxiety may increase.
Lastly, another one of the benefits of Wellbutrin is that it is on the FDA approved list for treating Major Depressive Disorder as well as Seasonal Affective Disorder (SAD). However please note it is NOT approved as a treatment for bipolar disorder and should not be used in preference to a “bipolar-specific” anti-depressant such as Lamictal.
Unlike so many other antidepressants, Wellbutrin does not induce fatigue but actually increases alertness and energy.
Many prefer Wellbutrin medicine to a Selective Serotonin Reuptake Inhibitor (SSRI) such as Zoloft or Prozac because Wellbutrin does NOT cause sexual dysfunction or weight gain.
Treating Bipolar with Wellbutrin
As with many medications, there are pros and cons to treating bipolar with Wellbutrin.
Perhaps the most obvious benefits of Wellbutrin lie in its different side effect profile. There is something almost too good to be true about an antidepressant that can improve sex drive and assist weight loss!
Also positive is the general feeling that Wellbutrin does not cause as much manic switching as other antidepressants.
It has helped me profoundly during my own periods of bipolar depression. In particular, it has been the much needed “helping hand” that has pulled me out of a black hole several times now and made it possible to get out of bed, wash my hair, and go to work. Fortunately, this “boost” in motivation and energy was not accompanied by any mania.
Are there benefits of Wellbutrin in relation to the most typical comorbid bipolar conditions? For example anxiety, substance abuse, impulsivity, and obesity?
There is evidence that Wellbutrin medicine can help with social anxiety and generalized anxiety. However, it does not help against panic attacks and may even make them worse. (This is why I stopped taking taking Wellbutrin. For someone who does not have panic problems, Wellbutrin may still be a good option, especially in combination with an anticonvulsant mood stabilizer or with lithium.)
Substance abuse? One of the best known benefits of Wellbutrin is how it helps folks quit smoking cigarettes – and marijuana! It may increase sensitivity to alcohol – or it may not – the evidence is inconsistent.
Impulsive behavior? Wellbutrin has been shown to be helpful for compulsive gamblers. It should be kept mind though that Wellbutrin is a medicine with stimulant properties and there is not enough data at this time to understand how it may either fuel or control impulsivity.
Obesity? Wellbutrin has been trialled as a weight loss aid and is unusual in being an antidepressant that contributes to weight loss rather than weight gain. This is extremely important as people with bipolar disorder suffer from higher than normal rates of obesity and are up to 3 times more likely to die from related diseases such as heart disease and diabetes.
Wellbutrin should not be taken by anyone who CANNOT afford to lose more than 5% of their body weight. It MUST NOT be used by anyone with anorexia or bulimia.
“Someone gave me some very good advice one time. Perhaps I have not been so good at following it. This was it: You are the one that is in charge of your own wellness. Go in to your appointment armed with research.”
Note that Wellbutrin is FDA approved for treating major depressive disorder, NOT bipolar depression specifically. However, there is growing belief it is one of the antidepressants LEAST likely to cause a switch into mania.
“Newer “atypical” antidepressants work differently than other available drugs. Currently, none are approved by the FDA to treat bipolar depression. But some evidence suggests they may play a role in treating depression in bipolar disorder. Studies have shown that Wellbutrin is effective when added to lithium therapy. However, findings are still preliminary.” (From WebMD)
1. NIMH (National Institute of Mental Health)
3. Mayo Clinic
4. The Merck Manual
Wellbutrin prescribing information
It is important to understand that Wellbutrin is an “atypical antidepressant”. It is chemically distinct from other antidepressants. This means that no matter what previous experience you may have had with other antidepressants, for example if you have been on Prozac, or some other antidepressant, you MUST EDUCATE YOURSELF ABOUT WELLBUTRIN SPECIFICALLY.
Wellbutrin is an norepinephrine-dopamine re-uptake inhibitor (NDRI). This means is increases the presence of the neurotransmitters/hormones norepinephrine and dopamine. These effect things like focus, motivation, and mood. This mechanism seems to reflect the main benefits of Wellbutrin. Other NDRI drugs include ADHD medications such as Adderall and Ritalin.
This stimulating quality makes it excellent for helping people to break free from debilitating depression, but can also cause problems such as agitation and sleep disruption which may be dangerous for folks with bipolar disorder.
It is essential to following dosing instructions precisely!
Also, you MUST tell your doctor about ALL your medication, alcohol drinking, recreational drug use and so on.
In the US, the FDA has approved the use of Wellbutrin in treating:
1. Major depressive disorder
2. Seasonal Affective Disorder (SAD)
The same medication, when labeled “Zyban” is approved as an aid to smoking cessation treatment.
SIDE EFFECTS: Include but not limited to: Changes in appetite; constipation; dizziness; drowsiness; dry mouth; headache; increased sweating; nausea; nervousness; restlessness; taste changes; trouble sleeping; vomiting; weight changes.
CAUTIONS: Can induce seizures. MUST NEVER be taken by someone with a history of seizures or in dosages above the daily recommended dose.
In summary, it is worth trying if you suffer from bipolar depression, especially when used in conjunction with a mood stabilizer. However, it is not a good idea to experiment with Wellbutrin if you are already in an episode of bipolar mania.