Benefits of Wellbutrin – A Quick Reference Guide
What is Wellbutrin and it’s benefits, especially in the treatment of bipolar disorder?
This is NOT your typical antidepressant! Wellbutrin, (generic name bupropion), can be considered a “helping hands” medication if someone with bipolar disorder is taking a mood stabilizer and exhibits mainly anti-manic signs.
Wellbutrin is often preferred over a Selective Serotonin Reuptake Inhibitor (SSRI) such as Zoloft or Prozac, since it does NOT cause sexual dysfunction or weight gain.
These are often the primary reasons people with bipolar disorder cite for not taking their meds, even during a serious depressive episode.
Wellbutrin does NOT cause these side effects. Medical News Today states:
“Wellbutrin is chosen in preference to other antidepressants because its use is less likely to cause weight gain or sexual dysfunction.”
Other benefits of Wellbutrin?
This is more than just a good medication for treating some cases of bipolar depression. Clinical studies have shown that as an antidepressant, Wellbutrin can be as effective as Zoloft, Prozac and Paxil. It is also more effective than Effexor.1
IN ADDITION, Wellbutrin is effective in helping compulsive gamblers that have other bipolar disorder symptoms.
It is also marketed under the name of Zyban and prescribed to help smokers quit.
Wellbutrin is FDA approved for treating major depression but NOT for bipolar disorder.
It may also be effective in treating ADHD.
Wellbutrin for Anxiety?
On the downside, it does not appear to be effective as an anti-anxiety medication. However, if you are experiencing a major depressive episode along with anxiety, then it might be beneficial. Complicating this is another caveat – if given in higher doses, your anxiety could increase.
A report released by the drug’s manufactured noted that a large percentage of patients treated with Wellbutrin experienced heightened feelings of agitation and anxiety, especially in the beginning.
Some licensed psychiatrists are quick to point out that every patient will react to the drug differently, most agree that it should not be prescribed to treat anxiety.
The reason Wellbutrin can exacerbate feelings of anxiety is due to it being a norepinephrine-dopamine reuptake inhibitor (NDRI).
When taken as prescribed it will increase the amount of norepinephrine your body produces. This is one of the “fight or flight” chemicals that are produced in response to any stimuli that results in feelings of anxiety. While this can help balance out dull and inactive moods that are often a result of depression, it is seldom beneficial for someone that has been diagnosed with an anxiety disorder.
Lastly, another benefit of Wellbutrin is that it is on the FDA approved list for treating Major Depressive Disorder as well as Seasonal Affective Disorder (SAD). 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.
Get detailed information on Wellbutrin benefits from the National Institutes of Health and the U.S. National Library of Medicine.
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!
While increased libido and a smaller waist are certainly benefits that almost anyone can appreciate, it is also important not to lose sight of the fact that this medication comes with possible negative side effects. Like any prescribed drug these can range from mildly annoying to life threatening.
Your psychiatrist will be able to discuss these potential side effects with you in greater detail. Some of the less serious ones can include,
- Stomach cramps, nausea, dry mouth
- Dizziness, headaches, ringing in the ears
- Decrease in sex drive
- Muscle pain, sore throat
- Changes in appetite and weight
- Skin rash, itching
- Increased urination
If you ever experience any of the following while taking Wellbutrin, it is imperative that you contact your primary health care provider immediately. Some of the more serious ones associated with this NDRI can include,
- Convulsions (seizures)
- Rapid heartbeat
- Confusion, trouble breathing, unusual thoughts or hallucinations
- Severe skin reaction
- Fever, joint pain or swollen glands
Even though these are serious side effects associated with Wellbutrin, for most patients with depression the pros outweigh the cons.
Wellbutrin does not cause as much manic switching as other antidepressants, and this is a definite benefit.
It has helped me profoundly during my own periods of bipolar depression. It has been the much needed “helping hand” that has pulled me out of a black hole 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.
I also highly recommend bipolar counseling online if you’re going through bipolar depression. Sometimes, you just need to talk. But WHO you talk with is just as important.
Wellbutrin can also produce positive results when it is used to treat attention-deficit/ hyperactivity disorder (ADHD) and depression. Though it is usually not the first medication prescribed, if the other common stimulants are ineffective it might be a viable option.
In most cases a person that has been diagnosed with ADHD will find that stimulants like Adderall, Ritalin, Concerta and others will help reduce their symptoms, but this is not always the case. This can be especially true if the person is also suffering from depression.
If the commonly prescribed treatments for ADHD are not minimizing the symptoms, a re-evaluation might be needed to check for another contributing factor. ADHD can exhibit some of the same signs associated with depression, and Wellbutrin might be the best course of treatment. This is because it can target the symptoms associated with both problems.
Since it has shown to be effective at increasing the amount of norepinephrine and dopamine it can help improve focus and concentration. These are two of the main symptoms associated with ADHD. When the production of these chemicals is increased, some people have noticed a significant improvement in their symptoms.
If you are dealing with ADHD and depression, Wellbutrin might be a good treatment option. However, if you have only been diagnosed with ADHD it will probably not be your best course of action.
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 it can help with social anxiety and generalized anxiety. However, it does not help against panic attacks and may even make them worse. For someone that does not have panic problems, Wellbutrin may still be a good option, especially in combination with an anticonvulsant mood stabilizer or lithium.)
Substance abuse? One of the best-known benefits of Wellbutrin is how it helps folks quit smoking cigarettes! It may increase sensitivity to alcohol – or it may not – the evidence is inconsistent.
Even though the studies are still ongoing, there are a few things you should know if you are considering drinking alcohol on Wellbutrin.
It is commonly prescribed to treat depression, and alcohol is classified as a sedative. This alone makes overindulging a poor decision if you have been diagnosed with depression. Wellbutrin also reacts chemically with alcohol. This can intensify the side effects from both substances. The most common complaints regarding mixing the medication with alcohol include symptoms associated with a lower tolerance level such as,
- Black outs
While these side effects can be debilitating, there have been reports of more serious health problems occurring when Wellbutrin and alcohol are mixed.
- Impaired motor control
- Impaired judgment
- Suicidal thoughts/feelings
Psychiatrists and physicians state that since Wellbutrin has shown to enhance the effects of alcohol, it only makes sense that problems associated with having a lower tolerance would be commonly reported. Adding to the danger of taking the two substances together is the fact that some of these side effects could easily become life threatening.
People used to consuming large amounts of alcohol will often find that their risk for a seizure increases, along with their chances for an overdose.
With that being said, suddenly stopping alcohol consumption when starting Wellbutrin can also increase your risk for seizures, along with some of the more serious side effects associated with this medication.
If you are used to consuming alcohol on a regular basis, this should be discussed with your psychiatrist before starting a treatment plan that includes Wellbutrin. In most cases you will want to stop drinking before you start taking the medication, but once again this will be up to you and your doctor. Every patient is different, and the best course of action for one person might not be right for you.
Impulsive behavior? Wellbutrin has been shown to be helpful for compulsive gamblers. It should be kept mind though that it 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 trialed as a weight loss aid and is unusual in being an antidepressant that contributes to weight loss rather than 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 conditions such as heart disease and diabetes.
Unlike SSRIs that often list weight gain as one of the side effects, clinical trials are showing the opposite to be true with Wellbutrin. Even though, relieving the symptoms associated with depression is preferable, even if it comes with a slight weight gain, if it is more than a few pounds loss of confidence and issues with self-image are common.
This can lead to problems with depression again, rendering the treatment ineffective.
On average a person can expect to gain around 10 pounds when they are on some of the commonly prescribed antidepressants. This might not seem like a lot of added weight, but for some people with fragile egos it can cause their depression symptoms to worsen.
Currently there is only one antidepressant on the market in the United States that is showing to be effective in some people at promoting weight loss. It is important to remember that the clinical trials are still ongoing, but preliminary results are showing that Wellbutrin is linked to the weight loss some people experience.
It is a NDRI and this means that it speeds up your metabolism, and increases your energy level. This helps you get up and start moving, which can be difficult to do when you are suffering from depression. The boost in energy results in more calories being burned, and this is enhanced by the increase in your metabolism.
In some people Wellbutrin also acted as an appetite suppressant, which in turn resulted in the loss of a few pounds.
The only downside associated with weight loss and Wellbutrin are the feelings of anxiety that some people reported experiencing. This is usually only a problem if their serotonin levels are already unbalanced. Since the drug is not designed to even this out, relief from the anxiety typically only occurs after the treatment has stopped.
If you are concerned about any weight gain that might occur from treating your depression, Wellbutrin might be the best treatment option for you. It is important to remember that it should not be taken as a primary weight loss aid. It is an antidepressant and contains powerful medication that should only be used under the strict guidance of a licensed health care professional.
There have been some rare cases of people reporting weight gain on Wellbutrin. This only emphasizes the fact that it does affect everyone differently.
IF THESE STATS CONCERN YOU (THEY SHOULD!) DISCOVER THE BIPOLAR DIET.
Here’s what you’ll get:
- A list of meds most likely to cause weight gain (and varying degrees of weight gain)
- The 12 worst foods people with bipolar disorder should never eat!
- Easy and straight-forward daily food plans you can follow
- And many more winning strategies to manage your weight and take control of your life
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.
Wellbutrin and Withdrawals
For some people the relief from their depression symptoms combined with its relatively low risk of side effects makes a treatment plan that includes Wellbutrin something that they and their doctor intend to continue for an extended. Others may find that the side effects are worse than their symptoms or that they just want to experience life without the use of prescription medications.
If you are planning on removing Wellbutrin from your treatment plan there are a few things you should know.
Chances are you will experience some type of withdrawal, and it is important that you are aware of any symptoms you might experience. The type and severity, along with the duration will vary depending on several factors which should be discussed with your prescribing doctor before you stop taking Wellbutrin.
- Time Span
The amount of time you were taking Wellbutrin will determine the length and severity of the withdrawal symptoms. If you have only been on the antidepressant for a few weeks, there might not be any noticeable symptoms. If there are, they typically only last for a few days. However, if you have been on the medication for several months or years you can expect the withdrawal symptoms to be more severe. In this case you might be better off weaning the dosage down, instead of trying to stop “cold turkey”.
- Dosage and Subtype
The dosage will play a key role when you are trying to “come off” of the medication. A person on a higher dosage will find that the withdrawal symptoms are more severe. It will also take more time before the withdrawal effects aren’t felt anymore.
The subtype also affects withdrawal. If you were taking “IR” (immediate release) or “XL” (extended release) Wellbutrin you might discover that the symptoms from withdrawal are more noticeable. “SR” (sustained release) Wellbutrin is designed to be taken twice a day, instead of only once. This can make the withdrawal symptoms less noticeable, and easier to fully “come off” the antidepressant without experiencing any severe side effects since it is easier to gradually reduce your dosage.
- Your Physiology
It cannot be stressed enough that Wellbutrin withdrawal symptoms will affect everyone differently. Your environment, amount of support that you receive, along with your nervous system will all play a role in the severity and duration of the withdrawal symptoms, and this means that it is impossible to compare your case to another.
Wellbutrin Withdrawal Symptoms
Not everyone will experience all the symptoms associated with withdrawal. The severity and duration will also vary. While some people might experience two or three symptoms, others might have to deal with more. Some lucky people also report not experiencing any withdrawal symptoms, though this usually only occurs when they were on the antidepressant for a short period of time. Some of the common ones’ users report experiencing include,
- Body Aches
- Crying Spells
- Depersonalization (no longer feel like yourself)
- Depression (if this symptom returns it is important to speak with your physician)
- Increased appetite
- Lack of coordination
- Decrease in sex drive
- Seizures (this should be immediately reported to your physician)
- Weight Gain
You should also be aware that Wellbutrin can stay in your system for 5 to 10 days, and this will affect how long you experience the symptoms associated with withdrawal.
Even though the amount of time it takes you to fully withdrawal will vary, there are a few things you can do to make it a little less miserable. Exercise, eating a healthy diet and making time to socialize with friends and family can all help to lessen the severity of the symptoms, and even speed up the withdrawal process. In most cases you can expect to start noticing a significant decrease in withdrawal symptoms after a few weeks of stopping the medication.
If you feel like the withdrawal process is taking longer than it should or your feelings of depression return it is important that you make time to discuss any problems or concerns with your prescribing psychiatrist or physician.
“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)
- Current Psychiatry. 2012 June; 11(6):E3-E4
- Michigan Medicine. University of Michigan
- Harvard Health Publications. Harvard Medical School