Are there any dangers or health-related reasons one shouldn't go on and off Wellbutrin this
May 25, 2010 10:08 PM   Subscribe

Are there any dangers or health-related reasons one shouldn't go on and off Wellbutrin (as opposed to "you shouldn't do it because your moods will vary")?

Quite honestly, the drug makes me lose weight and I usually miss this after I'm off it for a while even though it doesn't help me otherwise.
posted by mintchip to Health & Fitness (9 answers total) 1 user marked this as a favorite
Do you mean abruptly going on/off, or tapering on and off? Physical symptoms will differ depending on what you do.

There are other drugs out there that can help with weight loss that don't have the potential side effects or the high cost of Wellbutrin.
posted by Fui Non Sum at 10:35 PM on May 25, 2010

The CrazyMeds info sheet on Wellbutrin spells out, a bit flippantly, the major issues with taking it.

Note that it lowers your seizure threshold; anecdotally, I took it as prescribed for a while, got off it, and was re-prescribed it later... at which point my leg started spasming uncontrollably in the middle of a call at work, and my GP said "OK NO MORE OF THAT EVER." You probably don't want to drink while you're on it, either, for the same seizure threshold reason and because it's rough on the ol' liver.

There is probably a better way to do what you're trying to accomplish without screwing around with your norepinephrine reuptake in this fashion, and you should talk to a GP about it.

Note that the CrazyMeds page makes a point of saying, upfront, that Wellbutrin can be used to enable unhealthy or disordered eating habits-- I'm not saying this is you because I don't know, but if you see yourself in that description, I'd encourage you to find a specialized therapist you can talk to about your relationship to food.
posted by fairytale of los angeles at 10:55 PM on May 25, 2010 [2 favorites]

If you read the actual CrazyMeds boards, you will also discover that a great deal of the bad reports on Wellbutrin are actually for generic versions of Wellbutrin, and not usually the brand version. Most people use the generics because that's all they can get, due to simple affordability. My experiences have been just that...brand Wellbutrin worked great, generic bupropion formulations were horrible experiences. You should also read CrazyMeds with a tongue firmly planted in-cheek. That place does tend toward the "they're out to screw with you" mind-set.

As to your question...You discount the "you shouldn't do it because your moods will vary" response, yet that will be the most obvious result of going on-and-off. Using a psychoactive medication like bupropion as a weight-control isn't really a good idea. The on-and-off effect in your brain can't be good in the long run. Maybe you should ask your doc about a lowered dosage in order to better control the weight loss effect?
posted by Thorzdad at 5:29 AM on May 26, 2010

What fairytale of los angeles said. It increases your risk for seizures, though usually the risk is still minor. It's contraindicated for people with eating disorders both because it can enable them and because the seizure risk is increased even more.

Most of the complaints about generic Wellbutrin are for the Teva-manufactured Budeprion XL, 300 mg in particular. If that's a concern, see if you can find a generic from another manufacturer, or get a script for the 150 mg dosage, which has fewer complaints.

Anecdotally, I've gone on and off antidepressants as needed for a few years. Going back on something I've taken in the past results in much milder, or non-existent, side effects. It might not do anything bad for you, but it might not do anything good after a while either.
posted by Metroid Baby at 6:58 AM on May 26, 2010

I'm in the process of going off Wellbutrin right now, and I've gone through a couple of weeks of stomach aches. Don't know if it's related to Wellbutrin withdrawal or my trip to Mexico two weeks ago, but I've read that stomach cramps can be one side effect of coming off the drug.
posted by Evangeline at 7:18 AM on May 26, 2010

The seizure threshold thing is why I asked about tapering vs. cold turkey. Carefully increasing the dosage allows you to monitor side effects like fairytale of los angeles's leg twitch so that you don't end up suffering a more serious seizure by immediately jumping to a high dose. This is all hypothetical, because I am in no way a doctor. It's just something for you to consider and ask your own doctor about.

Also, I have experienced somewhat the reverse of Evangeline's symptoms, where when I began taking Wellbutrin (I've been on/off several times under doctor's supervision), I had a week or two of upset stomach and nausea. It didn't necessarily cause any damage, but it was unpleasant for sure. Not an ideal way to lose weight.

All of the above is completely anectodal, though, which is just not going to give you an accurate idea of the dangers or health-related reasons one shouldn't go on and off Wellbutrin. You really need to speak with a doctor about this if you want to know the facts. I'm not trying to be judgmental; I've felt much the same way as you do about medications and weight loss. It's most important for you to be healthy, though.
posted by Fui Non Sum at 9:52 AM on May 26, 2010

IIRC Wellbutrin made my migraines more frequent, so if you're a migraine sufferer, that's something to consider.
posted by IndigoRain at 6:25 PM on May 26, 2010

A psychiatrist I was seeing for a meds consult once told me that (I'm paraphrasing from memory here) research seems to indicate that for any particular drug and any particular person, there is a set number of times that you can go off and then back on again and have it continue to work. The problem is that there's no way to know ahead of time what this number is.

So if you take the Wellbutrin for depression, this is something to consider.

Quite honestly, the drug makes me lose weight and I usually miss this after I'm off it for a while even though it doesn't help me otherwise.

Speaking as someone who's been taking it for something like a decade and considers it literally lifesaving, I think it's a serious enough drug with significant enough side effects that this doesn't seem like a good risk-to-benefit ratio. If there's anything else that helps you maintain a healthy weight that doesn't involve taking a psychoactive drug that's apparently not actually having its intended effect, do the other thing.
posted by Lexica at 7:37 PM on May 26, 2010

I read on Lev Grossman's blog that his psychiatrist told him that if you go off Wellbutrin, and back on it, then its effects are diminished the second time around. So if you plan to go on it again, you might want to just stay on it. Then again, there's lots of little things like this out there for medications, so it's hard to say whether it's true or not. You say you've been off it before, so maybe you already know whether it applies to you.

Try eating more, and more protein, and see if that makes a difference? I'm assuming you're upset about losing muscle. If you don't care what weight you gain, try eating more carbohydrates.
posted by Nattie at 11:02 AM on May 27, 2010

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