buproprion and e.d.'s
September 27, 2012 4:37 AM   Subscribe

Why is Wellbutrin contraindicated for patients with eating disorders?

Hi all,

I was wondering why specifically Wellbutrin is contraindicated for patients with e.d.? Is it just the weightloss side effect or does it make them worse? I currently have an ED-NOS-r diagnosis and am symptomatic, but also on 400mg bupropion and it does make a dent in my depression, but not 100% by any means. Should I be on something else?

(I am also on Abilify, Inderal, Cogentin(to counteract twitchies with the Abilify) and Lorazepam prn. Female, mid-twenties.)
posted by lettuchi to Health & Fitness (5 answers total) 3 users marked this as a favorite
It's an appetite suppressant. When I was on wellbutrin I had to remind myself to eat or it wouldn't occur to me until I was about to pass out.
posted by winna at 4:44 AM on September 27, 2012 [5 favorites]

If I recall correctly it's mainly Wellbutrin's link to seizure risk, which seems to be more of a risk in patients with bulimia or who vomit to purge (I believe they suspect it has to do with electrolyte imbalances/radical shifts in blood sugar/dehydration combined with bupropion's effect, but I haven't read the literature in a while).
posted by Uniformitarianism Now! at 6:35 AM on September 27, 2012 [6 favorites]

Yes, there is a definite seizure risk for people with food issues.
posted by elizardbits at 6:51 AM on September 27, 2012

It is not the appetite suppression; appetite suppression is okay for some, not all eating disorder patients. It's the seizure risk - Wellbutrin lowers your seizure threshold. So does electrolyte imbalance, which is most common in bulimics (due to purging). I believe that severe restriction of calories can also lead to electrolyte imbalance, but am not sure.

In my experience, doctors will prescribe Wellbutrin to people recovering from eating disorders, but only if they do not/ no longer purge and there is a very very low risk that they will purge while on it.
posted by insectosaurus at 8:09 AM on September 27, 2012 [1 favorite]

Wellbutrin is bad for anorexics because appetite suppressant. Wellbutrin is bad for bulimics because of the seizure risk. If your ED-NOS includes either restricting or purging, it's something you should talk about with your psychiatrist.

Psychiatrists do prescribe Wellbutrin specifically to patients with binge eating disorder if they don't purge either by vomiting/laxatives or through exercise.
posted by Sidhedevil at 12:00 PM on September 27, 2012

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