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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by smokeymadison on December 21, 2004, at 16:10:47
first, thanks for making yourself available to answer questions on Psychobabble!
i have been anorexic in the past--i was for about three years in high school. it has been four years since then and i have had bouts of bulimia. When my psychiatrist prescribed Wellbutrin, i said that i was not having any problems with bulimia. well, i am starting to again and i am wondering what Wellbutrin has to do with bulimia, if anything. i know that it is not something you should take if you are anorexic, or so i have heard, but is there any reason not to take it if you are bulimic? thanks!
SM
Posted by Racer on December 22, 2004, at 1:16:34
In reply to Steinhauer--Wellbutrin and bulimia?, posted by smokeymadison on December 21, 2004, at 16:10:47
Not the doctor, but I can offer some of the answer.
Wellbutrin can lower the seizure threshold, and this effect is amplified by electrolyte imbalances caused by bulimia. (Actually, it's thought to be a safe enough drug for anorexics, but dangerous for bulimics.) How real the risk is probably has a lot to do with other risk factors, and personal biochemistry. In general, the risk is around one in 250, but I believe it goes up from there with higher dosages and more risk factors.
I look forward to reading what the doctor has to say, but I'll advise in the meantime to tell your doctor that your bulimic symptoms have returned, in order to assess whether it's wise to continue this med.
Posted by Dr. Beth Steinhauer on December 22, 2004, at 11:28:18
In reply to Re: Steinhauer--Wellbutrin and bulimia?, posted by Racer on December 22, 2004, at 1:16:34
Wellbutrin (bupropion) was about to be released to market in 1986, but its release was delayed when it was recognized that it increased the risk of seizures. It was eventually discovered that this risk was dose-related (i.e. the higher the dose, the higher the risk) and that certain populations, such as bulimic women, were also at higher risk. This is because bulimic people often have disordered electrolytes, as their body chemistry is affected by vomiting and laxative/diuretic abuse. Wellbutrin's release to market was delayed until 1989, and the Physicians' Desk Reference still states that Wellbutrin is contraindicated for people with a current or previous history of anorexia or bulimia. The seizure risk is approximately 4/1000 people.
Your doctor likely chose Wellbutrin for you because s/he was unaware that you are actively bulimic. Wellbutrin is an excellent antidepressant with a favorable side effect profile (no sexual side effects, doesn't cause weight gain, enhances alertness and energy). However, for people who struggle with eating disorder symptoms, SSRI antidepressants, e.g. Prozac, Paxil, Zoloft and the like, are thought to be more effective.
I'd recommend that you let your psychiatrist know that you have resumed bingeing and/or purging, so that s/he can reassess the choice of medicine for you.
Best of luck with your recovery!
Posted by Calypso on January 23, 2005, at 0:39:39
In reply to Re: Steinhauer--Wellbutrin and bulimia?, posted by Dr. Beth Steinhauer on December 22, 2004, at 11:28:18
Hi there,
Thanks for all of this information. I am a little worried too about the association Wellbutrin/bulimia: I have been prescribed Wellbutrin and would like to start taking it (have the pills but haven't started taking them yet), but reading the package insert I saw that it was contra-indicated for people with bulimia. I don't know if I fall in this category or not. I am not bulimic per se, but it does happen that when I feel very down, I'll have a small binge and then make myself throw up. This happens maybe a couple times a month when I feel very down; most of the time I'm fine and don't purge for several months in a row.
Should I still avoid taking Wellbutrin? If I start taking it, I can make a commitment not to make myself throw up even if I feel really down, will that do?Thanks in advance!
Posted by vikala on February 4, 2005, at 11:58:41
In reply to Re: Steinhauer--Wellbutrin and bulimia?, posted by Calypso on January 23, 2005, at 0:39:39
I am on Wellbutrin SR (200mg am and 150mg pm) and I have an eating disorder. I plan to slow down and stop the purging, but I am still going to keep my calorie intake low. I can't tell my doc about this, because Wellbutrin and Effexor are the only meds (of 50 that I have tried) that have worked. I won't risk having them taken away. I couldn't get out of bed before this, and now I make it to work 5 days a week. I don't feel great or fantastic, yet, but I'm functional.
I am curious as to:
What type of seizures are they? Is there symptoms or info on what to do if I had one? (to tell my roommates)
Is it tolerable for me to have a calorie intake of about 500-1000 a day and still be on these meds? I am OBESE technically. I lost 20 pounds in the last 2 months. I was too sick to even care about myself for so long I gained 60 pounds. I purge 1-5 times a week.
Any advice is appreciated. Please don't attack me, I've been through enough.> Hi there,
>
> Thanks for all of this information. I am a little worried too about the association Wellbutrin/bulimia: I have been prescribed Wellbutrin and would like to start taking it (have the pills but haven't started taking them yet), but reading the package insert I saw that it was contra-indicated for people with bulimia. I don't know if I fall in this category or not. I am not bulimic per se, but it does happen that when I feel very down, I'll have a small binge and then make myself throw up. This happens maybe a couple times a month when I feel very down; most of the time I'm fine and don't purge for several months in a row.
> Should I still avoid taking Wellbutrin? If I start taking it, I can make a commitment not to make myself throw up even if I feel really down, will that do?
>
> Thanks in advance!
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