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Dr. Bob is Robert Hsiung, MD,
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Posted by SalArmy4me on June 9, 2001, at 22:14:29
I think that the risk of seizures associated with Wellbutrin is exaggerated. In the early studies, the rate of occurence was about 0.30 percent in general patient populations at dosages as high as 900mg. This is about equal to the tricyclics. More recent studies indicate that the SR (sustained release) version of Wellbutrin at dosages up to 300mg carries no greater risk to produce seizures than most other antidepressants; the rate being about 0.10 percent. However, the rate of seizure increases significantly in people with a pre-existing seizure disorder. It is also increased when treating people who have an imbalance of electrolytes such is seen in eating disorders like bulemia. The rate of seizure also increases at dosages greater than 300mg. Even so, the rate at 450mg is no greater than that of the tricyclics. I would not want to speculate at dosages exceeding 450mg. More frequent dosing helps to minimize risk. It was during a pre-marketing investigation designed to study the efficacy of Wellbutrin in treating bulimia that seizures emerged. I think most of the bad reputation this drug has was born of that study.
Posted by Elizabeth on June 10, 2001, at 10:04:50
In reply to Seizures in Buproprion HCL, posted by SalArmy4me on June 9, 2001, at 22:14:29
> It is also increased when treating people who have an imbalance of electrolytes such is seen in eating disorders like bulemia.
Bulimics don't tend to suffer electrolyte imbalances; anorexics (or depressives with serious weight loss) do. Wellbutrin may also be a risk for people with anorexia nervosa or appetite loss because it tends to decrease appetite.
The evidence to support the idea that Wellbutrin is a risk for people with bulimia nervosa (a single study which was not designed with the intent of testing seizure risks) is not terribly compelling.
-elizabeth
This is the end of the thread.
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