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wellbutrin and seizure risk


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i know this has been addressed in other threads (feel free to merge this) but i have a question about the seizure risk of wellburtin.  everything i've read says the risk is low and dose dependent....

first, background:  i have a strong family history of epilepsy, both trauma induced and sudden onset.

i used to take wellbutrin xl 300 mgs.  it caused me to be shakey and jerky.  according to my husband, while i was on it, i would suddenly jerk in the middle of the night quite a bit.

i don't know if these were myoclonic jerks or just the normal way some people jerk in their sleep.  but he did say that they stopped when i went off the wellbutrin.

right now i'm not on any ADs b/c the SSRIs/SNRIs trigger mania. 

i'd like to go on wellbutrin b/c 1) i really want to quit smoking.  i stopped for a while, but i can't seem to kick it this time.  (adderall makes me really want to smoke for some reason.) and 2) i feel like i'm slipping into a depression.  BUT, i did just have a very close family member die, so this could be like normal greif depression and not slipping into a clinical depression.  i don't know.  i mean, my depression has been pretty much gone (other than when under extreme stress and with this death) so maybe i don't need the wellbutrin for that and i'm just wanting it for smoking cessation.

anyway... i was thinking of trying 150 mgs XL... but well, considering that the family member who just passed died of SUDEP, i'm feeling super paranoid. 

do you think that the fact that i was jerking in my sleep while on wellburtin is a sign that the seizure risk for me is high? 

i never saw a neuro about the jerks, because this was before i knew that there was a such thing as a myoclonic jerk.  but the fact that they stopped when i went off...

anyway, any input is appreciated.

penny

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i'd like to go on wellbutrin b/c 1) i really want to quit smoking.  i stopped for a while, but i can't seem to kick it this time.  (adderall makes me really want to smoke for some reason.) and 2) i feel like i'm slipping into a depression.  BUT, i did just have a very close family member die, so this could be like normal grief depression and not slipping into a clinical depression.  i don't know.  i mean, my depression has been pretty much gone (other than when under extreme stress and with this death) so maybe i don't need the wellbutrin for that and i'm just wanting it for smoking cessation.

Regardless of the cause of the depression, when you're depressed you're depressed and if you're prone to clinical depression you're likely to fall a lot lower and stay there longer than someone who is not.  I think you are right in being cautious about this, particularly since you are already on Adderall.  You should definitely make a pdoc appointment and bring it up there.  Dealing with the grief in therapy could also help keep you from sinking again.

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Regardless of the cause of the depression, when you're depressed you're depressed and if you're prone to clinical depression you're likely to fall a lot lower and stay there longer than someone who is not.  I think you are right in being cautious about this, particularly since you are already on Adderall.  You should definitely make a pdoc appointment and bring it up there.  Dealing with the grief in therapy could also help keep you from sinking again.

i see my pdoc next friday.  i was already planning on asking him about the risk, etc.  but sometimes you guys have more personal experience, ya know?  (wait... i don't have to justify this site to you or me, lol)

maybe i'll take advantage of the free school tdoc service this quarter.  no, i WILL take advantage of it.  (i just hope they have some good ppl there, heh.)

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Heya Penny,

By all means get pesonally assessed for risks/benefits!

In the meantime, the degree of risk of seizure for *you* is related to how close the family member(s) are who have/had seizure disorders.

Likely, if this was your parent, brother or sister, the doc won't recommend Wellbutrin/Zyban/bupropion.

--ncc--

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I started Wellbutrin a few weeks ago. I was also concerned about seizures (although I don't have a family history of it). I'm just a little med paranoid lol. Anyway, I think a lot has to do with the dose/type. If I remember correctly, Wellbutrin XL has a lower chance of giving you seizures then the immediate release formula does. Your pdoc may say no way, or give you a lower dose. I feel a little "jerky", but not too bad. Mostly my head/neck feel kinda weird, but I've experienced much worse side effects (damn Zyprexa!! lol). That's my 2 cents. Good luck, and let us know what the doc says.  ;)

Jacki

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Myoclonic jerks while you are falling asleep are quite normal but during sleep and at certain points within the sleep cycle while you are asleep are not (I'm not a neuro, mind you...)  I was having some of these and they basically cleared up along with all of my other seizure problems with the right meds.  I'm just a little concerned about the family history stuff plus these "jerks" while you are asleep.  I believe it also can depend on how long they last.  A little "twich" here or there could possibly be a muscle spasm as opposed to seizure activity if the jerks are prolonged.  At least this is my line of thinking.

And the shakiness and jerkiness while you were on the drug? How did that manifest itself? Both myoclonus and tremor are listed as a fairly common side effects (checked on rxlist.com...FYI if you want to know.)  Hard to tell though if it is/was seizure related in your case.

Seizure risk was mentioned as dependant and also based on concomitant meds.  Also family history which of course we are all talking about.  Divided dosing was also recommended to avoid peak plasma concentrations.

Definitely something to review with your pdoc.  Good luck and let us know.

Also, as a sidenote, someone once told me that "Zyban" didn't work for those who wished to quit smoking if you suffered from depression.  That it only worked as a smoking dessation drug if you didn't need it as an antidepressant.  I don't know if that's just bunk or not.  Anyone who is simultaneously depressed and a smoker ever use the drug successfully for both treatments? Maybe that deserves a new thread.

Karen

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Myoclonic jerks while you are falling asleep are quite normal but during sleep and at certain points within the sleep cycle while you are asleep are not (I'm not a neuro, mind you...)  I was having some of these and they basically cleared up along with all of my other seizure problems with the right meds.  I'm just a little concerned about the family history stuff plus these "jerks" while you are asleep.  I believe it also can depend on how long they last.  A little "twich" here or there could possibly be a muscle spasm as opposed to seizure activity if the jerks are prolonged.  At least this is my line of thinking.

yeah, they weren't the normal falling asleep jerks.  they were when i was dead asleep and apparently violent enough to wake up my husband (then fiancee.)  and they did stop when i stopped taking the wellbutrin.

And the shakiness and jerkiness while you were on the drug? How did that manifest itself? Both myoclonus and tremor are listed as a fairly common side effects (checked on rxlist.com...FYI if you want to know.)  Hard to tell though if it is/was seizure related in your case.
yeah, i know... it makes a lot of people shakey.  (i'm so confused right now, sorry if i start to ramble here.) it even made my friend shake and sweat profusley.  at least i didn't sweat.

during the day it would just be occasional hand tremors.  and at night, well i don't know because i was asleep but hubby would occasionally wake me up to see if i was ok.  i asked him if i looked like i was seizing and he said no, just either kicking or jerking.  (neither of us knew about seizures other than partial complex and tonic clonic at the time, and neither of us has seen a myoclonic so i wouldn't know one if i did see one probably)

oh.  and there was a time on wellbutrin where i started yelling at him and i don't remember that at all and i wasn't like drunk or something.  then again i used to dissociate (but i didn't black out while dissociating, so... )  but it's not like i really gave it a thought past "i think you're making that up, but ok"

Seizure risk was mentioned as dependant and also based on concomitant meds.  Also family history which of course we are all talking about.  Divided dosing was also recommended to avoid peak plasma concentrations.

Definitely something to review with your pdoc.  Good luck and let us know.

yeah.  i already take adderall.  and i'm not giving that up.  le sigh.  i see pdoc on friday.

wtf is a girl to do for depression if the seratonin meds make her into a foaming at the mouth dysphoric dish breaker and she can't take wellbutrin?

Also, as a sidenote, someone once told me that "Zyban" didn't work for those who wished to quit smoking if you suffered from depression.  That it only worked as a smoking dessation drug if you didn't need it as an antidepressant.  I don't know if that's just bunk or not.  Anyone who is simultaneously depressed and a smoker ever use the drug successfully for both treatments? Maybe that deserves a new thread.

nah.  when i was on wellbutrin i had to FIGHT to keep smoking.  which is kind of gross.  it would make me want to puke.  but dammnit i was dead set on smoking at the time.

thanks for your post. 

i guess this is an unanswerable question.

i get the feeling that friday's session will be about risk assessment and whether or not the risk is worth taking... le sigh

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Heya Penny,

By all means get pesonally assessed for risks/benefits!

In the meantime, the degree of risk of seizure for *you* is related to how close the family member(s) are who have/had seizure disorders.

Likely, if this was your parent, brother or sister, the doc won't recommend Wellbutrin/Zyban/bupropion.

--ncc--

heh.  every single member of my mother's side has had a seizure.  mom, grandma, both aunts, three cousins.  which is enough to make me scared to just sit here.  but not all of them were spontanious.  there's some drug use, alchoholism and head trauma in there. (a healthy bunch of people, really.  heh.  at least my dad seems to have not passed any neurological or mental illness genes my way.  just teeth that needed braces ;) )

my dad  said my mom had a non drug related (she had, at points in life, been quite a coke addict, but she was clean at the time) tonic clonic but i don't know too much about it because i don't talk to my mom and my dad doesn't really enjoy revisiting memories about her.  and i don't know anything about her current health at all. 

maybe i should try those niccotine candies or that foul gum.  and just hope that if i keep busy i don't slip back into depression from my cousin's recent death. 

i dunno.  i'll see what the doc says on friday.

i'll let y'all know.

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just to end the story for y'all...

doc put be on 150 xl.  desire to smoke is already gone.  hopefully it'll help mood at that dose too.

he said despite my fam history, with xl and that dose i was safe. 

and, he pointed out that during the time i was having the jerks, i was still in nyc and quite  a heavy drinker, so my risks now are lower than before.

anyway.  most of the session turned into a how to deal with death thing and him talking me out of epilepsy paranoia... and it was a good session.  and some other med tweaks will be added in over the next 2 months probably.

but yeah.  basically he really calmed me down about my epilepsy (and sudep) fears.

i love my pdoc.

sorry if that was disjointed.  i'm exausted.

so, er... moral of the story.  risk at 150 with xl with no eating disorder and no drinking is super low.

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