Wellbutrin and Seizures

by on August 8, 2012

Wellbutrin (bupropion) is a prescription medicine used to treat depression. As with other medications, it is known to cause a number of side effects and it appears that seizures are one of them. It is thought that Wellbutrin lowers the seizure threshold of an individual increasing the possibility of occurrence  Compared with Wellbutrin regular tablets, the longer-acting form of this drug (Wellbutrin XL) has a lower chance of causing seizures.

What Studies Say?

Clinical studies conducted before this medication was approved by the FDA show that around 4 out of 1,000 people taking Wellbutrin, with a daily dose of up to 450 mg, experience seizures. The risk of seizures is dose dependent such that people who take higher doses have increased chances of experiencing a seizure. Furthermore, the likelihood of a seizure is increased during initiation of treatment and at every dose adjustment. Also, some people have higher risk of developing a seizure compared to others.

Studies further show that seizures were less common among people taking Wellbutrin sustained-release or extended-release tablets.

Alcohol

Drinking excessive amounts of alcohol may increase the chances of experiencing a seizure while on Wellbutrin.  Post-marketing reports suggest that consuming alcohol while on Wellbutrin can cause acute episodes of neuropsychiatric events. It has also been shown that bupropion may likely reduce a person’s tolerance to alcohol.

High Risk Population for Wellbutrin Seizures

Some people are at increased risk of experiencing seizure with Wellbutrin. People with history or existing seizure disorders are at the greater risk of developing seizure with this medication. Wellbutrin is contraindicated in people with seizure disorders.

This medication is also not recommended in people with history or current eating disorders, particularly bulimia and anorexia because of the increased incidence of seizures in these patients. It is also contraindicated in people with severe liver impairment or cirrhosis.

Caution should be taken when using Wellbutrin in patients who have predisposing factors for seizures, including underlying neurologic abnormalities such as brain damage, head trauma or CNS tumors; addiction to street drugs such as stimulants, cocaine, and opiates; chronic alcohol problem or abrupt withdrawal of alcohol use; use of insulin or antidiabetic agents for diabetes; use of sedative agents; and use of other medications that can lower seizure threshold.

The healthcare provider should consider the benefits and risks of using Wellbutrin in such patients to avoid possible adverse effects. In case dose needs to be increased, it should be gradually adjusted to monitor response to treatment.

Preventing Wellbutrin Seizures

To avoid possible a seizure with Wellbutrin use, the total daily dose of the Wellbutrin regular tablet or Wellbutrin extended-release tablet should not exceed 450 mg. Meanwhile, the dose of Wellbutrin sustained-release tablet should not be more than 400 mg per day. You can also discuss with your healthcare provider if it is possible for you to divide your dose of short-acting Wellbutrin into three smaller doses, usually 150 mg or less, taken throughout the day. This may help minimize the risk of Wellbutrin seizure. If you experience seizures with Wellbutrin, be sure to inform your healthcare provider right away.

It is also important that you tell your healthcare provider if you have any of the mentioned conditions. Be sure to consult your healthcare provider before taking this medication. In case Wellbutrin causes severe seizure, your healthcare provider may consider withdrawing the drug or switching it to another antidepressant.