Please Help-Anorexia and Welbutrin

[LongTermReader]

Hi everyone,

37 year old female here. I've been reading your forums for years but never registered.

I have battled Major Depression with SUI Ideation for years and last year finally found a medication that works great for me- Lamictal.
I also am prescribed Benzos for anxiety but have no addiction to them or any other drug except Vaping 6 mgs nicotine after stopping smoking.

I also have Anorexia Nervosa but had it under control until about 2 months ago. I went through some major stress, my marriage is a dead end and it all hit me a once.
This can jar things around a bit.
BUT....at the same time my Dr put me on a very low dose of 75 mgs Welbutrin.
Then he resigned a week later and I'm currently shit out of luck until next month when I can get it to see someone.

My weight plummeted and while my ED brain has enjoyed the ride a bit, my rational side is HELL NO, we aren't going there again.
Problem is, I am trying to eat but seriously not hungry. I have almost no appetite.

People with anorexia often say they are not hungry but I suspect that is BS because when I was losing weight on purpose I was starving all the time.
I'm honestly not hungry and my weight is getting dangerously low. I don't want to go back to a hospital ($5000 and traumatic for my son) and trying to wait this out until I can see a doctor but I live in a tiny town and this seems to be where the newbies come. In a polite way- they don't know shit.

I have researched online the effects of Welbutrin and Anorexia but these are all much higher doses.
I know the lack of electrolytes can cause seizures (I've had seizures as an epileptic anyway!) and higher doses are an appetite suppressant.

WTF was he thinking? I have no idea.

I am trying to decide whether to just abruptly stop taking the Welbutrin and see if it really is that medication that has caused my appetite to vanish but not sure if it's the best idea and unsure if such a low dose can really cause this kind of appetite suppression.

I'm 5'6 and down to 106 lbs and dropping. I see a Psychologist but he can't say anything about medications.

Yesterday I ate 1 piece of pizza and woke up sick to my stomach in the middle of the night.

Any input or experience here?

Thank you.

 

[Cherrysoduh]

I was prescribed Wellbutrin for smoking cessation. 150mg twice a day. However I only took it once a day. I too had decreased appetite and weight loss with out even trying. I quit taking it because I wasnt ready to quit smoking, it made me not sleep at night, I was barely eating and didnt want to lose any more weight. Weight loss and anorexia are listed as common side effects. In fact people often ask for it instead of traditional depression medicines because of the weight loss side effect. It is contraindicated for individuals with history of anorexia. I would call the prescribing docs office and ask them to get you in with someone else at that office. Since your doc is no longer there. I would think with your hx of anorexia and seizures that they would be more than willing to get you in sooner than later.

 

[Moreaux]

I am very sorry to hear about the stress that's currently occurring in your life right now. In my opinion, you shouldn't have been scripted Wellbutrin in the first place as its counter indicated for both eating disorders and siezures. I know when I took Wellbutrin it killed my appetite, though I wouldn't say I have an eating disorder per se (I am obsessed with my weight and track everything, but it's from my OCD, and I'm not a dangerous weight). I did get off Wellbutrin after only taking it a few months because I dropped down to 100 lbs, and had zero interest in food. Can you see another doctor? Even though low dose, I would be very concerned about just abruptly stopping it for fear of siezures. If you can't see a doctor try tapering off of them.

 

[highflyingsalmon]

I would highly highly recommend seeing a different doctor asap and explaining all of this (in detail) to them, and explain that something is wrong. Cross reference what the new doctor says with your old one and see how different their opinions are and be sure to explicitly state every tiny detail (including emotional ones). Ive done this myself for various mental health disorders and its surprising how one doctor can be so much more helpful than another.
It may be dangerous to immediately come off any medication as the sudden withdrawal could be harmful if you have a history of epilepsy, major depression and SUI ideation. At my very low points of depression i had almost no appetite and even looking at food would make me feel sick, i wasn't on any medication at all, since then i have regained some of my appetite (without use of medication) and eat more regularly. so i can only assume that i was experiencing a psychological problem. Perhaps this is something you can consider as the lack of appetite occurred when all these other emotional factors came into play?

I did some very brief research on when you should not take Wellbutrin - 'Do not use Wellbutrin if you have seizures, an eating disorder, or if you have suddenly stopped using alcohol, seizure medication, or sedatives.'
Additionally it's also mentioned that one of the more common side effects of Wellbutrin is weight change.
Following this, it seems you should not have been given a prescription of it, i recommend trying to lower your dosage to reduce the risks and try and see a doctor as quickly as possible. Do not immediately stop taking it as it can have unpleasant withdrawal effects. I couldn't find any solid evidence of Lamictal reacting badly with Wellbutrin so i think that can be ruled out as a cause.

The problem with taking multiple medications as well as having a history of mental illnesses is that any symptoms could be as a result of various different things, making it hard to identify the exact problem. I hope that some of this was helpful, and if not i hope that someone else is. I wish you the best of luck and please try to stay away from taking any new drugs (legal or illegal) in the mean time .

 

[SKL]

Wellbutrin is not a good choice for you, full stop. Lamictal does not in any meaningful way and in ordinary doses and circumstances either with benzodiazepines or Wellbutrin; it might manage but not eliminate sz risk as might benzos, and will do nothing for your appetite. The ED, thing, however: if your BMI is going south of about 17 and decreasing since the Wellbutrin started, it's almost certainly not helping and probably making matters worst while at the other end of the spectrum it may both (a) manage depressive tendencies, although this is a tiny doze even though are probably yoursellf quite small (b) and actually can possibly worsen anxiety which as I assume you know having been in therapy/done reading about ED can in and of itself be a trigger for unsafe eating practices, this coupled with the anorectic (appetite-supressing, not to be convinced with the diagnosis of anorexia nervosa) effects of Wellbutrin itself is not a good combination.

Lamotrigine is a good mood stabilizer especially in bipolar(II) cases where in layman's terms the depression is of more severity than the mania (in these cases, hypomania), and can itself have antidepressant qualities but is more usually used as an adjunct to another antidepressent, Wellbutrin for the aforementioned reasons not necessarily being the best case.

Your best choice of action until being able to see another doctor would probably be the discontinuation of Wellbutrin and the management of anxiety, etc. with benzodiazepines which can mildly stimulate appetite (nowhere near the extent to manage the opposite effect of Wellbutrin), coupled with using techniques you have used in therapy and an ED visit as a last result in the case of serious suicidal ideas or threat from electrolyte or caloric imbalance due to anorexia.

There are no acute risks to stopping Wellbutrin (as opposed to, say, Lamictal or benzos which could cause seizures) apart from the risk of rebound depression, but in the overall context and at this dosage I would see this as probably the lesser evil. But overall it is imperative that you get to capable psychiatric care in the very near future and this may very well involve an inpatient stay if, as you recognize, your suicidality or eating tendencies are unmanageable. Despite suicidal ideation it sounds that you do have will to live and protective factors which are positive; while trying to manage your own way out of a difficult settings these will be things that will be very important to keep in mind.

Please be advised that I have not evaluated you in person, or in any other clinical setting, nor your records or among other things, your overall life situation and the larger context of your illness, psychiatric and medical history, overall life situation, medication history, and so forth, and nothing that I say here can or should be taken as clinical advice.

Short of clinical advice, please do feel free to contact me however.

 

[GoPoundSand]

Wellbutrin killed my appetite. I hated how I felt on it and it gave me the tremors really bad. Hated it.

 

[paranoid android]

Wellbutrin is contradicted in people with Anorexia so it is insane to put someone who has suffered from a eating disorder on this drug. I take it for Bipolar Depression and especially SAD and it does not lower my appetite but i only lose my appetite when i am miserably depressed.

My suggestion would be to go see another doctor ASAP.