Bulimia and Wellbutrin?

Question

BACKGROUND:

-in recovery from bulimia

-have been taking prozac 20 mg once daily for 3 months

-can't stand side effects of prozac (no s*x drive, suicidal ideation, tired during the day, insomnia at night, nausea, weight gain)

-haven't purged in over 2 and 1/2 months

-have never been underweight

-want to switch to Wellbutrin but shrink says it's contraindicated for eating disorder patients

QUESTION:

Will I ever be able to switch to Wellbutrin (like if my electrolyte levels are normal etc.)? If so, when, like how long after I've stopped purging? Can my doc somehow check to make sure my electrolyte levels and all that stuff is normal so it's okay to switch to Wellbutrin? Or are you NEVER allowed to take it if you've ever had an eating disorder in your lifetimen (if this is the case, then why)?

Answer 1

Hi ilks42,

The reason that your doctor probably wants to avoid switching to Wellbutrin at this time is that it really has not been all that long that you have not been purging.  Since you made the reference to "electrolyte levels," it sounds like someone has explained to you that Wellbutrin is contraindicated in people who may be prone to seizures, including anyone whose electrolyte balance may be disturbed.  The problem is not your electrolyte balance at this precise moment--the problem is that if you did have a relapse and begin purging again, it would be safer for you to be on Prozac than to be on Wellbutrin, because it would be less likely to cause seizures.  So your psychiatrist is correct--Wellbutrin is contraindicated for your problem.

A more delicate issue is that of suicidal thoughts (or "suicidal ideation" in psych-speak)--Prozac has been shown to reduce them, Wellbutrin has not.  I am not going to ask whether or not this is an issue for you, but that is something else that I would consider if I were your psychiatrist.

If the Prozac is specifically being prescribed to treat your bulimia and there is no concurrent depression, it is probably appropriate.  If you continue your great progress and you do continue to need an antidepressant in the future, perhaps your psychiatrist will eventually consider switching you over.   Of course, as the PP said, a second opinion is never inappropriate.

I wish you all the best in your recovery!

Answer 2

I always get a second professional opinion in a situation like yours and I'd recommend that you do too !

Answer 3

According to my knowledge , Wellbutrin are not contraindicated in bulimia , but I recommend another antidepressant with less side effects like effexor XR