Wellbutrin

[FoundersBrew]

Doc put me on Wellbutrin and says to only have one or two beers, at most, per night. Does anyone have any experience with this? I hope he is just being extremely cautious! This sucks!

 

[Brek81]

YMMV, but i have been on wellbutrin for a while now, I defiantly can have more than two , it seems the line between "okay" and "tipsy" narrows though. My recommendation is to take it slow and see how it goes, as everyone handles med's differently. Even more so whith med interactions. Hope that helps, and hope you feel better.

 

[E-Mursed]

The clinical teaching for the drug is to have no alcohol at all....so you're doctor saying to have 1 or 2 beers a day is pretty generous.

I wouldn't suggest getting your health care advice on a homebrew forum. :cross:

 

[FoundersBrew]

The clinical teaching for the drug is to have no alcohol at all....so you're doctor saying to have 1 or 2 beers a day is pretty generous.

I wouldn't suggest getting your health care advice on a homebrew forum. :cross:

Like I stated, I already spoke to the doc and got his professional advice; just throwing this out to see if anyone else has the same issue.

 

[emjay]

I had no problem with alcohol on 300mg/day when I was taking it. I have a pretty extensive knowledge of pharmaceuticals like these (as a neuroscience student who's done a significant amount of research on psychotropic pharmaceuticals) and I tend to educate my doctors when it comes to things like these, but even the ones I've spoken to acknowledge that these warnings tend to be overkill (NEVER assume this to be the case.)

I'm not sure if you're taking this for smoking cessation or other reasons (based on your reference to the brand name Wellbutrin, I would assume the latter), but it's unimportant. Knowing your dosage would help a bit though.

Ultimately, Wellbutrin is an antidepressant, and virtually all antidepressants carry a warning against alcohol. Most of the time, they are almost completely unnecessary, but there IS a bit of merit to the warning in this case. One serious side effect of the drug is that it lowers the seizure threshold. Alcohol technically tends to raise the seizure threshold (through the exact same mechanism as certain anti-epileptic drugs), but heavy intoxication has been known to lowers it, and due to the fairly rapid speed with which it is eliminated from your bloodstream, alcohol actually produces a rebound effect (sort of like withdrawal) where the seizure threshold is then subsequently lowered, particularly after you stop drinking. The effect is far stronger in chronic alcoholics who stop drinking, which can produce serious and even fatal seizures, so an alcoholic on this medication would absolutely *have* to keep drinking, but for the same reasons, giving this medication to alcoholics is very uncommon, and often considered reckless.

So basically, it's the combination of both Wellbutrin's and alcohol's ability to lower the seizure threshold that makes the warning important. Luckily, the effect dose-dependent, which means that lower doses means a less serious effect, so a couple drinks is fine for most people. The effect is actually particularly dose-dependent for Wellbutrin though, almost non-existent at lower doses, but quite serious at higher doses, which is why I said it would help to know your particular daily intake.

The most important warning I can give you is not to let the lack of a bad experience give you the confidence to increase alcohol consumption... not even ONE night of heavy drinking. With psychotropic drugs, effects can USUALLY be gauged as you increase the dose (eg, you can monitor how drunk you are with each additional drink, allowing you to stop before you get "too" drunk), but that is not the case here - it is impossible to monitor your seizure threshold. You will either have a seizure, or you won't... there's no in-between. So make sure you keep things in moderation, don't get cocky, and you should be fine.

 

[FoundersBrew]

emjay,

Thanks for the input! I think I will be fine, because my dosage is low (150mg each morning) and I only have beer on the weekend and even then it is in moderation at about four pints a day. I believe I will taper the amount I drink down to two pints and see how that affects me and then gauge from there.

 

[Revvy]

The clinical teaching for the drug is to have no alcohol at all....so you're doctor saying to have 1 or 2 beers a day is pretty generous.

Yeah, most of the time with any anti-depressant it's NO Alcohol. It is believed that it negates the effects of the medication, and can even increase suicidal thoughts/behaviors.

So I wouldn't complain if you're being allowed 2 beers a night, it could be a doc who still adheres to the no booze rule whatsoever rule.

 

[Homercidal]

Beer is my anti-depressant.

 

[InLimbo]

I was told not to drink shortly after taking the medication, and I was taking it in the AM. I have been on every dosage up to and including 450mg of Wellbutrin XL (extended release) daily. I never had any problems. I averaged between 10-12 hours between taking the Wellbutrin, and having beer at night. I'm not trying to dispense advice on here, but I'm telling you what I was instructed to do, what I did, and what my experience was.

 

[maltoftheearth]

Yeah, no alcohol is the rule here. On the plus side, Wellbutrin is relatively ineffective in my experience so I would go ask your doctor about ditching the medicine altogether.

 

[emjay]

Yeah, no alcohol is the rule here. On the plus side, Wellbutrin is relatively ineffective in my experience so I would go ask your doctor about ditching the medicine altogether.

300mg/day is often considered to be the point at which a lot of people see effectiveness.

However, with that being said, Wellbutrin is much more well-regarded by most of the profession for augmenting ANOTHER drug. Often an SSRI, as it then covers all 3 of the relevant neurotransmitters, instead of just serotonin. It also helps to reduce many of the side effects from SSRIs - most importantl daytime fatigue and sexual dysfunction. Again 300mg/day seems to be the magic number... lower doses are of questionable effectiveness.

If Wellbutrin works for you though, that's fantastic. It is far better, in my informed opinion, to be taking that, rather than having to rely on an SSRI/SNRI, or a tricyclic, MAOI (which I'm currently tapering off of), or an atypical. If it's truly helping, it's not worth getting off of just because of the alcohol thing. Heck... with the med I'm on, I can't drink ANY draft beer whatsoever (bottled is fine), and have to minimize my consumption of live yeast... even a single 1-pint bottle of hefe (with the yeast re-suspended) will give me a bad headache, and at some point beyond that (I haven't pushed it), it can get as serious as a stroke... literally.

But unless you have some other major risk factor for seizures, there's really no problem at all with having a few beers, at most doses. If you're at 450mg/day (high enough that many doctors won't even prescribe it), then I'd be a bit more cautious, as the seizure threshold is affected rather exponentially (ie, chances are even more than doubled when going up to that from 300), but even then it generally wouldn't be an issue, unless, as I already mentioned, you have another major risk factor for serious.

Point is though, it ought to be absolutely okay as long as you don't get hammered. 2-3 beers is fine for most people (depending on your weight, and of course the ABV of the beers), and you could probably even get away with a couple more if they're not too strong, but when I give advice like this, I'd much rather err on the side of extreme caution - which is what 2-3 beers really is, especially at a mere 150mg/day. In fact, the seizure threshold for most people is barely affected at this point, and the vast majority of people would probably be fine up to the point of a blackout (as in memory loss... not unconsciousness). But some people are already more naturally prone to seizures, and going so carelessly overboard can cause a much more severe (and therefore dangerous) seizure), so I can't advise more than three 12-oz beers up to 7%... we'll call that 21 alcohol units (21 AU).

Of course, some people are going to take it further than that despite all advice, and I'm a big proponent of harm reduction. So I'll just add that if you're going to disregard exceed the recommended limits (and let's be clear... I STRONGLY advise you don't, then you can at least make it safer by titrating to a larger amount - ie, never increase your consumption by more than 3-4 AU per day, so that if something DOES happen, it's not nearly as severe. Also make sure you're with somebody else if drinking more more than just a couple, as well as afterwards - the most vulnerable period for something to happen is actually as your BAC *DROPS*. And lastly, make sure you don't drink too soon after taking your dose, and don't take your dose while you're drinking, still intoxicated (even slightly), or for a short while afterwards. Your blood level of Wellbutrin XL is at its peak an hour or two after taking it, making it the most vulnerable time of day. But let me reiterate one more time that none of this is should be taken as a go-ahead to exceed the 2-3 beers, I STRONGLY advise against it, and this info is only here to help you be *a bit* safer if you're reckless enough to ignore the warnings.

But before you do anything, I have one further question which is surprisingly important with this particular drug, as it could change everything depending on the answer: Assuming by your once-daily dosing that you are taking the XL formulation (and if for some reason you're not, which ARE you taking - SR, or instant release?), is this brand name Wellbutrin XL, or generic bupropion XL, and if it's generic, who manufacturers it?