Here's some drug company info on Wellbutrin you might like to see.  This 
isn't submitted in the spirit of debate, just information:  I am generally 
anti-pharmaceuticals, although I've taken plenty in my time;  A few years ago 
I took Prozac and got my Joy back: what a relief!  But I don't think I would 
ever take an antidepressant again.  I've realized that the drug corporations 
are withholding a lot of negative infomation on their products (and God knows 
we get blasted with chemicals in this country every day, just in our food!).  
The following info is just what they're willing to admit.  Anyhoo, here's the 
quoted material:

In a letter to health professionals,1 Health Canada and GlaxoSmithKline
stated that 1127 reports of suspected adverse drug reactions for bupropion
were received between May 1998 and May 28, 2001. Included were reports of 19
deaths (including 1 case of liver failure, 1 case of myocarditis, 3 cases of
suicide), 172 reports of seizures or convulsions and 37 reports of
serum-sickness-like reactions. Although cause-and-effect relations have not
been established in the vast majority of the reports, it is important to
remind physicians and warn patients of possible adverse effects of this
medication.

The drug

Bupropion appears to block noradrenergic reuptake and dopaminergic reuptake
in the brain. It is used as an antidepressant (marketed in Canada as
Wellbutrin SR) and as a smoking cessation aid (marketed in Canada as Zyban).
Common adverse events include dry mouth and insomnia, nausea, headache and
rash.2 Bupropion is known to reduce seizure thresholds, with a seizure rate
of about 1 in 1000 subjects treated.3 Anaphylactoid reactions, including
dyspnea, angioedema, urticaria and pruritus, have been reported at a rate of
1 to 3 cases per 1000 patients enrolled in clinical trials.2 Symptoms of
arthralgias, myalgias and fever and rash resembling serum sickness have been
reported rarely. For detailed descriptions of drug interactions and adverse
effects, see the product monograph.

What to do

Patients should be warned of the risks of potential serious adverse effects
of these medications, including seizures and allergic reactions. Zyban and
Wellbutrin SR should not be administered concurrently, nor should they be
prescribed to patients with a seizure disorder. Furthermore, bupropion
should not be administered to patients with conditions altering the seizure
threshold, including anorexia nervosa or bulimia, patients with potential
benzodiazepine or alcohol withdrawal, those with head trauma or central
nervous system pathology, or patients taking antipsychotic drugs, systemic
steroids, quinolone antibiotics or antimalarial drugs. Doses should be
limited to no more than 150 mg per single dose and to no more than 300 mg
per day. If a seizure or allergic reaction occurs, the medication should be
discontinued and appropriate medical attention sought. To avoid prolonged QT
intervals and ventricle arrhythmias secondary to thioridazine toxicity,
bupropion should not be administered if a monoamine oxidase inhibitor or
thioridazine antipsychotic drug has been given within the past 14 days.
Bupropion is contraindicated in patients with severe hepatic impairment. A
patient information sheet is now available online.4 - Eric Wooltorton, CMAJ

Offered with concern and respect,
Neil
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