Wellbutrin and Seizures in Alcoholics?

[ryerica22]

Hi,
I was wondering how often does this happen? I have a patient who is liking the Wellbutrin but is drinking socially on the weekends (5-6 beers). I always advise them to reduce Alcohol consumption and educate regarding seizure risk. I only have them on the SR formulation, but would like to do XL to minimize BID dosing.

Thanks

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[valid username]

Wouldn't it be the withdrawal from EtOH that would be concern for seizures? This persn is drinking alot at a time but only once a week, rt?

 

[splik]

if drinking 5-6 beers on the weekend = alcoholism we're all screwed.

 

[Liquid8]

Thought that seizures on Wellbutrin was dose related, with greater risks being associated with doses above 450mg/day. However, I don't prescribe it much due to the horrendous pricing in Australia.

Regarding alcohol, intake can raise the seizure threshold and it is cessation and withdrawal which is associated with seizures.

 

[WisNeuro]

if drinking 5-6 beers on the weekend = alcoholism we're all screwed.

So, in DSM-VI, we're going to see the prevalence of alcohol use disorders climb to about 50%+ of the population?

 

[TexasPhysician]

I wouldn't define that as alcoholism. Seizure risk with wellbutrin has been extremely low in my experience.

 

[PistolPete]

If it's working for him/her, keep it and just document that you talked with them about the (low) risk of seizures.

 

[Blitz2006]

I believe on uptodate it states there is a 0.04% chance of seizure up to 450 mg q24h, and above 450 mg it is 3.0%.

So that's why max dose is 450 mg q24h. BTW, I always use XL not SR.

I wouldn't worry about once a week drinking. I think wellbutrin is pretty safe with that regard. I personally only avoid Wellbutrin in patients with a seizure disorder or blatant EtOH use disorder. But honestly, good thinking. Better safe than sorry.

But I agree with pistolpete, I always document that I explained to the patient the above percentage of seizures.

 

[PsyDr]

So, in DSM-VI, we're going to see the prevalence of alcohol use disorders climb to about 50%+ of the population?

Buddy, it's already 29.3% according to the CDC.

Preventing Chronic Disease | Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011 - CDC

 

[675015]

B

Buddy, it's already 29.3% according to the CDC.

Preventing Chronic Disease | Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011 - CDC

Binge drinking in the last month isn’t alcohol use disorder...

 

[WisNeuro]

B


Binge drinking in the last month isn’t alcohol use disorder...

By itself, no, but tack on 2 symptoms of AUD and then it is. Drinking more than planned and a couple of hangovers would technically qualify.

 

[Shikima]

I remember someone saying on this forum how the seizure threshold was effectively embellished from the study published on Wellbutrin (my words).