Q: Akathisia After Wellbutrin|
In Nov. 2002 I was given Wellbutrin as an aide to stop smoking. 12 days later I
felt "like my insides were in turmoil and ready to come out of my chest." I was
then given paxil, changed to zoloft, changed to serax, changed to zyprexa,
changed to depacote with the agitation getting worse with each change. I have
now been disgnosed with bi-polar/depression and the doctor has me taking ECT
treatments! I have read about akathesia, but the doctor insists I am bi-polar.
I cannot sit still more than a few seconds and when I do, my left twitches
badly. The ECT does not seem to help whatsoever. Do you know of a specialist
on the west coast I can call. Please help - I am desperate. I am only 56 years
old and I was an analyst for the State of CA for 35 yrs. before this started.
There is no history at all of mental illness and no indications before the
Wellbutrin that I had any problems.
THANKS - pleae help me and my family.
Dear Gerry --
I've never seen something like this before. Sounds like akathisia that doesn't
quit. Akathisia is one of a collection of movement problems collectively
referred to as EPS: "extrapyramidal symptoms", meaning literally outside the
"pyramidal system", which is the main voluntary movement center in the brain; so
extrapyramidal means the non-voluntary muscle systems of the body, which
are associated with setting muscle tone throughout the body, among other
EPS can be caused by antipsychotic medications, and occasionally by
antidepressants -- particularly the serotonergic ones like Paxil and Zoloft.
I've never heard of EPS from Wellbutrin; it can cause tremor and agitation, so I
suppose some of that could be "EPS" in a sense.
Sorry, this is sort of thinking out loud, as I have no experience with this
nor have I seen it in the literature as such. I wonder what a neurologist would
say and do, though generally they seem to have little to offer in the way of
treatment for something like this. So I offer the EPS business as link to
the literature on "tardive dyskinisia" just in case what you have is something
like that (TD is the long-lasting version of EPS, and includes some variations
called "tardive dystonia" that are closer to your situation).
However, I must emphasize that this is mostly guessing and could be
completely off base (probably is). If there is a history of mood problems in
your family I'd go back to the "unmasked bipolar presenting as agitation after
antidepressants" theory (while keeping my eye on non-psychiatric explanations as
well, like checking thyroid and seeing smart internal medicine doctors also).
Published November, 2003