Strattera, Wellbutrin, & Bipolar
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Q:  Strattera, Wellbutrin, & Bipolar


My child has been treated for ADHD & depression, currently prescribed to take Straterra & Wellburtrin.

Is it a concern that if he is in fact BiPolar that these combinations might be making thigns worse.  I have arranged for a specialist to evaluate him but I'm concern that information I have received advises me to take him off this combination of Rx. 

Thanks!
 

Dear Darlene -- 
There is controversy about whether stimulants (e.g. Straterra) can make bipolar disorder worse.  I've been watching the comments about this in the psychiatric literature for several years and opinion still seems about evenly split (half of psychiatrists report their worry about the combination, but the other half announce their sense that the combination is not worsening things.)  The few research studies on this question are not precisely designed to address this question, but even those we have seem to point to opposite answers (e.g. stimulants may pose risk
Soutullo;  and stimulants seem not to pose any riskGalanter). 

By comparison, antidepressant medications (e.g. Wellbutrin) clearly can make bipolar disorder worse.  How often, that's controversial; how much protection against this that one gets from a mood stabilizer, that's not clear either; and when to stop an antidepressant if things are going well, that's controversial too.  But that they can in many people, at least 20% and perhaps more like 30 or 40%, depending on circumstances -- that's well agreed upon.  

The real question here, the place you have to start, is "does he have bipolar disorder?"  Because even those who would consider using a stimulant in someone with bipolar disorder generally agree: "treat the bipolar first". 

Dr. Phelps


Published May, 2004
 

 

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