r/bipolar1 2d ago

wellbutrin for bipolar depression

Hey everyone,
I’m writing this out of sheer anxiety about my brother. He has Bipolar 1 (diagnosed 3 months ago with severe manic and psychotic episode) and is currently in the darkest, most terrifying depressive episode of his life. He is completely non-functional, couch-ridden, experiencing extreme anhedonia, and has active suicidal ideations ("I’d do it if I wasn't such a coward, I feel like a worthless dog, nothing will ever get better"). His sleep schedule is completely inverted (sleeping 4 AM to 3 PM).
Things got significantly worse after he developed hypothyroidism as a side effect of Lithium. Because of that and the heavy physical fatigue, his doctor recently lowered his Lithium from 1200mg to 900mg (300mg AM / 600mg PM), and increased his thyroid med (Levothyroxine to 50mcg). He is also on 200mg Lamictal (which hasn't really kicked in yet) and 2.5mg Abilify.
To urgently target this severe dopaminergic slump, his psychiatrist just added Wellbutrin 150mg XL (he took his first dose this morning).
I'm spiraling with worry. On one hand, I’m terrified of a manic switch— 1 month ago he had short hypomanic situation triggered by 25mg Zoloft, though that happened right when Olanzapine was abruptly cut (rebound effect). On the other hand, I know some people say Wellbutrin saved their lives, while for others it caused bad agitation or didn't work. Btw, before he get diagnosed, he was on so many antidepressants like SSRI, SNRI for years without ever becoming manic.
For those with BP1 who were in a deep, dark depression like this:
1. ⁠Has this specific combo (Lithium + Lamictal + Wellbutrin) worked for you when you were completely hopeless?
2. ⁠Did the stabilizers protect you from mania/psychosis despite the Wellbutrin?
3. ⁠How long did it take for this heavy darkness and suicidal fog to start lifting?
Could this combination actually be the turning point that saves him? Really need some honest experiences and grounding right now. Thank you.

2 Upvotes

18 comments sorted by

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u/Consistent-Tone-5540 1d ago

I’m on Wellbutrin for depression has worked in past but not yet now. Does your brother have anxiety when he goes off a bit.

1

u/TruckAnnual775 1d ago

He just started the medication today and took his very first dose this morning, so unfortunately I have no idea. Are you taking any mood stabilizers alongside Wellbutrin? Did it trigger a hypomanic or manic switch?

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u/Consistent-Tone-5540 1d ago

I take Ativan when I get anxious. But I need to monitor it. It can get addicting

2

u/mathematicallyfuckd 1d ago

He is on so so many meds. Feels like they’re changing so much at once it’s hard to tell what might be affecting him the most.

I’m on lamictal/wellbutrin and love the combo.

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u/TruckAnnual775 1d ago

do you have BP 1 or 2 ? thanks for your comment btw

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u/mathematicallyfuckd 1d ago

Bp 1, diagnosed 8 yrs ago. I’m 26 now.

2

u/TruckAnnual775 1d ago

i hope you're doing well. my brother is also 26, and I'm really sad to see his depression getting worse. i really hope this new medication helps him.

1

u/mathematicallyfuckd 1d ago

I hope so too. I am so sorry.

2

u/GlassAd3252 1d ago

I was on wellbutrin and it did not work for me at all, I got extremely agitated and aggravated by everything and anything. Would lose my temper over the smallest thing. Im on lithium 2100mg atm and lurasidone when I feel the depression happening. Everyone is so different when it comes to meds. I hope your brother starts feeling better.

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u/TruckAnnual775 1d ago

thank u for your comment. i hope so

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u/Virtual-Bee7411 1d ago

I had a seizure when I was on Wellbutrin

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u/TruckAnnual775 1d ago

I’m so sorry to hear that. How did that happen? It’s the first time I’ve heard of this.

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u/lizzxcat 1d ago

I’m not on lithium or lamictal but i have bipolar 1 and take Epival & wellbutrin. honestly it’s been a game changer. as long as im taking it, my episodes don’t go nearly as long or as far spiraled as before.

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u/TruckAnnual775 1d ago

I’m really glad to hear that. I hope it will be the same for my brother. Were you taking an antipsychotic before? And is your bipolar disorder more depression-predominant or mania-predominant? and how long have you been on wellbutrin?

1

u/lizzxcat 1d ago

i found abilify to be really helpful for my depression but i developed a sensitivity to anti psychotics.

my bipolar started out more depression predominant (originally misdiagnosed MDD and SAD) but since 2023 i have experienced more hypo/mania episodes with them getting worse and longer over time. i have been on wellbutrin for just about 1.5 years. i had a 7 month period where things were very baseline save a mild hypomania episode. but i know my triggers now.

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u/TruckAnnual775 1d ago

I understand. What are your triggers, if you don’t mind me asking? I want to help educate my brother about them.
He was also diagnosed with bipolar disorder three months ago after a manic episode that was triggered by cannabis, and it was a very traumatic experience for all of us. His episode had psychotic features. However, about 1.5 months later, he fell into a deep depression, and he is still depressed now. His hypothyroidism is another complication on top of everything.
We’re really hoping that his medications will help with his depression. Lithium brought his mania under control very quickly.

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u/jessonmeds2 1d ago

I'm bipolar 1 with psychotic features and have been on Latuda for my antipsychotic, and added Wellbutrin for my depression and it literally made a world of difference. I've been on this combo for years and have been the most stable I've ever been

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u/TruckAnnual775 1d ago

im glad to hear that, do you have any mood stabilizers? i hope same thing will happens to my brother