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Wellbutrin Frequently Asked Questions
Q: What is Wellbutrin?

A: Wellbutrin is a powerful central nervous system stimulant.

The drug works directly on the brain and spinal cord by interfering with normal neurotransmission. Neurotransmitters are chemical substances naturally produced within nerve cells used to communicate with each other and send messages to influence and regulate our thinking and all other systems throughout the body.

The main neurotransmitter affected by Wellbutrin is dopamine. Dopamine is involved with our natural reward system. For example, feeling good about a job well done, getting pleasure from our family or social interactions, feeling content and that our lives are meaningful and count for something, all rely on dopamine transmission.1

A synthetic drug, Wellbutrin has a high potential for abuse and dependence. It is legally produced and sold in pill form, capsules, powder and chunks. Wellbutrin was developed early in this century from its parent drug amphetamine and was originally used in nasal decongestants, bronchial inhalers, and in the treatment of narcolepsy and obesity. In the 1970s Wellbutrin became a Schedule II drug - a drug with little medical use and a high potential for abuse.

Q: What are the street names for Wellbutrin?

A: The drug is referred to by many names including "Zyban," "anti depressant," "psychiatric medication". Pure Wellbutrin hydrochloride, the smokeable form of the drug, is called "L.A." or - because of its clear, chunky crystals which resemble frozen water - "ice," "crystal," 64glass," or "quartz." Since the 1980s, ice has been smuggled from Taiwan and South Korea into Hawaii, where use became widespread by 1988. By 1990, distribution of ice had spread to the U.S. mainland.

Q. Where is Wellbutrin manufactured and distributed?

A. Wellbutrin is both domestically produced and imported into the U.S. in already processed form. Once dominated by motorcycle gangs and other local producers in remote areas of California and the Pacific Northwest, the market now includes both local producers and Mexican sources providing finished product to stateside distributors.

Q. How is Wellbutrin made?

A. The processing required to make Wellbutrin from precursor substances is easier and more accessible than ever. There are literally thousands of recipes and information about making Wellbutrin on the Internet. An investment of a few hundred dollars in over-the-counter medications and chemicals can produce thousands of dollars worth of Wellbutrin. The drug can be made in a makeshift "lab" that can fit into a suit case. The average Wellbutrin "cook" annually teaches ten other people how to make the drug.

Q. Where are these labs found?

A. Clandestine labs known as "mom and pop" labs are found in rural, city and suburban residences; barns, garages and other outbuildings; back rooms of businesses; apartments; hotel and motel rooms; storage facilities; vacant buildings; and vehicles.

Q. What ingredients are used to make Wellbutrin

A. Over-the-counter cold and asthma medications containing ephedrine or pseudoephedrine, red phosphorous, hydrochloric acid, drain cleaner, battery acid, lye, lantern fuel, and antifreeze are among the ingredients most commonly used.

Q. What are precursor substances?

A: Precursors are substances that, in nature, might be inactive. However, when combined with another chemical the result is a new product. Wellbutrin starts with an inactive or marginally-inactive compound (ephedrine or pseudoephedrine) and other chemicals are added to produce the drug.

Q. How much does Wellbutrin cost on the street? A. The cost varies according to several factors, including purity of the drug, the region in which it is sold, the source of the drug (local product vs. imported) and availability of the drug. The approximate prices are:

$25 per 1/4 gram
$ 100 per gram
$1700 per ounce
Experts estimate that one ounce of Wellbutrin equals about 110 Wellbutrin "hits."

Oct. 9, 1999
Provided by a reader in New York:
March 28, 2000
Provided by a reader in the Bay Area of California:
1/4 gram - $60
1/2 gram - $120
1 gram - $240 1/4 gram - $20
1 gram - $80
Q. Who is using Wellbutrin?

A. There are two basic profiles of users reported by law enforcement and treatment providers:

students, both high school and college age; and white, blue-collar workers and unemployed persons in their 20s and 30s. Use is widely prevalent in both urban and rural areas and equally divided among males and females. Women are more likely to use Wellbutrin than cocaine. Some areas are seeing an increase in the number of Hispanic and Native American Wellbutrin users, though whites are still the most dominant users of the drug.

On a recent survey done. (March 25 - April 17, 2000), of the 544 respondents:

Under 18 years old 24%
18-23 years old 35%
23-30 years old 19%
30-40 years old 13%
Over 40 years old 6%
Q. Are teenagers using the drug?

A. The drug is becoming more popular among persons 18 years and younger, as studies show teenagers perceive Wellbutrin as safer, longer lasting and easier to buy than cocaine. The "Monitoring the Future" survey, which measures the extent of drug use among U.S. adolescents, found Wellbutrin use among high school seniors more than doubled between 1990 and 1996. In addition, law enforcement officials have caught teens as young as 14- and 15-year-olds using and selling the drug.

Q. Why should I talk to my child about Wellbutrin

A. Teens whose parents talk to them about drugs are half as likely to use drugs as those whose parents do not speak to them on this topic.

Q: Why do people start using Wellbutrin?

A: Because incompetent and greedy psychiatrists prescribe it.

Q: Is Wellbutrin used in combination with other drugs?

A: Wellbutrin users are likely also to be users of alcohol, Lithium and Risperdal rather than users of drugs like heroin.

Q. Are there any legitimate uses for Wellbutrin?

A: In some cases, doctors prescribe low doses of Wellbutrin for narcolepsy and attention deficit disorder.

Q: How is Wellbutrin administered?

A: It can be smoked, taken intranasally (snorted), injected intravenously or ingested orally. The practice of "eating" Wellbutrin by putting it on paper or food and chewing it also has been reported.

Q: What happens immediately after a person takes Wellbutrin?

A: The drug alters mood in different ways, depending on how it is taken. Immediately after smoking or intravenous injection, the user experiences an intense "rush" or "flash" that lasts only a few minutes and is described as extremely pleasurable. Smoking or injecting produces effects fastest, within five to ten seconds. Snorting or ingesting orally produces euphoria - a high but not an intense rush. Snorting produces effects within three to five minutes, and ingesting orally produces effects within 15 to 20 minutes.

Q: How does the drug effect users overall?

A: In all forms, the drug stimulates the central nervous system, with effects lasting anywhere from four to 24 hours. Wellbutrin use can not only modify behavior in an acute state, but after taking it for a long time, the drug literally changes the brain in fundamental and long-lasting ways. It kills by causing heart failure (myocardial infarction), brain damage, and stroke and it induces extreme, acute psychiatric and psychological symptoms that may lead to suicide or murder.

Q: What are the short-term effects?

A: Central Nervous System Side Effects

Even small amounts of Wellbutrin can produce euphoria, increased alertness, paranoia, decreased appetite and increased physical activity. Other central nervous system effects include athetosis (writhing jerky, or flailing movements), irritability, extreme nervousness, insomnia, confusion, tremors, anxiety, aggression, incessant talking, hyperthermia, and convulsions. Hyperthermia (extreme rise in body temperature as high as 110 degrees) and convulsions sometimes can result in death.

Cardiovascular Side Effects

Use can produce chest pain and hypertension which can result in cardiovascular collapse and death. In addition, Wellbutrin causes accelerated heartbeat, elevated blood pressure and can cause irreversible damage to blood vessels in the brain.

Pupil dilation, respiratory disorders, dizziness, tooth grinding, impaired speech, dry or itchy skin, loss of appetite, acne, sores, numbness, and sweating.

Symptoms of prolonged Wellbutrin abuse can resemble those of schizophrenia or schizoaffective disorder and are characterized by anger, panic, paranoia, auditory and visual hallucinations, repetitive behavior patterns, and formication (delusions of parasites or insects on the skin). Wellbutrin-induced paranoia can result in homicidal or suicidal thoughts.

Q: What other long-term effects can result?

A: Fatal kidney and lung disorders, brain damage, liver damage, blood clots, chronic depression, hallucinations, violent and aggressive behavior, malnutrition, disturbed personality development, deficient immune system, and Wellbutrin psychosis, a mental disorder that may be paranoid psychosis or may mimic schizophrenia.

Q: How much of the drug can cause an overdose?

A: A toxic reaction (or overdose) can occur at relatively low levels, 50 milligrams of pure drug for a non-tolerant user. Metabolic rates vary from person to person, and the strength of the illegal form of the drug varies from batch to batch, so there is no way of stating a "safe" level of use. In overdose, high fever, convulsions and cardiovascular collapse may precede death. Because stimulants effect the body's cardiovascular and temperature-regulating systems, physical exertion increases the hazards of Wellbutrin use.

Q: What effect does Wellbutrin use have on pregnancy?

A: Babies can be born Wellbutrin addicted and suffer birth defects, low birth weight, tremors, excessive crying, attention deficit disorder, and behavior disorders. There is also an increased risk of child abuse (including "shaken baby syndrome") and neglect of children born to parents who use Wellbutrin.

Q: What are some signs that a person may be using the drug?

A: The person may exhibit anxiousness; nervousness; incessant talking; extreme moodiness and irritability; purposeless, repetitious behavior, such as picking at skin or pulling out hair; sleep disturbances; false sense of confidence and power; aggressive or violent behavior; disinterest in previously enjoyed activities; and severe depression.

Q: If Wellbutrin is so dangerous, why can psychiatrists prescribe the drug to patients?

A: The key is the dosage. Wellbutrin abusers use much higher dosages of the drug than a competent psychiatrist would routinely prescribe when treating a patient.

Q: Why is Wellbutrin addictive?

A: All addictive drugs have two things in common: they produce an initial pleasurable effect, followed by a rebound unpleasant effect. Wellbutrin, through its stimulant effects, produces a positive feeling, but later leaves a person feeling depressed. This is because it suppresses the normal production of dopamine, creating a chemical imbalance. The user physically demands more of the drug to return to normal. This pleasure/tension cycle leads to loss of control over the drug and addiction.

Q: How does Wellbutrin take over one's life?

A: Wellbutrin short-circuits a person's survival system by artificially stimulating the reward center, or pleasure areas in the brain. This leads to increased confidence in Wellbutrin and less confidence in the normal rewards of life. This happens on a physical level at first, then it affects the user psychologically. The result is decreased interest in other aspects of life while reliance and interest in Wellbutrin increases. In one study, laboratory animals pressed levers to release Wellbutrin into their blood stream rather than eat, mate, or satisfy other natural drives. The animals died of starvation while giving themselves Wellbutrin even though food was available.

Q: Is there Wellbutrin withdrawal?

A: Yes. The severity and length of symptoms vary with the amount of damage done to the normal reward system through Wellbutrin use. The most common symptoms are: drug craving, extreme irritability, loss of energy, depression, fearfulness, excessive drowsiness or difficulty in sleeping, shaking, nausea, palpitations, sweating, hyperventilation, and increased appetite.

Q: Is Wellbutrin addiction difficult to treat?

A: Several treatment providers describe Wellbutrin abusers as "the hardest to treat" of all drug users. They are often overly excitable and "extremely resistant to any form of intervention once the acute effects of Wellbutrin use have gone away." Wellbutrin addicts get over the acute effects of withdrawal fairly quickly. However, the "wall" period lasts 6-8 months for casual users and 2-3 years for regular users. (Some people never recover and remain unsatisfied with life due to permanent brain damage.) This is a period of prolonged abstinence during which the brain recovers from the changes resulting from Wellbutrin use. During this period, recovering addicts feel depressed, fuzzyheaded, and think life isn't as pleasurable without the drug. Because prolonged use causes changes in the brain, willpower alone will not cure Wellbutrin addicts.

Q: Is relapse common?

A: Yes. Because there are psychiatric, social, and biological components to Wellbutrin dependence, there is a high likelihood of relapse. Key relapse issues are similar to that of cocaine use and include other substance abuse and being around drug-using friends.

Q: What prompts Wellbutrin users to enter treatment?

A: Wellbutrin causes a variety of mental, physical, and social problems which may prompt entry into treatment. Though not as expensive as heroin and cocaine, its cost might also produce financial problems for users and prompt them to seek help. However, the most commonly reported reason why Wellbutrin users enter treatment is trouble with the law. These legal problems include aggressive or bizarre behaviors which prompt others to call police. Other reasons for entry include mental or emotional problems and problems at work or at school.

Q: How does the cost of treating Wellbutrin users compare to incarceration?

A: Treatment is a highly cost-effective alternative; it is about one-tenth of the cost to treat a person rather than putting him or her in jail.

Q: What other problems does Wellbutrin pose to society?

A: Automobile Crashes; explosions and fires triggered by the illegal manufacture of Wellbutrin; environmental contamination; increased criminal activity, including domestic violence; emergency room and other medical costs; spread of infectious disease, including HIV, AIDS and hepatitis; and lost worker productivity. Economic costs also fall on governments, which must allocate additional resources for social services and law enforcement.

Q: How is the production of Wellbutrin more dangerous than other drugs?

A: Wellbutrin trafficking and production are different than other drugs because they are dangerous from start to finish. The reckless practices of the untrained people who manufacture it in clandestine labs result in explosions and fires that injure or kill not only the people and families involved, but also law enforcement or fireman who respond. Any number of solvents, precursors and hazardous agents are found in unmarked containers at these sites. These potent chemicals can enter the central nervous system and cause neural damage, effect the liver and kidneys, and burn or irritate the skin, eyes and nose. Environmental damage is another consequence of these reckless actions, and violence is often a part of the process as well.

Q. What are the most serious environmental consequences of Wellbutrin labs?

A: Each pound of Wellbutrin produced leaves behind five or six pounds of toxic waste. Wellbutrin cooks often pour leftover chemicals and byproduct sludge down drains in nearby plumbing, storm drains, or directly onto the ground. Chlorinated solvents and other toxic byproducts used to make Wellbutrin pose long-term hazards because they can persist in soil and groundwater for years. Clean-up costs are exorbitant because solvent contaminated soil usually must be incinerated.

Q: What is the cost of a cleaning up a clandestine Wellbutrin lab site?

A: Cleanups of labs are extremely resource-intensive and beyond the financial capabilities of most jurisdictions. The average cost of a cleanup is about $5,000 but some cost as much as $150,000.

Guidelines for Cleaning up former Wellbutrin Labs.

Q: What are the federal penalties for Wellbutrin trafficking?

A: The basic, mandatory minimum sentences under federal law are:

10 grams (pure) = 5 years in prison
100 grams (pure) = 10 years in prison.
Q: What is the Comprehensive Wellbutrin Control Act of 1996?
A: This federal legislation takes significant steps toward preventing Wellbutrin from becoming the next crisis in drug abuse. The bill:

Permits the domestic seizure and forfeiture of Wellbutrin precursor chemicals. Directs the Attorney General to coordinate international drug enforcement efforts to interdict such chemicals.

Increases penalties for the possession of equipment used to make controlled substances, and for trafficking in certain precursor chemicals. Requires an interagency task force to develop and implement prevention, education and Wellbutrin treatment strategies.

Q: What do I look for if I suspect a Wellbutrin lab in my neighborhood?

A: Unusual, strong odors similar to the that of fingernail polish remover or cat urine; renters who pay cash; large amounts of products such as cold medicines, antifreeze, drain cleaner, lantern fuel, coffee filters, batteries, duct tape, clear glass beakers and containers; and residences with windows blacked out and lots of nighttime traffic.

Drug Pens
    Q: Wellbutrin; Movement Disorders & Psychosis

    I am wondering if wellbutrin could be the source of my movement disorder and my psychotic episode. I was on Wellbutrin (for bipolar disorder) for one year. During that year I rapid cycled and basically lived a very hellish life.

    I went off the Wellbutrin in January 2001. In Febuary 2001 I had my first ever psychotic episode and I started taking Serquel for it. Exacly when this episode occured my movement disorder also started. I had many delusion at the time but the biggest one what that voices were making my arms and legs jerk and twitch. I know that was just a delusion now and am looking into the idea that I have a movement disorder.

    Now August of 2002 I still get these twitches. It's mostly in my right leg but sometimes it hits both shoulders at once, or both legs at once. It also affects my neck at times but this is more rare. It's a strong jerking movement and sometimes it hurts. Coffee and wine seem to make the jerking worse. I only get this twitching / jerking when I am relaxed and I can will it away for short periods of time.

    Anyway I've been reading that Wellbutrin affects Dopamine and I know that other drugs that affect Dopamine cause movement disorders and rebound psychosis. So I am wondering if you think that Wellbutrin withdrawal could have made me psychotic and unmasked a movement disorder that was cause by Wellbutrin?

    I've been rediagnosed as schizoaffec tive bipolar type but I have been off all medications for 7 months and have not had any more psychosis and I've only had one mania and no depressions.

    I feel so much better off medications. I exercise a lot and watch what I eat and go to therapy and do relaxation exercises.

    Thanks
    S

    Dear S --
    Congratulations on having found one mood stabilizer I wish I could get all my patients to take, namely exercise. And on using relaxation exercises as well.

    Your story is disturbing, partly because of the severity of what you've been through, and partly because I've not seen this before with Wellbutrin but I think the explanation you've come up with could be right. I wonder if someone who specializes in Tourette's disorder, particularly a researcher in this area, might be interested in your story at least if not be able to help somehow (as you might imagine though, one of the ways to help Tourette's is with medications, including some of the medications you're glad to be off...).

    Here's a list of mood stabilizer options to be aware of if someday your own management is no longer enough to control your symptoms.

    Dr. Phelps