Wellbutrin is not officially prescribed for bipolar disorder but it’s become quite popular as an off label medicine for type-2 bipolar disorder. It was added to my medication regimen, too, in Oct, 2016 and I’m currently on 300 mg per day.
I started feeling its positive effects on my mood within 2 weeks of starting it, though it took around 4 weeks for it to kick in fully. I had been taking Lexapro for about 3 months before I started Welbutrin. Lexapro had worked wonders on the depressive part my bipolar, but it had reduced my motivation and I felt tired all the time. Wellbutrin counteracted all these side effects and increased my energy level many folds. However, what surprised me most was its effect on my drinking.
I had my share of struggle with alcohol in the 90s after untimely death of my father in 1992. Though, I managed to rein in my heavy drinking after 4-5 years of indulgence, I had to fight the temptation all my life. Fortunately, I seem to have a very strong willpower and that stopped me from relapsing into heavy drinking. Bipolar people often have addictive personality, too.
However, I noticed a few months after continuing Wellbutrin that I didn’t have to fight temptation anymore as there was none. I didn’t get tempted even in situations when it’s very difficult to refuse. It looked as if Wellbutrin fixed the defect in the brain that was causing the alcohol craving.
What was that defect in my brain? Defective neuronal wiring? Chemical imbalance? Unfortunately, psychiatry and neurology haven’t made as much progress as to answer this question with surety. However, the most probable culprit was the imbalance in dopamine.
Dopamine is a chemical that performs different functions in different parts of our body. In our brain, it acts as neurotransmitters that help neurons send and receive signals. The other notable neurotransmitters in our brain are Serotonin and Norepinephrine.
Dopamine in the brain is an important neurotransmitter. Its imbalance in different parts of the brain affects different functions like Reward & Pleasure, executive functions, motor control, sexual gratification etc. Its impact on the Reward & Pleasure system is actually responsible for alcoholism or any type of addiction. Neurologically, all the addictive behavior like alcoholism, drug abuse, gambling, sex addiction have the same basis.
Any pleasurable and rewarding experience like food, sex etc. causes release of dopamine which provides feelings of enjoyment and motivation to repeat the experience. On the other hand, when we consume alcohol, it enters brain through blood as it can pass through the Blood-Brain barrier. Once inside the brain, it directly affects the system and causes release of a large amount of dopamine and we feel happy. However, this alcohol induced high level of dopamine negatively affect its natural production. With prolonged alcohol abuse, our natural dopamine production gets very significantly reduced and then we need regular intake of alcohol to maintain dopamine level in our brain. With passage of time, we need more and more alcohol to produce the same amount of dopamine; which causes tolerance and addiction.
Perhaps, Wellbutrin’s ability to maintain the dopamine level in brain, reduces alcohol craving as now the brain doesn’t need alcohol’s stimulation for dopamine production.