People’s Pharmacy: Treating seasonal affective disorder with Wellbutrin and a light box
Q. I wanted to share my experience with seasonal affective disorder and light box therapy. Having suffered with moderate SAD for years, I started using a light box in addition to the antidepressant medication I was taking. It helped my symptoms to some degree. Spending an hour every morning in front of the bright lights wasn’t great, but the symptom relief made it worthwhile.
Then, six months ago, I was switched to Wellbutrin for depression with anxiety. Wow, this is the first winter in 30 years that I have not been bothered by SAD. It is the most effective medication I’ve been on so far.
As a side note, in the past, I would enjoy a few drinks most weekends at home with my partner. Since starting Wellbutrin, I really don’t crave alcohol at all. That isn’t an unwelcome side effect for me. I wonder if others have had the same results from Wellbutrin.
A. Bupropion (Wellbutrin) was introduced as an antidepressant in 1989. It also has the Food and Drug Administration’s blessing for treating SAD. The drug was later approved to help people quit smoking.
There is very little research on the impact of bupropion on alcohol cravings. We did find a report that parallels your experience (Psychiatry On-Line, May 14, 2004). The authors describe two different individuals taking the drug to quit smoking. While on bupropion, each reported that alcohol tasted bad and had no appeal.
You may want to learn more about the pros and cons of bupropion, how to access brand-name Wellbutrin at an affordable price and light box therapy in our eGuide to Dealing With Depression. This online resource can be found under the Health eGuides tab at peoplespharmacy.com.
Q. My latest bloodwork shows a potassium level of 5.8, which is considered too high. After trying to find out what I can and cannot eat, I feel that I need a registered dietitian.
When I called the practice where I have seen one in the past, the receptionist said their nutritionist wouldn’t deal with that. The same person answering the phone also proceeded to tell me what I could not eat. I found that inappropriate!
Why is my potassium too high? What happens if I ignore it? Are there therapies for this condition? If I can’t get help from a dietitian, who could help me?
A. We agree that it is inappropriate for a receptionist to offer nutritional advice.
The human body usually tries to keep potassium within a relatively narrow range, from 3.5 to 5.0 mmol/L. At 5.8, your potassium level is elevated. That is rarely due to eating high potassium foods unless you are also taking a blood pressure medication such as an ACE inhibitor (for example, lisinopril), an ARB (like losartan) or a potassium-sparing diuretic (such as spironolactone).
Other conditions, such as Addison’s disease, kidney disease, diabetes or congestive heart failure can also raise potassium levels. You should ask your doctor to rule these out and check your medications. An interaction between the blood pressure drug lisinopril and the antibiotic cotrimoxazole (TMP-SMX or Bactrim) can boost potassium levels quickly into the danger zone.
When potassium goes too high, it can lead to heart rhythm disruptions, chest pain, muscle weakness, nausea, vomiting, diarrhea and stomach pain. In extreme cases, it can lead to cardiac arrest.
You also need to consult with a registered dietitian. Until you see one, make sure you are not using a salt substitute, as it might contain potassium.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website peoplespharmacy.com. They are the authors of “Top Screwups Doctors Make and How to Avoid Them.”