Professor claims Wellbutrin does not have a lethal dose

[DrugReptoNurse]

On on one of my latest psych test the professor had a question comparing tricyclic antidepressants to Wellbutrin. The professor stated the correct answer for the question was that Wellbutrin does not have a potentially lethal dose.

I checked the package insert and the PDR to verify that there is a lethal dose for Wellbutrin. The professor disagreed with the package insert, the PDR and with me. She said the answer she gave is correct and that is the end of discussion. She told our entire class that Wellbutrin does not have a lethal dose.

I am floored. I can only imagine one of my classmates telling a depressed patient...."Go ahead and take all the Wellbutrin you want when you are feeling down....it can't hurt you"

Somebody I'm sure will get a patient killed if they follow this advice. I have brought up my professors error the the department head but am finding she is of no use either.

What advice would you give to corrrect this dissemination of incorrect information to class of 60 nursing students?? Should I go talk to the dean or just let it go??

[morte, LPN, LVN]

I spoke to the chairperson today of the psychiatric nursing department. I was told that the answer "Wellbutrin does not have a lethal dose" is correct.

I am seriously considering switching nursing schools after hearing this. I can't believe I am dealing with instructors who disagree with the Physicians Desk Reference.

get it in writing, signed, with explanation

[maolin]

Bupropion's LD50 (dose which is lethal to 50% of subjects (usually rodents)) is 980mg/kg. (source: http://www.chemicalland21.com/lifescience/phar/BUPROPION%20HYDROCHLORIDE.htm). Other sites list 400-600mg/kg.

LD50 for TCA's is approx 35mg/kg (source: http://www.emsvillage.com/articles/article.cfm?id=2100)

[maolin]

Additional info on toxicty & lehtality of Wellbutrin overdose...scroll down to 7.0 about toxicity & specific cases of OD's.

http://www.antidepressantsfacts.com/bupropion2.htm

I imagine what your instructor was getting at was it is far easier & more serious to OD on TCA's (at barely more than therapeutic levels) than Wellbutrin.

[Noryn]

I think what your professor is getting at is that an overdose of a tricyclic is acutely lethal causing cardiac dysrhthmias whereas an overdose of wellbutrin will not immediately harm a person. Like tylenol, wellbutrin may have eventual liver (or other) damage but an overdose will not kill you right then and there. I beleive this is one of the reasons that tricyclics are not as popular as they once were. I also beleive that d/t the acute lethal affects of tricyclics, they are prescribed only in small amounts... 2-4 week supply at a time. If a person REALLY wanted to commit suicide and die, the way to go would be a tricyclic overdose... quick, sure, and relatively painless.

I just saw this thread and thought I would comment. I also wanted to point out that I disagree with the above poster on a few points. With Wellbutrin the acute period after the overdose IS what you worry about. It really isnt like Tylenol at all.

Your professor may actually be correct. In nursing school, they try to teach critical thinking so you have to be careful especially when you think an answer or question is obvious. It all lies in interpretation of that answer.

To the above posters that say there is a lethal dose of Wellbutrin, then what is it? I see a couple of figures from 500-980. So I weigh 100 kg then 98000 mg would be lethal to me? What about 97000 or even 45000? For the most part we dont have lethal dose information in humans because of all the variables involved. You can take 20 rats and experiment on them all day to get a lethal dose but you cant do that with humans (although some groups have done it in the past). The data on humans too is usually skewed as you have to take into account co ingestants along with co morbidities.

Even in perfect lab conditions you cannot obtain an exact lethal dose because every living creature is different. Sure you can say 10,000,000 mg of Wellbutrin is lethal but then you have to consider that 30,000mg has also been lethal in one person. But then if you say 30,000 mg is the lethal dose, what about the person who survived after taking 35,000?

Anyway I am rambling at this late hour. The bottom line, can you overdose and die from Wellbutrin alone? Yes, it is rare but single acute ingestions can cause death usually from prolonged seizures. Is there an established lethal dose in humans? Not really.

[TachyBrady]

You are right noryn. I was wrong in likening a tylenol overdose to a wellbutrin overdose. After having read the info maolin posted, I see that seazures and death can occur but they are rare. However, I do think the tricyclics are more lethal due to their mechanisms of action. We went over tricyclics in ACLS (a few years ago).

[Megsd, BSN, RN]

I spoke to the chairperson today of the psychiatric nursing department. I was told that the answer "Wellbutrin does not have a lethal dose" is correct.

I am seriously considering switching nursing schools after hearing this. I can't believe I am dealing with instructors who disagree with the Physicians Desk Reference.

If this were me, I don't think this is the atrocity I would be willing to switch nursing schools for, especially considering how difficult it is to get into a program in the first place. I'd probably err on the side of caution and assume everything has a lethal dose, although perhaps people are using the term "lethal dose" in different ways, causing a discrepancy.

In my program my pathophysiology professor was notorious for giving us wrong info. We were good about reading the book and notes ahead of time, in order to ask appropriate questions. I cannot even count the number of times she said X, and one of us would say "Dr. B, I know you just said X, but in the book on page 47 it says Z. Could you explain the difference?" And the answer we always got was "For the purpose of my class, X is correct."

So we filed away in our heads to answer X on her exams but know that Z was really more accurate. Sure we could have called her out on it or gone to other sources about the problem, but it was not really a battle we wanted to fight.

[Lisa CCU RN, RN]

If this were me, I don't think this is the atrocity I would be willing to switch nursing schools for, especially considering how difficult it is to get into a program in the first place. I'd probably err on the side of caution and assume everything has a lethal dose, although perhaps people are using the term "lethal dose" in different ways, causing a discrepancy.

In my program my pathophysiology professor was notorious for giving us wrong info. We were good about reading the book and notes ahead of time, in order to ask appropriate questions. I cannot even count the number of times she said X, and one of us would say "Dr. B, I know you just said X, but in the book on page 47 it says Z. Could you explain the difference?" And the answer we always got was "For the purpose of my class, X is correct."

So we filed away in our heads to answer X on her exams but know that Z was really more accurate. Sure we could have called her out on it or gone to other sources about the problem, but it was not really a battle we wanted to fight.

Books are wrong you know. Maybe not the PDR because I assume it has been reviewed by many others, but professors are the ones who write your textbooks. I've seen three slightly different answers to the same question before in the SAME book!

Anything can be lethal (causes death) including water and air.

To OP, I wouldn't switch schools over this either.

By lethal, does the professor mean it won't kill you instantly in overdose. I was told that benzos won't kill you in overdose, they will just make you sleep alot, but adding ETOH to them can cause respiratory depression.

I think what really bugs me about your post is that the instructor in question refuses to give her rationale for saying that there is no lethal dose for Welbutrin. That would clear everything up.

[jay fro]

wellbutrine does not have a lethal dose i took 23 in one night.. it triped me out .. split personality and seeing some messed up stuff while i was on it by the way the 23 mi took was 300mg peeled and crushed..i have done it more then once:clown:

[jay fro]

i wouldnt tell any one to do it!!!!! DONT DO IT!!!! worst trip of my life!!!! Will i do it again? mabie? i have like 5 hours i blacked out sent some messed up txt messages while i was blacked out 6900 mg and im still here:lol2:

[ashleyisawesome, BSN, RN]

*ahem* w t f? :uhoh3::uhoh3:

[FoolMeTwice]

I have been through a buproprion overdose twice. How anyone could ever consider whether to intentionally overdose on Wellbutrin (any drug for that matter) is beyond me. Worst. Experience. Ever.