“Living”
with Dystonia
C
David Ericson
Intrathecal Baclofen Test (July 12, 2008)
In
September, 1998, I began taking Zyban as part of a "Smoking Cessation
Plan". My doctor prescribed it after the patch and inhaler were
ineffective. At the time I was healthy as I could hope for at the age of
37, and I wanted to quit smoking to stay that way. I was living in Seattle
at the time, but in October my wife and I moved to Jacksonville, Florida. (She was also taking Wellbutrin to quit smoking, although her Insurance
would only pay if it was prescribed as an Antidepressant, even though she was
not depressed!) On the way down I
started having daily diarrhea. Once we got there, I went to work at
another Sears. I had transferred as a Sales Associate in Hardware.
Much of my job required me to answer the phone frequently. Within a few
weeks I was not able to answer the phone because the party on the other end
could not decipher what I was saying. I thought it was just nerves that
caused me to get tongue-tied, but soon I couldn't even talk to my co-workers or
customers. I knew what I wanted to say, but the words came out as gibberish.
Then I realized I was unable to write. My left (dominant) hand would shake
uncontrollably whenever I picked up a pen. I couldn't read my own
handwriting. I used to be able to print like a draftsman; perfect.
Now I was getting worried, and stopped taking the Zyban, as did my wife. After several
more days, I went to urgent care. The doctors there were certain I had MS, and
sent me to the hospital for a brain scan. That test was negative, so they
said I must have had a small stroke. They sent me for a different scan,
which also came back negative. The only thing they knew for sure was that
I had a Urinary Tract Infection, and started me on antibiotics. They then
sent me to a Neurologist. This doctor said I had Writer's Cramp, and mild
Dysphonia. He "explained" that they were Dystonias, whatever
that was. By this time my wife and I had decided to return to Seattle.
When I told the Neurologist this, he told me I should go see Dr. Bruce Ransom, at the
University of Washington Medical Center. Said he was the best at
diagnosing and treating Dystonia. In November, 1998, I went to see Dr.
Ransom. He said it was Dystonia, and that it "could have been
triggered by the Zyban". By the way, I was smoking again. The
tremor in my voice had somewhat subsided, but the writing was impossible.
He said he could try Botox (which I had never heard of before) to hopefully
regain some control of the hand. He said Insurance would pay for it,
"because it works". I decided the whole thing was blown out of
proportion, and I didn't need to write that much anyway. I used a computer
more than anything else. I considered, and then dropped the idea of Botox.
After all, why would I want that "poison" injected into my arm?
I saw Dr. Ransom until my Insurance said "no more". I did not
immediately find another Neurologist, just to hear the same diagnosis,
prognosis, and treatment option. The symptoms, including the daily
diarrhea, came and went, but mostly came over the next two years.
THEN!!!
Approximately July of 2001, I was unable to stand upright. My doctor and I
did not immediately associate it with the Dystonia, so my GP sent me to Physical
Therapy. They were not making any progress, then one day I got a different
therapist who thought I was there for a compressed disc, which had been ruled
out by an MRI… He put me in a "RACK" like medieval times, and
streeeetched my back. When I got out of that I went home and never went
back. I had never had so much pain in all my life. And now rather
than being hunched over 45 degrees, I could not stand unless I was looking at
the ground with my back 90 degrees to my legs. Then they sent me home
with a TENS machine. That didn't help, except while I was wearing it.
My doctor then sent me to a specialist; a Physical Doctor. This doctor
said my muscles in my lower back were hard as bone. Then he proposed and I
succumbed to Intramuscular Stimulation. This consisted of
"Hammering Nine-Inch-Nails into the muscles". Three times a
week. He said it could take several months of this. After one week,
I called and told him "no more"! The next day, this same Doctor
called me at home at 8 o'clock in the evening, and told me to pick up a
prescription at my pharmacy. It was December of 2001, and the prescription
was for 5mg diazepam daily. I was upright and out of pain in a week.
Even returned to work after six months of disability. This Physical
Doctor explained that constant spasms in my back were causing the muscles to
harden. (Today I am on 30mg Diazepam, 30mg Baclofen, 60mg Prozac, 20 mg
Omeprazole, and 0.4mg Flomax)
During this time I also went through all the usual tests of my GI tract, to
explain the diarrhea. Other than setting a hospital record for how fast
the Barium went through me, no abnormalities were found. No polyps, etc.
Also, Sinus Infections became a twice annual unpleasant event.
As I returned to work, I received a promotion, and was required to write more,
so I got a referral to a Neurologist. I received the Botox injections in
my arm, and it did help after a while, for a while. I went back about 4
times. The entire Neurologist Dept. at that Medical Center in Seattle was
fascinated by my case. They suspected the muscle spasms in my back could
be related to the Dystonia (first time I had heard that), but at the time Botox
had not been perfected for the back. They were afraid it would make it too
weak. And if the spasms were too deep, it wouldn't work, anyhow. They
also confirmed my suspicion that the diarrhea was possibly caused by spasms
in my stomach. That is when the Baclofen started. Also the increase
in Diazepam began here. None of these drugs helped with spasms in my
stomach. I also began to have anxiety attacks (like a knife in the heart).
I utilized Sears' "Employee Assistance Program" and visited a
therapist. They decided I needed an MD, so they sent me to a
Psychiatrist. First thing he did was tell me I probably had Sleep Apnea,
and sent me for a Sleep Study. The diagnosis was confirmed, and I now
sleep with a CPAP machine. March 2002. I am convinced to this day that
I would be dead by now without it. Breathing is essential to getting
oxygen to the brain!!! It gave me more energy, and I was less tired during
the day, but it did nothing for any of my other symptoms. He also put me
on Prozac because I was "clinically depressed", and again increased
the dosage of Diazepam. By this time I am at 20mg per day. Pain is
returning to my back with a vengeance. I resort to going to Canada to buy
Tylenol with Codeine. They work if I eat them like Pez. One other
advantage, the Narcotic rid me of the diarrhea. That, to me, was reason
enough to keep making the trip to Canada. Doctors will not prescribe
Narcotics for chronic pain, but they have no other solution. I
stopped going to any of my doctors for some time. I was coping. Not
exactly living, but coping; taking all my meds, stretching my back and wearing
my CPAP at night religiously.
In November, 2002, I moved to Lincoln City, Oregon, starting a new career as a
slot machine technician. I was only there 7 months, but during that time I
had to go to the emergency room once for severe chest pain, which turned out to
be a gas bubble rubbing against my heart. This was probably due to spasms
in my stomach, according to the doctors.
April, 2003, I moved back to Federal Way, Washington. Again I was
coping with the pain and spasms. Still taking the same medications,
and only occasionally going to the doctor. Botox was not an option at this
point because I needed to be able to lift heavy monitors, and move slot
machines. Again making a few trips to Canada, I was able to do my job, and
do it well. My employer was willing to forgive my attendance problems,
even allowing me to make my own schedule. This was my life for 3 years,
during which my father passed away at 63, from Bladder Cancer. Then I made
likely the worst decision of my life. I decided that I could make a
better career for myself if I moved to Las Vegas. I was kind of trapped in
a position of going nowhere working at a Tribal Casino. They made offers I
should have considered longer, to keep me there, but as I said, I made a
mistake.
April 2006, my wife and I moved to Las Vegas, where I had a slot technician job waiting
for me at the
Silverton Hotel and Casino. In March
of the next year, many of my symptoms returned, again with a vengeance.
I went to see my Primary Care Physician.
He refilled all my prescriptions, and referred me to a Neurologist.
I went to the Neurologist, where I had to fill out form after form asking
the same questions over and over, all with a tremor which made it take nearly an
hour to complete, and by which time my entire left arm and hand were in agony.
The waiting room was approximately 6 foot by 12 foot, with about three
square feet to a patient. Most of
the waiting patients were suffering from Alzheimer’s, or Multiple Sclerosis
and all were about 25 years older than I. My
expectations of this Neurologist were dwindling quickly.
When I finally finished with the paperwork, and wait an additional half
hour, my expectations were proven correct. He
actually had a look of disappointment on his face when I told him my diagnosis
to date was Dystonia. Then he did
the usual… follow the finger, squeeze my hands, close your eyes and touch you
nose, etc. Then he said he needed my
medical records from Seattle, even though I went there to confirm the diagnosis.
I didn’t want the same old, same old.
I wanted someone to try something different, even radical.
I didn’t care. But this
doctor spent approximately seven minutes with me.
He then had me fill out more papers to get medical records.
I never heard from him again. And
I certainly did not call him.
Here I am going to go off course a little to rant about something that
bothers me tremendously. Every time
I go to a Neurologist, I have to fill out a lot of papers, asking questions that
I already answered for my Primary Care Physician (the one that made the
referral). Many people, including
myself have difficulty filling out these forms, especially at a Neurologist.
I have been to 7 different offices of 7 different Neurologists, and not a
single office has an alternative to writing.
A very simple solution would be to put the forms in PDF form for
completion on a computer. If that is
too difficult for them to manage (the office or the patient) there should be
someone able to assist in filling out the forms.
Instead, I am told over and over again, “do the best you can”!
Every time I fill out the “Patient Questionnaires”, and my hand
shakes and my writing is so illegible, I can’t see any information gained from
all this, I ask myself, “why am I fighting this?
Send me the paperwork at home to complete.
I will scan it into my computer and fill it out there.”
There are so many easy solutions, but no one makes an effort to
accommodate a patient with any kind of movement disorder.
Where
is the ADA enforcement? Okay, that
is the end of that rant, but I am going to do something about these issues.
I believe even filling out the forms falls under the jurisdiction of the
Americans with Disabilities Act, and there should be some form of accommodation.
As I have mentioned, there are many solutions which would not be an
unbearable burden on the offices.
Alright, back to April, 2007. I
had missed 3 days of work, been late no more than 7 minutes a few times, and the
Director of Slots wrote me up for my attendance.
The first one mentioned my illness, but the next day they tear that one
up, and write a new one for me to sign, with no mention of doctors or Dystonia.
I should not have signed that one. I
still have a copy of the original, though. They
wrote me up again in a week after I was one minute late.
They said if I was tardy or missed a day in the next 365 days, I would be
terminated. I gave my 2-weeks notice
that day.
I was unable to get back to work until June.
The Orlean’s Casino hired me as a tech for a very specific job.
It allowed me some leeway in my schedule, and they were more than happy
to let me work the graveyard shift. Most
of my “issues” are in the morning, so this worked out well.
They were extremely happy with my work performance.
But then that day came, when the tremors started going crazy, I had no
insurance yet, and I could not walk for the pain in my back.
I had to take a leave of absence. By
now I had insurance, but the doctors were so slow, and the insurance made me
jump through hoops to see a doctor that actually could define Dystonia, that I
ran out of Leave, and on November 16, 2007, I was terminated without so much as
a phone call. Under the umbrella of
the ADA, they should not have terminated me, but rather extended my LOA.
When I mentioned this to Human Resources I thought it fell on deaf ears,
but although they did not hire me back, they did expedite my Short Term
Disability, although it still took nine weeks before I received a check.
That same month I was forced to file Chapter 13 Bankruptcy.
After the short term disability ended on February 10, 2008, I expected to
go to Long Term Disability. These
are insurances I paid for out of every paycheck since I was diagnosed with
Dystonia, and even before. But a
pre-existing condition clause that only covers 90 days, kept me from
getting the LTD. My last check for
STD will come next week, then I have no idea what will happen next.
I have to make $875 payments to the Trustee of the Bankruptcy (at our
first meeting it was to be $400) every month, which is more than my rent, for 5
years. The new “Means Test” did
not exactly work for me because my wife had to work overtime while I was not
getting paid, just to pay the Lawyer $1300 to start the proceedings.
So we had too much “disposable income” to fall under Chapter 7.
Over the course of the 5 years we will pay more than 25% more than our
debt, plus have to hand over our Income Tax returns for 4 years.
Time to change withholding on my wife’s W-4!
That is my story to this day, February 5, 2008.
I have appointments with my PCP to get a referral to an ENT for the
Dysphonia, and with my Neurologist to finally discuss the results of the EMG and
Nerve Conduction Study. These are
both within the next seven days. I
now have an advocate at Health Plan of Nevada, who is a retired nurse, and sweet
as can be, who handles my referrals and communication between my doctors.
She said if this Neurologist does not come up with a plan of action; request a
referral to UCLA Neurologist. We’ll
see how that goes! I have not heard
a single word regarding my visit to the Gastroenterologist, which ended in an
ambulance ride to the ER, because my spasms looked like a Grand Mal Seizure.
The EMT gave me a “shot of something” and I had not felt so relaxed
in 9 years. But it soon wore off,
and the ER doctor gave me Adivan, (1mg X 3/day) which actually caused me to fall
asleep with food in my mouth. I took
it upon myself to go back to the Diazepam.
That
was as of February 2008.
Now
it is June 9, 2008.
New
PCP. New Neurologist/Movement
Disorder Specialist. No income to
date. Applied for jobs I felt I
could do, but no takers.
I
am now taking only Omeprazole and 30mg Diazepam.
Tried Sinemet, but apparently I do not have dopa-responsive Dystonia.
Had a blood test for Stiff Person Syndrome which was only very slightly
elevated which means “negative”. Dystonic
“storms” are less than weekly with the warm, even hot, weather.
Can start doing gentle stretching and other exercises, as well as relax,
in the pool of our apartment complex. Can
only go on days when my wife can accompany me, but it helps a lot.
Have met other people with Dystonia, and learned from them, that I am not
alone. Have a couple of Dystonia Pen
Pals, and we e-mail each other frequently. We
each have a place to vent, when we feel we have burdened our respective spouses
and family enough. I have learned
from one, a therapy called Ortho-Bionomy,
although no one close to me practices it, and insurance doesn’t cover it.
It is very interesting, though. Check
out the link.
Amazingly, last Friday, I read on the Social Security web site that a decision had been made in my case, and I would receive a letter in the mail stating such. Even more amazingly, there was a direct deposit to my checking account today from SSDI for $2400. Haven’t even gotten the letter yet! Boy is this a relief. My wife has been working overtime just to make ends meet, even though we have paid the lawyer more money and converted to Chapter 7. I just paid bills online that I could. I will have to go to the lawyer’s office to pay another $500. And I mustn’t forget to “pay it forward” to the United Methodist Church here in Las Vegas for keeping us from getting evicted.
Met with my new PCP and MDS Neurologist within the last couple of weeks. The Neurologist, as I mentioned has, for the most part, ruled out dopa-responsive Dystonia. He referred me to Pain Management so they could take care of my hardened (and painful) Lumbar Muscles. He suggested Baclofen be injected into the muscles. Oral Baclofen only made me sleepy, and that was at a minimum dose. And it did nothing to relax the muscles, which is it's job.
I waited for more than a week for the referral, then started making phone calls. Found that the referral was not sent because I have an HMO, and all referrals have to go through my PCP. HPN, my insurance company, still had me with my old PCP, who did not want to deal with my condition or me anymore. So the referral went nowhere.
I managed to get an appointment with my new PCP, although that was an ordeal also. Switching your PCP at Health Plan of Nevada HMO requires that you wait until the first day of the month following the request, and an additional month if the request is made after the 20th of the month. My request was after my last appointment with the former PCP, which happened to be May 25. This meant I could not see my doctor until July 1. Another fight with Health Plan of Nevada HMO ensued. I won, though, and got an appointment on June 20th.
So I finally met my new doctor. He was familiar with some types of Dystonia, but not mine, and was taken aback when he started working my muscles to test reflexes, and actually triggered a storm in his office. I took 10mg of valium, but he also gave me a shot of 5mg more. The storm did not last too long, and I left there with a referral for Pain Management. He did not seem to think the insurance would go through with it, though. That was discouraging, but I told him I could handle that fight too. I have a Specialist and a PCP who agree I need it. I am in constant pain, and there is nothing that will touch the pain in my lower back without causing side effects that make me useless. And the Neurologist can't treat the remaining symptoms from my Dystonia until the back is taken care of. The back may be causing some of the symptoms to appear, and others to worsen. Come Monday, the battle is on. I will get the treatment I need. I have all the documentation, and no pencil-pusher is going to decide whether or not I need the treatment. I am adamant.
(Note July 9: Denied Pain Management because there are no pain management doctors within the scope of my insurance who deal with movement disorders. Adamant or not, I lose.)
The only thing I can do alone to relieve the pain is to do absolutely nothing. I can go to the pool occasionally, but that is such a temporary solution it hardly seems worth it. The water is still cold, despite the 107-degree days we are consistently having, and is not pleasant for a long time. Once I have been in the water for a while and gotten used to it, it helps, until I get out. Need a salt-water pool, at about 80 degrees, so I can float easily, and take the pressure off my back. But I think the apartments would take offense if I dumped a hundred pounds of Epsom Salt in the pool!
Jean and I are planning a trip to Tampa, Florida, to see my family, including my new niece, adopted by my sister from China last November. She just turned three. I am certain we will have the opportunity to get to the beach at Clearwater. We stayed there several years ago, and the water is tepid as bath water, and the waves are gentle. Will have some difficulty getting across the beach sand to the water, but there is a will, so there will be a way! Not sure how I will get around when we are there. I doubt if I can take my scooter on the airplane. I will have to find out if I can rent one at the airport, or elsewhere. Another expense to budget for the trip. Flight prices vary by lay-over or non-stop a lot. Can save $600 by stopping along the way for an hour or so. Since I am traveling East, across three time-zones, it is not that big of a deal. (although Jean HATES taking off and landing!). Will have to allow 6 days to go for 4. Jean has scheduled vacation dates, but don't know if they will work. May have to use her usual four days off plus a couple of PTO days, which means she will have to go right back to work when we get home, jet lag or not.
Still taking the Diazepam and Omeprazole. No longer willing to take any anti-depressants or muscle-relaxers. I don't like sleeping the day away, and I believe every anti-depressant actually cause more spasms and triggers storms.
Storms are coming with increasing frequency again. The pain is unbearable. And yet... Health Plan of Nevada has again denied any Pain Management referrals from my Movement Disorder Neurologist and Primary Care Physician. My advocate at Health Plan of Nevada HMO is working on it as she has returned from vacation, but I must admit, I was floored when I read yesterday on my Health Plan of Nevada HMO web page that the Pain Management was denied again. This is the third time! What do they expect me to do? I told them my only alternative was to go buy marijuana from the guy on the corner of Arville and Sirius. I don't have to worry about a drug test to get a job, and I don't drive. I was being facetious, but what's a person to do? I am becoming increasingly angry, and the anxiety that comes with it is causing a vicious circle of storms and pain. I have previously rarely had storms at home, where I am usually at ease, but have had two violent storms in the last three days in my living room and on my deck. One of the storms resulted, I believe, as I tried unsuccessfully to transfer from a lawn chair to my transport chair. I fell, and as I tried to stand, the chair, which was not locked, moved and I torqued my back enough to cause just enough pain to make me angry, which made me overly anxious, which, in turn, brought on a storm. Fortunately, I was not alone, and Jean forced Valium into my mouth, tried to hold me steady, and got my CPAP machine to help me breathe. My biggest obstacle to overcoming these storms is breathing. I either stop altogether, or hyperventilate. Neither of which is good, and it takes everything I can muster to concentrate on breathing, when every muscle from my feet to my back to my esophagus and neck are spazzing like there is an 8.5 earthquake going through my body.
We have decided to put off our trip to Florida until November. I am worried about flying until after the election, and I hope the economy will improve to the point that the cost of the trip will not be so exorbitant I also hope that my health will improve somewhat before I see my family. I don't want them to witness my storms, and I am also afraid of having a storm on the airplane. I don't know how much valium it would take to prevent that from happening. Can't take my scooter on the plane so have to rent one in Florida. 40 dollars a day is more than a rental car! Bizarre.
We are moving back into a one-bedroom apartment in this same complex on the 28th of this month. It is ridiculous to spend the extra rent and electricity on a two-bedroom, especially since I can hardly get around in my chair in this one. There are too many corners, the kitchen is narrower by two feet, and the bathroom is nearly inaccessible. The apartment management has agreed to take out the shower doors, install handles, put in another ramp, and reverse the door on the refrigerator so I don't have to enter the kitchen to access it. And the patio is twice the size of this one, and with the wall around it, and lattice for more privacy, I can set up an office of sorts to write. We have a northern exposure, so it stays relatively cool even when the temperature is triple-digits.
That is my rant and ramble for the day. Will be back when I have something to say.
At long last, the day has arrived for my first trial of Intrathecal Baclofen Therapy. It is the first of two. The next will be on the 26th, and the doctor will try a different dosage, depending on the outcome of this trial. I arrived 30 minutes early, at 7:30 am, as instructed. I signed some forms and paid a 50-dollar co-pay. I signed some more forms. The nurse gave me very explicit instructions to follow after the procedure, which was to take 4 to 5 hours. Eat, then rest for at least 4 hours. Be prepared for noodle-like muscles, and if I have a headache which Tylenol doesn't rid me of, then I am to call them, because there could be some leakage of Cerebrospinal Fluid, as the Baclofen injection is very similar to a spinal tap.
After listening to the instructions, and getting a bit nervous, I was taken to the recovery room of the Day Surgery Center. When I entered, I was the only patient. The room is usually where patients are awakened from general anesthesia after minor surgery, mostly of the spine. After an hour or so in this room, as I lay in one of those hospital beds with rails on both sides, and propped a little at the head in a meager attempt to make me more comfortable, I was told there would be a delay. The manufacturer of the pump for which I am being considered was sending a representative. They showed up at 10:15. I had not eaten since 11pm, because I was instructed that I was not to consume any food for 6 hours prior to the procedure, and no liquids for 3 hours. By now all I could think about was how much longer before I could eat! The representative from Medtronic answered all my questions, and instructed the nurses in how to measure my spasticity and rigidity of the muscles. They did an initial assessment before the injection, then hourly after. They were excited at the response. Some tremors in my arms and legs were gone completely, if only on one side. But any response is considered a good response, and increases the likelihood of receiving the Intrathecal Baclofen Pump. The pump is a permanently implanted device under the skin just below the navel, to one side. It has a catheter attached, which runs around to the spine and is fused between Lumbar discs 3 and 4, into the gap between the spinal cord and the epidural space. It runs up to the thoracic region. How high it goes depends on how much upper body spasticity is present. Typically it only goes as far as T11. The pump is programmed to dispense Baclofen at a very specific dose, continuously. The trick, I guess, is determining that dosage, and manipulating over time, until the best results are seen. How effective it is will not be known ahead of time, even with the tests. The tests determine if a patient is a candidate for the pump. It may remove some of my spasms, rid me of some of my pain, or it might be something resembling a miracle, which would have me walking again, even if only a little.
Intrathecal Baclofen Therapy (ITB) has proven to work very well on patients with Multiple Sclerosis, Cerebral Palsy, Brain Injuries, and victims of stroke. In all the materials provided (DVD, Website, Flyers) there was never a mention of Dystonia. But I have heard from some who have received the ITB for Dystonia of different types, and they say it has improved their quality of life even if it did not CURE the Dystonia. I don't expect a cure. I know there isn't one. Not yet. But I have waited ten months for my Insurance company to finally do something, and now they are. I have already gotten approval for the pump, if the doctor believes it will benefit me at all. I can't ask for more. This is my last, best hope. Soon after the 26th of September, 2008, I will be told if I get it or not. The first test excited all the nurses, and when the doctor checked in on me after three hours, he seemed pleased.
Unfortunately, the instructions I was given for after the test... well... it didn't go so well. We stopped and ate, then filled the car with gas. Then the car wouldn't start. The battery was dead. I was in a wheelchair, pain around the injection spot was very uncomfortable, my legs would not work AT ALL, and it took 45 minutes for someone to offer us a jump. Then we went to Sears (Diehard Gold Battery in the car), where they said it would be a while because several of their techs had taken the day off to go the San Gennaro Festival, which was in their parking lot. One hour and fifteen minutes later, they say the battery is good. On our way home, I notice the speedometer isn't working. When we arrive home, nearly 12 hours after leaving for the doctor, the car does not start. Sparing you a bunch of boring stuff, suffice to say it was $375 to get it fixed on a Saturday because Jean had to go to work on Sunday. We ain't rich by any stretch, and that hurt. But fortunately we had it that week because we are saving for our trip to Florida in November. Now we have to take it back it for "tweaking". The radio doesn't work, and the Speedometer needs to be checked for accuracy. They will hook it back up to the computer today (as I write this, it is Thursday, 9/18/08) and finish the job. Supposed to be no more charges, but I am a pessimist when it comes to cars.
That is all for now (it is 4:20 am, and I have not slept for 23 hours). Next update will be after the next test. Fingers crossed!...
Thanks for listening. Again...
Dave
For more on ITB, go to http://www.spasticity.com
The underlined items are
the side effects which I experience or have experienced since taking…
BUPROPION
(Wellbutrin, Zyban)
Bupropion
HCl is indicated for the treatment of depression and as a smoking cessation
treatment.
Side
Effects:
Bupropion
has numerous side effects on all the body systems
*Body
as a Whole: Headache, Infection, Abdominal pain, Flu-like symptoms
*Dermatologic:
Rash, Sweating, Pruritis
*Cardiovascular:
Palpitation, Flushing, Edema
*Gastrointestinal:
Nausea, Dry Mouth, Decreased Appetite, Vomiting, diarrhea,
Abdominal Pain, Constipation
*Nervous
System: Insomnia, Agitation, Anxiety, Nervousness, Irritability, Ataxia (lack of
muscle coordination), Seizure, Myoclonus (muscle spasm), Dyskinesia (impairment
of voluntary movement), Dystonia (disorder of muscle tone) Somnolence
(sleepiness), Tremor, Dizziness
*Psychiatric:
Mania/hypomania, increased libido, Hallucinations, decrease in sexual function
and depression
*Respiratory:
Pharyngitis
*Urogenital:
Urinary frequency, Nocturia
*Special
Senses: Tinnitus, Taste perversion
IMPORTANT
WARNING: At a dose of 300 mg each day, there is a chance that approximately 1
out of every 1000 people taking bupropion HCl, the active ingredient in
bupropion sustained release tablets, will have a seizure.