Psychiatry Expert Discusses Inappropriate Cessation of Wellbutrin in Schizophrenia Case

This psychopharmacology case involves a female patient in Rhode Island who suffered a psychotic episode and was diagnosed with schizophrenia. She was hospitalized and then prescribed several medications. Her symptoms were well controlled for several years. The patient was seen by a new psychiatrist for the first time with complaints of insomnia and agitation and the psychiatrist subsequently took her off Wellbutrin. However, three days later, the patient murdered her brother.

Question(s) For Expert Witness

1. Do you routinely treat patients such as the one described in this case?

2. Do you routinely prescribe Wellbutrin? Is it within the standard of care to take a patient of this medications without titrating down the dose?

Expert Witness Response E-001060

I have a great deal of experience with patients like this as I have been a psychiatrist for 28 years. I was the Clinical Director for a state hospital for 4 years, where I treated hundreds of patients with schizophrenia. I also have a great deal of experience with Wellbutrin. In fact, I was involved in a study back in the 90s, when Wellbutrin was temporarily taken off the market due to it causing seizures. I am sure I've prescribed Wellbutrin over 1000 times. As far as the standard of care, it depends as it is multifactorial. I am Triple Board Certified and am a fellow of The American Psychiatric Association, which is the highest rank in that organization.