Lockup Doc

Bupropion (Wellbutrin, Zyban) is a unique but commonly prescribed antidepressant that inhibits the reuptake of dopamine and norepinephrine. It is FDA approved for the treatment of major depressive disorder, seasonal affective disorder, and smoking cessation. It is commonly used off-label for the treatment of attention deficit hyperactivity disorder (ADHD).

Anecdotally there have long been reports of abuse and diversion of bupropion in jails and prisons. In my own personal experience in these settings, I have not seen much evidence of such misuse. Inmates rarely present to me seeking this medication. By contrast, and about which I have previously written, quetiapine (Seroquel) is highly desired medication in corrections.

I conducted a literature search on this topic and Read more…

Seroquel (quetiapine), an atypical antipsychotic medication, is FDA approved for the treatment of schizophrenia, mania, bipolar depression, and maintenance treatment of bipolar disorder. It is used off-label for many different reasons. In a prison environment, it is often used to target problems with anxiety, sleep, and impulse control.

In the early 2000’s, Seroquel came up on the radar of my correctional system primarily because of cost. Not only was it expensive to use, but it was being greatly over-prescribed.

Shortly thereafter, it was recognized as not only costing money but also as likely being abused and diverted.

This suspicion was further validated when a somewhat famous letter to the editor of the American Journal of Psychiatry was printed in September 2004 detailing the extent of Read more…