Why Elon Musk’s Wellbutrin tweet worries experts

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Elon Musk’s recent tweets reflecting this medical experts say opinions about mental health drugs are misinformed – including a tweet that called for the removal of a widely used antidepressant from the market and another touting the benefits of psychedelics over prescription drugs – caused a swift reaction from patients, mental health providers and other affected people to the tech billionaire’s outsized public influence.

“Elon Musk has a massive following, and he’s very unique in that a lot of his followers think he’s a super-genius who should be believed more than almost anyone,” he said. Tyler Black, pharmacologist and clinical assistant professor of child and adolescent psychiatry at the University of British Columbia. Musk, CEO of Tesla, acquired Twitter for $44 billion in April and expressed interest in opening up the social media platform to “free speech”, which critics say could lead to an increase in the sharing of false informationamong other problems.

When Musk tweets an opinion about drugs to his more than 90 million followers, “he’s putting people at risk because there’s going to be a number of people who will believe him,” Black said.

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Reply to a tweet friday which included an excerpt from a 2016 New York Times Magazine article titled “Generation Adderall“, Musk wrote: “Wellbutrin is much worse than Adderall [in my opinion].” Wellbutrin is a brand name of bupropiona prescription antidepressant approved by the Food and Drug Administration in 1985 which is sometimes used to treat attention deficit/hyperactivity disorder, or ADHD. Adderall is often prescribed for ADHD.

“It should be taken off the market,” Musk added of Wellbutrin. “Every time this drug comes up in conversation, someone at the table has a story of suicide or near-suicide.”

In response, many people, including health professionals, shared personal experiences about how taking Wellbutrin helped them. Meanwhile, some mental health experts have been quick to highlight safety and effectiveness of the drug, imploring people to rely on qualified medical providers for advice.

“It is extremely distressing that a man who blithely launches [uninformed] opinions on medicine is about to acquire this whole platform,” tweeted Daniel Summers, pediatrician.

Black called Musk’s Wellbutrin comments “essentially medical misinformation.” The drug was approved “on the basis that it works and its benefits outweigh its harms, so what he shared unquestionably had the effect of misinformation,” he said.

Musk did not respond to a request for comment.

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Bupropion is approved for the treatment of adult depression and seasonal affective disorder, and to help people quit smoking. Experts say there is strong safety and efficacy data to support its use; a scientific review of bupropion released in 2005 estimated that it was used by over 40 million people worldwide at the time.

It is considered an “atypical antidepressant” because it acts on the neurotransmitters dopamine and norepinephrine, clarified Jessie Gold, assistant professor in the department of psychiatry at Washington University School of Medicine in St. Louis. Gold, who has been taking Wellbutrin for more than 10 years, added that the drug is preferred by some people because it can increase energy, usually does not cause weight gain and may cause weight loss, and poses a risk fewer sexual side effects. .

There have, however, been reports of seizures associated with the drug, although the risk is generally low, according to National Alliance on Mental Illness. The risk of seizures increases, in part, with higher than recommended doses. Additionally, the energy-boosting effect may make some people more anxious, Gold said. Like other approved antidepressants, Wellbutrin also carries a strong warning from the FDA regarding the risk of suicidal thoughts or actions.

“Bupropion itself has a very low to absent suicide risk signal, and while we would always recommend monitoring when you start it, it is certainly not an antidepressant or even an ADHD medication that is more associated suicide,” Black said.

Black also noted the difficulty in attributing suicides or suicidal ideation to drugs. “The reason people start taking drugs is often because their situation is getting more and more desperate,” he said. “We can’t tell the difference between the cause of the suicidality being the start of the drug or the reason the drug was started.”

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It’s unclear why Musk weighed in on the prescription drug. “I imagine that in Elon’s brain, he was hoping to help people,” Black said. “But, of course, the unintended consequences of telling people that Wellbutrin is scary could be very harmful.”

After sharing his thoughts on Wellbutrin, Musk continued to tweet about the drugs. He responded to a Twitter user’s question about Ritalin, another prescription drug for ADHD symptoms. Then, in a separate tweet, he wrote“I have spoken to many more people who have been helped by psychedelics and ketamine than by SSRIs and amphetamines,” referring to selective serotonin reuptake inhibitorwhich are the most commonly prescribed antidepressants.

“Psychedelics and ketamine, in many ways, are still in early testing,” Gold said.

Black added that despite ongoing research, “psychedelics are not yet the first-line treatments for anything in psychiatry, and they may never be, because the evidence will not support them.”

Health misinformation or misconceptions that could be construed as medical advice shared by influential public figures, such as Musk, could have broad repercussions, said Steven Hoffmanprofessor of global health, law and political science at York University in Toronto, who has published research on how celebrities influence people’s health decisions.

Hoffman said influence can result from psychological, sociological and biological factors, with admiration acting as a “key mechanism”. For example, people who admire Musk are more likely to trust his views on topics like drugs, despite his lack of expertise.

“If some people think the drug their doctor has prescribed them won’t work or could lead to suicides as Elon Musk claims, then that could encourage patients to stop taking their drugs,” he said. “It could also encourage patients to seek alternative medicine that Elon Musk recommends through illegal routes, which could also be quite dangerous.”

And the effect could spread beyond Musk’s fans as his opinions continue to gain visibility through retweets, likes, media coverage and public discourse. As information spreads, the original source isn’t always clear and details can be distorted, Hoffman said.

“There are going to be a lot of conversations around a lot of kitchen tables across the country where people are going to start talking about Wellbutrin and Adderall and psychedelics,” he said. “Those who hear this information at the kitchen table won’t realize it started with Elon Musk’s tweet.”

Musk should be aware of these potential ramifications, Black said. “I really hope that in his constant pursuit of freedom of speech, he will recognize that not all speech is trivial.”

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). You can also text a crisis counselor by messaging the crisis text line on 741741.

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