Damianamae: starting a Wellbutrin taper

[Damianamae]

Hi all.

I'm hoping to start tapering off of Wellbutrin XL 300mg in the next couple of days with my doctor's blessing and input. She's prescribed 150mg SR twice daily for a month and then we will talk about dropping from there. I was stable but not loving it until November 2018 when I had to switch from one generic to another due to a major shortage. It started off not bad, my body recognized that it was different, but I only had a mild recurrence of some of the good effects and I figured those would drop off after a few weeks. Instead, as time has gone on, the negative side effects are getting more troublesome. I've been off work since December 10, but I've only got 15 weeks of paid leave. I didn't really think that it could be the drug switch, but when I'm having a clear-headed time, I can look at the timeline more accurately and it really looks like I need to drop down at least a little. Part of the reason my doctor and I chose the SR over doing XL and SR is because of the supply issues. 150mg XL availability is really dicey where I am, even more than 300mg. 

 

A few years ago, I had a DNA test done and it said that my serum levels with Wellbutrin would be higher than expected, so it makes sense that this change would be problematic.

 

As a child, I developed OCD specifically related to illness, and I managed to hide it until I was 22. I've been through multiple rounds of treatment for it. Unsurprisingly, I was also diagnosed with depression and migraines at 15.

 

I am very, very scared to start this taper. I'm sure in part because of the increased anxiety levels from the Wellbutrin switch, but I am also so phobic about feeling unwell. 

 

As you can see from my signature, I've had a varied history with medications. Much of the issue, particularly with the ones I was only on briefly, is because I get bizarre side-effects. Often they are ones that typically only show up at higher doses than what I was taking (Risperdal), but usually they are ones that doctors have never had reported. For a long time, I wasn't believed (I'm quite sure that's a commonly expressed thing here), but the last couple of years the doctors are more accepting when I tell them that my sweat turned everything orange when I was on Zoloft, or that Celexa made me smell awful.

 

Hopefully I have done this intro correctly.

Edited January 30, 2019 by Damianamae
added piece about migraines

[ChessieCat]

Hi damianamae and welcome to SA,

 

I'm really pleased that you have found SA before you started tapering.  Other SA members have experienced issues changing from brand to generic of their drug.  generic-vs-brand-change-in-drug-manufacturer

 

SA recommends tapering by no more than 10% of the current dose with a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

When we take away some of the drug we can experience withdrawal symptoms.  The tapering protocol we recommend aims to do this slowly enough so that withdrawal symptoms are kept to a minimum.  Dr Joseph Glenmullen's Withdrawal Symptoms

 

This topic explains how to get the dose you need:  Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

 

Tapering Calculator - Online

 

It sounds like you have a good doctor.  However, many medical professionals taper much faster than SA's recommendations.  You might find these topics helpful:

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

Thank you for creating your drug signature.  Please update it whenever you make a change so that it remains current. 

Account Settings – Create or Edit a signature

 

This is your own introductions topic where your can ask questions about your own situation and journal your progress.

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[ChessieCat]

We strongly encourage members to learn and use non drug coping techniques to help get through discomfort and tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

[Damianamae]

Hi ChessieCat,

Thanks for all of the information! 

There was no real talk about going from XL to SR equivalent dosages right away, but the post from Felin on page 3 of the Wellbutrin taper thread really frightened me because of the OCD. I've had a lot of CBT and DBT so I'm definitely familiar with non-drug coping techniques, but I'd really know what is reasonable to expect in terms of timing from switching to once to twice a day. I mean in terms of details: am I getting a higher amount dumped into my system earlier? What if I overlap by too much? Will I have more than I'm used to having in my system from the XL? I don't know if anyone can answer this, but I'm totally paralyzed right now. The pills that I was given were the purple ones, and the description of them being evil is making me despair.

 

 

 

[Damianamae]

Ok I looked in detail at the charts about the bioavailability and it looks like even though the SR peaks more quickly, it will peak lower so I think the afternoon panic I will be having will still be less than if I took the 300 XL.

[Damianamae]

Second day of twice daily dosing. Already I'm finding pronounced daytime tiredness, but my heart seems to be beating less intensely and when I get anxiety waves, they're not nearly as profound. I've been doing a lot of crying, but I think that's less depression and more fear of the change, and fear of what is to come in a few more days if withdrawal starts. My appetite, which was already poor, has gotten worse. I can't say I'm upset about the weight loss because I'm sure I will start gaining once withdrawal starts in earnest, and I have never taken off the balance of the medication weight I put on in 2011-2012 from Lexapro. It was the only medication I ever gained weight on. I craved sugar like a drug.

 

This creeped up so insidiously, it makes me angry. I didn't even know what was going on, just that my whole life changed in a really short span of time. I've never really had a full and free life because of having OCD for so much of it, but my already small world got so much smaller. 

 

I'm lucky that I have a good support network. My mom wants me to go stay with her for a few days if withdrawal starts so she can take care of me, and my friends are so willing to listen, even if they don't understand fully what's going on or why I am the way I am. I need to remember to let them help me even though my inclination is to hide.

[Damianamae]

Thursday was quite lovely. I visited with my mom for five hours (would not have been able to do that a week ago) and we even talked about two different medical things without me feeling like I was going to pass out. I don't know why that has become such an issue in the last couple months. She said she could see a difference in me and didn't want to jinx it because she knows things could go south soon. 

 

The most profound thing for me is that I can't feel my heart beating all the time. That and not being nauseated or dealing with reflux more often than not.

 

She did a lot of reading on Wellbutrin and had no idea how bad it could be for people. She's very angry. I didn't have the heart to tell her that all psychiatric medications have similar stories, I just let her be mad about this one because it's personal. 

 

Yesterday I had a bit of a set back because I did some errands and came home a little dehydrated. I know that when this happens I just have to drink a bunch of water or gatorade and things will even out, but because of my recent experiences with awful chest-crushing anxiety lasting for hours, I couldn't handle the thought and took an Ativan. This is the trap I did not want to fall into. I know that the best thing for me is to just sit with the anxiety, it's the best way to help myself. The feelings receded before the Ativan could have started working so I was feeling a bit defeated, but I'm going to try to take it as a lesson instead of anything else.

 

Today I have a hair appointment. They're typically 3-4 hours, so I've already given my stylist a heads up about what is going on. I hope I can make it through the whole thing. It's so sad to me that even something as simple and enjoyable as that has become something to be feared. At least I haven't been getting the afternoon panic surge that I was getting from 300 XL. 

 

It's hard for me to not be angry about this. Having a clearer head, I look back at the last two months and how gradually it was building up. I don't want to say it was becoming toxic, but how else can I explain how the side effects were getting worse and worse instead of gradually getting better?

[Damianamae]

Stayed up too late last night because I expect that the withdrawal symptoms will begin today and I'm so scared. Got up and too my first dose and then went back to sleep after about an hour. I have tension in my migraine spots, but that's to be expected from the weather changes we have had recently. Honestly, it's really strange that I haven't had a migraine yet. I wonder if that has anything to do with not flooding my system with Wellbutrin because I've always been a headachey person, but it definitely became more pronounced when I started the medication. 

 

Once I'm done this adjustment, I've resolved to do a 10% taper. I'll need to speak with my doctor about switching this prescription to a combo of SR and IR, so I'll need to go through that adjustment too, but I need to minimize this fear.

[ChessieCat]

You might find it helpful to write a script and rehearse what you are going to say.  Be calm, gentle but assertive.  You are the customer, it is your body.  Use words like I'd like to try this, or I'd prefer to do it this way.  If a suggestion is made that you don't want to follow, say I'd like to think about it before making a decision.

[Damianamae]

Thank you for the suggestion. My doctor is pretty laid back, and she seems to trust that I have a good head on my shoulders about medications and such. When I was younger, being so self-directed was not a good thing, but now the physician/patient relationship seems to be good. She's worked with me previously on slow titrations to begin medication and takes my concerns about side effects and withdrawal seriously because of my particular OCD issues. I'm certain that as long as I present a reasonable plan to her, she will go with it to help me get out of this mess.

[Damianamae]

Today was not a good day. Maybe withdrawal, I don't know. I've had a lot of stomach acid since last night and my appetite has gone missing again. As a result, I waited far too long to eat and ended up panicking a bit over my stomach acid situation, resulting in not being able eat then either. I took a max dose of Gaviscon and rested until I was able to slowly work on my peanut butter and toast. Later on, I had some beef noodle soup that I found in my freezer. Mom food is the best on days like this. If the pattern from before reestablishes, I'll be hungrier tonight.

 

Chest tension has come back for the first time since switching to SR, and that worries me because that was a large piece of the panic attacks previously. I'm feeling weak and tired today, but that could be from the lack of food as much as anything else. Washing and pinning out a knit shawl that I finished left me shaky. Mild pressure in my head, not enough to be called a headache, just wanted to make note of it because I've been less headachey than I usually am the last while.

[Carmie]

Hi Damianamae, 

 

Welcome to SA from me too. I can see you’re extremely scared with this whole process, and there is no doubt it’s a scary process. It’s easy to worry about the withdrawals and the next taper etc. I’ve certainly been there myself. 

 

The problem is we can start to fear the fear as Claire Weekes talks about. Check out the links that ChessieCat gave you on that subject if you haven’t done so already. The fear can actually make our symptoms worse. 

 

You’ve only just recently changed from taking the 300mg dose once a day to taking 150mg twice a day so please do not taper or make any other changes for quite a while.  You need to let your body stabilise again. I personally wouldn’t make any changes for at least two months. It’s not a race, if we go too quick we will pay for it. I’ve done that in the past before I knew anything about these meds or tapering. 

 

I found the best thing for me when going through waves was to find distractions, I did arts n crafts, word games, crosswords, went out in nature, cranked up the music, watched DVDs and Netflix. The list is endless. Try and find yourself some things to do that will take the focus away from your symptoms. 

 

Wishing you all the best in your recovery 💚

 

 

Edited February 5, 2019 by Carmie
Removed white space

[Damianamae]

Hi Carmie,

Years ago, a great therapist I had recommended Hope and Help for Your Nerves by Claire Weeks, so I’m definitely familiar with her work. It was such a great book that I’ve given it away and had to re-buy it a few times. 

 

Can i I ask why you think it would be a good idea to wait two months instead of one this time? I absolutely want to be cautious, I’m just curious for the reasoning, that’s all.

 

Netflix and knitting have been my best companions through this, as well as silly game apps. It’s hard for me to get out sometimes because of the nature of my OCD and the physical symptoms I get from panic. When I’m able, I like to go for walks with my mom and her dog. So far changing from XL to SR has made a positive change. I’m very doubtful that I will have the same kind of experience as I did switching generic XL, that it felt like it was building and building in my system which is why I kept getting sicker. 

 

The two other helpful things that I’m doing are using an app called Calm for their daily 10 minute meditations and other programs, and going to a weekly group for managing anxiety. I’ve already learned the majority of what both are teaching, but it’s so good to have it in the front of my consciousness rather than just hovering in the back of my mind.

[Carmie]

Hi damianamae, 

 

I’m glad that Claire Weekes has helped you in the past. 

 

It’s up to you if you wait a month or two before you make any changes, I just know with myself that when I made changes too soon I payed for it later on. I err on the side of caution these days. Our bodies are the best indicators as to when to move forward, but sometimes even then too many changes can catch up with us later on, even if we did okay in the beginning. 

 

Before I knew about tapering I would make too many changes close together at times, and I’d be okay for a while and then I’d get hit like a ton of bricks. You know your own body, and you need to work according to that. Just go slow and be safe. 

 

Wishing you all the best.💚

 

 

[Damianamae]

Caution is definitely the path I want. I think you’re correct about two months. I started switching my generic mid-November and it took until January to put the pieces together that something was really wrong . I guess I’m just anxious to get this lower in my system because I’ve seen what too high can do and I’m afraid that even with the precautions I’ve taken, I’ll still be absorbing too much.

 

Coming off Paxil, I was doing my drops too close together and I was a mess. I can’t believe my ex put up with me. It wasn’t until a family trip caused me to put an extra week in that I realized what a disaster I’d turned into. I think I still went too quickly because I had two years of periodic vertigo after. The other drugs I’ve come off of haven’t seemed to have the long lasting effects, at least. 

 

For what it’s worth, I’m not trying to be argumentative or a know-it-all, I’ve just been on this path a long time and have had a lot of (good) professional help on the soft side of things.i am very lucky.

[Carmie]

Hi Damianamae, 

 

You don’t sound argumentative or like a know-it-all at all.😃 I’m so glad you’ve had a lot of help along the way, what a blessing. 

 

I wish you all the best in your continued tapering. Keep us updated. 

 

Sending hugs🤗

[Damianamae]

Another bad day, much worse than yesterday. I think I managed to get very dehydrated overnight and it was causing such problems that I needed to take an Ativan. I tried to sit with the anxiety because I know that’s how to battle it, but when I feel that sick to my stomach it’s just not possible. I could barely get any food down so I tried to drink water and Gatorade. I have been in bed except for the necessities. 

 

I hope that this is day two and not day one of withdrawal because historically day two is my worst day and I’m not sure I can mentally take a day worse than this. 

 

Had to cancel an appointment to get my car checked out, and I’m not sure if I can make it to group tonight. It’s effectively a three hour commitment including travel time and at this point I doubt my ability to commit to a five minute shower. I have the notebook for it here so I can do the work.

 

i don’t understand why this has reverted to being like before I switched from XL to SR in terms of feeling awful and sick in the morning, but having an appetite and doing ok by evening (if this follows yesterday’s pattern). I thought that having a lower plasma level generally would stop the idea that it’s flooding my system with too much too soon. 

 

If anyone has insight into this as a phenomena, please share the knowledge. For me, understanding the background and having the logic is a key to my cope levels being better.

[Damianamae]

Seeing my doctor on Tuesday to talk medication and OCD brain has me spinning about the next step. I’m not sure if I should go from 150mg SR twice daily to 100mg IR three times daily, or by staying at 150 SR in the morning and then two doses of 75 IR afternoon and evening, or maybe start an actual taper using SR. It’s a generic SR, so it’s unlikely to hold the sustained release properties. I’ve read the guide over and over again and I’m just digging myself into a rut, so a little hand holding would be super helpful. Can anyone make any suggestions?

[Damianamae]

Anyone?

[Altostrata]

Hello, Damianamae.

 

You have been taking 300mg Wellbutrin XL but switched to 150mg Wellbutrin SR twice a day on January 30, is that correct?

 

300mg Wellbutrin XL had been causing anxiety, chest tension, etc. and 150mg Wellbutrin SR twice a day somewhat relieved these symptoms? How has your sleep been while taking Wellbutrin?

 

How often do you take Ativan?

 

You haven't started tapering in terms of reducing the total daily dose yet, but your side effects have been reduced by changing the form of the drug. Please focus on that instead of your worry about withdrawal symptoms. It's possible you won't feel any withdrawal symptoms!

 

Since you are sensitive, this is probably the best way for you to taper:

 

14 hours ago, Damianamae said:

two doses of 75 IR afternoon and evening

 

You can initiate the transition to two doses of 75mg buproprion IR by cutting a 150mg SR tablet in half. While the "SR" glue will be damaged, it may get into your system a little slower than an IR tablet.

 

You can take the half-150mg SR tablet for one of your 75mg doses and an IR tablet for the second dose. You'll want to take them some hours apart so as to retain some buproprion in your system throughout the night. It sounds like you have a good understanding of the scheduling.

 

When you get settled with this, you can then make a liquid from the 75mg IR tablet for tapering by 10% per month, see Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

 

Typically, people reduce the evening buproprion dosage first because the drug tends to keep people awake. If you taper by 10% per month, it's very possible that you won't feel any withdrawal symptoms. You might even feel better and better as side effects are reduced when dosage is reduced. Think positive, you can do this!

 

You probably already have a toolbox for coping with your health anxiety. FYI, here is our discussion, please add to it if you wish. Health anxiety, hypochondria, and obsession with symptoms

[Damianamae]

Thanks for replying.

 

Yes, you are correct. 300 XL was causing a whole host of issues that 150 SR x 2 has helped. I'm finding that some of them are starting to appear again, however, which is why I'm antsy to start tapering. I had my first protracted panic attack since I switched, yesterday. I'll be going back to work next month, so I really, really can't have that happening there. Since taking Wellbutrin, I've needed less sleep which has been a real help because I've always been someone that needed a lot. The first thing I noticed when I switched dosing schedules was how utterly exhausted I was all the time. It got a little better after the first week, but I'm still pretty tired. That could be also attributed to it taking a while to figure out how much time I needed between doses to balance being able to sleep but still keeping some in my system for long enough.

 

I'm not taking Ativan too often. I would say that it averages to being about once a week now. Occasionally I'll go longer, occasionally I'll take two in a week.

 

Do you have any advice about the timing of the two split doses? Right now I find that if I take the SR doses more than 8 hours apart (which is the minimum you're supposed to have between), it keeps me awake. I'm concerned that it will get worse if I (for example) do the 150 SR at 7am, 75 split SR at 3pm and the last one much later. Though I suppose that the level hitting my system would be lower anyway so I probably won't have the same kind of stimulus. It will also hit more quickly so it won't be as high as long. Just to note, I'm on the generic SR and not the brand name. I was able to contact the manufacturer this afternoon to confirm if their SR can be split and still retain some of the sustained release effects, but the lady that called me back said no, which is what I kind of figured. It's a bummer because I love the idea of a smoother transition.

 

Your suggestion for reducing the evening dose first is how I was able to successfully taper off of Buspirone, so I'm happy that I was on the right track there. I intend to follow the tapering guideline once I get on 150/75/75, it's just the matter of getting there that worries me. It's kind of exciting to think that I'm progressing on this. 

 

Thank you for the link on health anxiety. It's frustrating because the OCD complicates every aspect of this (and, well, every aspect of life) because I am so terrified of throwing up that I will do anything to avoid it. I know that no one actually likes it, but this has been an overwhelming issue for a long time. I think if it wasn't for that, the prospect of withdrawal wouldn't scare me so much. Any time I'm getting blood sugar fluctuations from hinky eating patterns thanks to no appetite, or reflux from the same thing, it sends me into fear mode. I've been pretty good at figuring the cues out so I am able to sit with the anxiety for the most part, but the last couple months dealing with the reaction to the generic switch has made it exponentially more difficult. I will certainly take a look at the link and add anything helpful I find there to my repertoire.

 

[Damianamae]

A wrench has been thrown into my plans. Pharmacy is saying that Bupropion IR is not available in Canada. I was gobsmacked. I’m waiting to hear back from a compounding pharmacy to see if they can help. 

 

If they cannot, I’m not sure what to do. I’m thinking of maybe doing 150 SR in the morning and 100 SR in the afternoon. It’s a 16 or 17% drop, but I have few options because the pharmacy is adamant that I should not be cutting the pills due to not knowing how fast things will hit my bloodstream. 

 

Fingers crossed that the compounding pharmacy can get the ingredients needed. 

[Damianamae]

Three of the compounding pharmacies called me back. Two were the ones I was most interested in working with. Of them, the one is looking into the potential effects of making me a suspension (ie the effects on my gut, she said that without my prompting so that was nice) and the other has said they can do it, but it will be $80-90 every two weeks rather than the $27 a month I'm paying now. In both cases, they are unable to get the proper powder because of shortages in the supply chain, so it would have to be pills with the coating removed and then ground up. Canada is having a serious medication shortage right now and Wellbutrin is one of the ones affected which is what started me on this whole path.

 

For the time being, I'm remaining on 150SR twice daily until there's any kind of viable plan. I can't afford $170 a month for the next four years to get off of this. 

 

I don't know what else to do. Maybe if I go down to 250mg a day of the SR it'll be enough to help bring the anxiety down and I can go into a holding pattern until something magically resolves with this shortage.

 

It's really demoralizing.

[Altostrata]

On 2/25/2019 at 2:20 PM, Damianamae said:

Right now I find that if I take the SR doses more than 8 hours apart (which is the minimum you're supposed to have between), it keeps me awake. I'm concerned that it will get worse if I (for example) do the 150 SR at 7am, 75 split SR at 3pm and the last one much later.

 

I would arrange the doses so they do not affect your sleep. (Wellbutrin is stimulating, as you have experienced.)

 

If you can't get bupropion IR, you'll have to taper with buproprion SR. If you cut up an SR tablet, it effectively become immediate-release. To taper accurately, you'll have to use a digital scale to weigh tablet fragments.

 

How to cut up tablets or pills

 

Using a digital scale to measure doses

[Damianamae]

All of the pharmacists I’ve talked to are strongly recommending against that because of unpredictability. I don’t know if that’s because they are unfamiliar with IR or for another reasons.

 

i need to do something soon though, I think it might be building up in my system again. Except I’ve been very depressed at the same time so I don’t know what is going on. I’m so tired of this, I just want to have a day where I’m feeling better than gross.