CoolheadLuke: I am going to make it through this year ...

July 21, 2019

Hey all, 36 year old here – trying to sort out withdrawal effects, med side effects and potential underlying medical issues.

Current meds:

Bupropion (Wellbutrin) IR – 75mg w/breakfast, 37.5 w/ lunch, 37.5 with dinner (150 mg total)
Amphetamine salts (Adderall) – 2.5 mg morning, 2.5 mg afternoon (5 mg total)
Caffeine – 100 mg late morning
Loratadine (Claritin) – 10 mg w/ breakfast
Cefuroxime (antibiotic) – 250 mg morning, 250 mg evening
Doxylamine Succinate (OTC sleep aid) – 17.5 mg before bed

Current / past health issues:

Depression – on and off since about 2000, started Bupropion in 2009
Anxiety – has always been low level, much worse since WD started
IBS – dx around 2000
Chronic bladder inflammation (interstitial cystitis) – dx in 2010
Prostatitis – sort of chronic, reason for current antibiotics

WD history, short version:

Started Bupropion (SR) about 10 years ago. 2018 tapered 50 mg at a time from 300 down to 150.

2/2019 tried to taper from 150 to 100 and stopped due to withdrawal effects. Effects returned 4/2019 despite no dose change. Ended up switching from 150 SR to 150 IR on April 26^th, and made large cut to my Adderall and Caffeine doses April 29^th. Still recovering from symptoms and trying to stabilize fully.

WD history, long version:

In 2018, I started tapering the Bupropion down 50 mg at a time (at the advice of my doctor) starting at 300 mg. At the time I was taking the SR formulation.

Sept/Oct 2018 - I taped from 200 mg to 150 mg around and got fairly sick for a week in October. Upset stomach, fever, flu-like symptoms. At the time I thought it was just a stomach bug, but after having similar symptoms during WD I’ve been wondering if it was WD.

Feb 2019 - Tried to taper from 150 mg to 100 mg and experienced severe dizziness, nausea, fever/chills and sinus symptoms. I went back up to 150 mg after 5 days and felt better within a day or two

.

April 14^th - Picked up my Rx refill, and on April 15^th I started to feel lightheaded, dizzy and tired.

I got worse over the next few days with headache, congestion, fever/chills, nausea and chest pain. I went to an emergency dentist on 4/21 thinking it might be an abscessed tooth (they said tooth looked fine) and went to urgent care due to pain while urinating. Urine culture was normal, and I tested negative for flu.

I went to my PCP on 4/23 with very bad shakes in addition to the other symptoms. At this point, I started wondering if my new refill had somehow been a “bad batch” of the generic meds, so I got an Rx for the same meds from a different manufacturer. I tried that for two days with no improvement.

4/26, I switched from Bupropion SR (taken once a day at this point) to Bupropion IR (taken 3 times a day). The total dose didn’t change. Also had blood work done (CBC w/ diff, comp metabolic panel) – results normal.

4/29, following a morning with very rapid heartbeat, I cut my ADD meds (generic Adderall) from 15 mg to 5 mg. I also cut my daily caffeine from 200 mg to 100 mg. I’d reduced both the ADD meds and the caffeine in the past without any apparent ill effects, so I didn’t think it would have any effect this time around.

5/6 – 5/13 - Symptoms mainly resolved, except for some GI issues.

5/14 I had a rash, fever and shaking. Bad anxiety due to symptoms – went to Urgent Care b/c of rash. Over the next week I also started getting nauseous.

5/22 – Had blood work done again - (CBC w/ diff, comp metabolic panel plus ESR-Wes+CRP to check for inflammation). Also had Urine Analysis. All results normal.

5/29 – 6/6 again felt mostly better save for some lasting GI issues including mild belly pain.

6/6 had fever, chills, fatigue, added dizziness and shakiness over the next few days

Most of June: occasional dizziness and stomach pains.

6/17 - Tried to taper from 150 to 131. Reinstated after a few days dizziness and nausea.

Early July: Feverish, pains in stomach and chest. Occasional tightness in chest and heart palpitations. Lots of anxiety about symptoms.

Started antibiotic July 17^th.

Current (past few days): some pain in stomach and chest, more frequent heart palpitations. Stomach a bit upset (probably due to antibiotics). I’m seeing a therapist every other week, mostly about anxiety. I’d been planning (hoping) to try tapering the Bupropion again this coming week because I have a few weeks off work, but I’ve having second thoughts since I just started the antibiotic. Also wondering if it would be better to taper the caffeine first, since I should be able to get off that more easily.

Glad I found this site, very good to know I’m not the only one 😊

July 23, 2019

Hi CoolheadLuke.

Apologies for taking so long to get back to you.

Welcome to SA.

I am a junior mod and your drug history means you will need the attention of the top mods.

In your drug signature you have ? marks over three items. It is often difficult to remember exact time scales but approximate is better than nothing.

We certainly need to know if any of these happened in the last two years.

Sassenach

July 23, 2019

2 hours ago, Sassenach said:

Hi CoolheadLuke.

Apologies for taking so long to get back to you.

Welcome to SA.

No worries, thanks!

2 hours ago, Sassenach said:

In your drug signature you have ? marks over three items. It is often difficult to remember exact time scales but approximate is better than nothing.

We certainly need to know if any of these happened in the last two years.

I'm a little embarrassed that I don't have better data on my own med history; I've had a lot of different doctors over the years, thanks mainly to insurance that changes every year or two.

I was able to go through some old visits via the MyChart website, and I've found the following:

Lexapro was discontinued, and Wellbutrin was reduced to 300 mg, sometime before 2014.

I started tapering down the Adderall in May 2017.

I'll update my signature with these new dates.

July 24, 2019

Hi Luke

On 7/21/2019 at 8:48 PM, CoolheadLuke said:

Sept/Oct 2018 - I taped from 200 mg to 150 mg around and got fairly sick for a week in October. Upset stomach, fever, flu-like symptoms. At the time I thought it

was just a stomach bug, but after having similar symptoms during WD I’ve been wondering if it was WD.

This was almost certainly the beginning of withdrawal from a too fast taper, particularly as you started at 300 mgs.

On 7/21/2019 at 8:48 PM, CoolheadLuke said:

4/26, I switched from Bupropion SR (taken once a day at this point) to Bupropion IR (taken 3 times a day). The total dose didn’t change. Also had blood work done (CBC w/ diff, comp metabolic panel) – results normal.

4/29, following a morning with very rapid heartbeat, I cut my ADD meds (generic Adderall) from 15 mg to 5 mg. I also cut my daily caffeine from 200 mg to 100 mg. I’d reduced both the ADD meds and the caffeine in the past without any apparent ill effects, so I didn’t think it would have any effect this time around.

Again very big changes for your CNS ( central nervous system to) keep up with.

On 7/21/2019 at 8:48 PM, CoolheadLuke said:

I’d been planning (hoping) to try tapering the Bupropion again this coming week because I have a few weeks off work, but I’ve having second thoughts since I just started the antibiotic.

You should definitely not start tapering at present:

1: Because the antibiotic will confuse the issue and could have side effects of it's own. This means there is no way of knowing which drug is causing which symptom.

2: Your CNS is in disarray because of the changes you have already made. We all feel we have to be proactive to make us feel better, unfortunately it usual makes matters worse. The reality with withdrawal is that time is the only healer. However the top mods on this site have more knowledge of withdrawal than all but the most enlightened doctors and they can can help with reducing your meds in the right order which is very important.

It is now almost a month since your last updose, have you noticed any improvement in symptoms?

On 7/21/2019 at 8:48 PM, CoolheadLuke said:

Also wondering if it would be better to taper the caffeine first, since I should be able to get off that more easily.

See above. Why were you prescribed Caffeine as it is one of the first things we are told not to take in W/D?

On 7/21/2019 at 8:48 PM, CoolheadLuke said:

Started antibiotic July 17^th.

Presume you have almost completed antibiotic course by now. Has it solved the issues?

These are links to reinstatement, stability and tapering

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

https://www.survivingantidepressants.org/topic/17909-are-we-there-yet-how-long-is-withdrawal-going-to-take/

https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

To summarise:

Hold, do not change drugs or doses at present.

Please look around the threads and you will see that so many others are in the same situation.

Let us know how you doing and do not hesitate to contact us.

Sassenach

July 25, 2019

Hi Sassenach,

Thanks for the feedback and links.

8 hours ago, Sassenach said:

You should definitely not start tapering at present:

1: Because the antibiotic will confuse the issue and could have side effects of it's own. This means there is no way of knowing which drug is causing which symptom.

2: Your CNS is in disarray because of the changes you have already made. We all feel we have to be proactive to make us feel better, unfortunately it usual makes matters worse. The reality with withdrawal is that time is the only healer. However the top mods on this site have more knowledge of withdrawal than all but the most enlightened doctors and they can can help with reducing your meds in the right order which is very important.

That makes sense - I'll hold steady on the meds for now. I think I'll continue with the lower caffeine dose, though - I noticed a bit more fatigue and headache on Monday and Tuesday, but felt okay today. I wasn't prescribed caffeine - it's just something that I've been taking for many years. I switched to the pills 5 or 6 years ago because they were easier on my stomach/bladder than coffee or energy drinks.

8 hours ago, Sassenach said:

It is now almost a month since your last updose, have you noticed any improvement in symptoms?

I do seem to be in a bit of a window right now, so trying to be thankful for that while it lasts. Still experiencing some stomach pains, anxiety and heart palpitations. Also some dizziness / lightheadedness that comes and goes (but doesn't seem related to the palpitations). Definitely better than I was a month ago (and much better than two months ago). I did order some magnesium citrate that I'm going to try tomorrow. I ended up with 100mg capsules, so I'm going to try and split them so that I'm taking closer to 25-50mg to start out with

8 hours ago, Sassenach said:

Presume you have almost completed antibiotic course by now. Has it solved the issues?

Unfortunately the antibiotic course for my issue is 4-8 weeks, so I have a ways to go still. Doing alright so far, though - eating yogurt and taking a probiotic to try and keep my gut somewhat stable.

July 25, 2019

Hi Luke

Good to see things going in the right direction.

As you have already made substantial decreases in the caffeine dose, it would be best to hold as you suggest and allow everything to settle down.

You are better to start with low dose of Magnesium 25mgs for a few days and ensure it does not have any adverse effects, particularly with regards to your stomach.

Slowly is definitely better for stabilisation.

Hope you continue to improve.

If you need any help get back to us.

Sassenach

July 25, 2019

Hi CHL,

I was also on an SSRI and Adderall at the same time. Like you, the Adderall started to cause heart palpitations as my dose of the SSRI got lower. I ended up having to pause my SSRI taper and get myself all the way off the Adderall.

It's crazy how these things interact. Might have been nice if our doctors had given us a heads up.

Best of luck with the taper. Slow and steady is the way to go.

July 27, 2019

On 7/25/2019 at 9:53 AM, Sassenach said:

Hi Luke

Good to see things going in the right direction.

As you have already made substantial decreases in the caffeine dose, it would be best to hold as you suggest and allow everything to settle down.

You are better to start with low dose of Magnesium 25mgs for a few days and ensure it does not have any adverse effects, particularly with regards to your stomach.

Slowly is definitely better for stabilisation.

Hope you continue to improve.

If you need any help get back to us.

Sassenach

Thanks - I will continue to hold at my current doses. I have some travel planned at the end of August, that I definitely want to be stable for.

On 7/25/2019 at 12:09 PM, PatriciaVP said:

I was also on an SSRI and Adderall at the same time. Like you, the Adderall started to cause heart palpitations as my dose of the SSRI got lower. I ended up having to pause my SSRI taper and get myself all the way off the Adderall.

Ugh, sorry you had to go through that as well. Did you find anything that helped with the palpitations? How was it getting off the adderall at 5 mg?

On 7/25/2019 at 12:09 PM, PatriciaVP said:

It's crazy how these things interact. Might have been nice if our doctors had given us a heads up.

Yes! I know it's ultimately my responsibility, but it would have been nice if one of the may doctors (or pharmacists) over the years had said "you know, you really shouldn't be taking these two drugs together.". Ah well, thanks for the comments and good wishes - I hope your taper continues to go well too!

July 27, 2019

2 minutes ago, CoolheadLuke said:

Ugh, sorry you had to go through that as well. Did you find anything that helped with the palpitations? How was it getting off the adderall at 5 mg?

Yes! I know it's ultimately my responsibility, but it would have been nice if one of the may doctors (or pharmacists) over the years had said "you know, you really shouldn't be taking these two drugs together.". Ah well, thanks for the comments and good wishes - I hope your taper continues to go well too!

The only thing that helped the palpitations was stopping the Adderall. It wasn't too bad going CT off the 5 mg. I was very tired though. I slept a lot the first week.

I don't think it's too much to ask our doctors to know enough about the medications they're giving us to avoid poisoning us. It's not your responsibility. It's theirs. How could you even know what to ask? It's a shame that our healthcare system has become "buyer beware ".

Just don't blame yourself. You figured it out and are doing the best you can to make it better. That puts you miles ahead of most.😊

July 29, 2019

On 7/26/2019 at 6:27 PM, PatriciaVP said:

The only thing that helped the palpitations was stopping the Adderall. It wasn't too bad going CT off the 5 mg. I was very tired though. I slept a lot the first week.

I was afraid of that, but glad to hear that the CT from 5 mg wasn't too bad. Other than my last reduction (where I wasn't thinking clearly and reduced 3 drugs at once), the Adderall reductions have been pretty mild - super low energy for sure, but nothing like the Wellbutrin withdrawal.

On 7/26/2019 at 6:27 PM, PatriciaVP said:

Just don't blame yourself. You figured it out and are doing the best you can to make it better. That puts you miles ahead of most.😊

Thanks, that's much appreciated 🙂

August 6, 2019

I'm still hanging in there - had a rougher week this week due to dizziness, stomach pain/digestive issues and anxiety.

I've been having a lot of anxiety around my different symptoms, especially my stomach / abdominal pain. It started around the same time I switched from Bupropion SR to IR; it's not bad pain, usually more of a pressure/bloating, but it's been going on for a few months now. I think the antibiotics have made it worse.

I talked to my doctor about it last month, but he didn't sound too worried (just said to come back if there was blood in my stool). I'm trying to be logical and tell myself it's unlikely that I'd suddenly get colon cancer symptoms at the same time that I had all this other medical stuff going on, but I still end having anxiety spirals fairly often.

I was diagnosed with IBS around 2000, but that's always presented with diarrhea (sorry if this is all TMI), not with pain / pressure. I've tried to make an appointment with a GI specialist, but because I'm "self-referred" I think I'm pretty low on the list and they haven't gotten back to me yet. Even if I do get an appointment, I'm not sure I could handle the colonoscopy prep right now.

So, stomach pains and anxiety - trying to breathe.

August 6, 2019

Stomach pain is a side effect of buproprion:

https://www.drugs.com/sfx/bupropion-side-effects.html

https://www.rxlist.com/wellbutrin-side-effects-drug-center.htm

It definitely looks like changing to IR from SR caused this side effect.

August 9, 2019

On 8/5/2019 at 9:06 PM, ChessieCat said:

Stomach pain is a side effect of buproprion:

https://www.drugs.com/sfx/bupropion-side-effects.html

https://www.rxlist.com/wellbutrin-side-effects-drug-center.htm

It definitely looks like changing to IR from SR caused this side effect.

Thank you for the reassurance (and sorry for the delayed reply!). I feel like I've spent a lot of time over the past few months trying to seperate withdrawal symptoms from side effects, while worrying that I might be overlooking some potential underlying condition I'm hoping the stomach pain (and other digestive effects) will lessen as I start to taper down the bupropion.

August 9, 2019

Q: How many times a day are you taking it?

From https://medlineplus.gov/druginfo/meds/a695033.html

Quote

How should this medicine be used?

Bupropion comes as a tablet and a sustained-release or extended-release (long-acting) tablet to take by mouth. The regular tablet (Wellbutrin) is usually taken three times a day, with doses at least 6 hours apart, or four times a day, with doses at least 4 hours apart. The sustained-release tablet (Wellbutrin SR, Zyban) is usually taken twice a day, with doses at least 8 hours apart. The extended-release tablet (Aplenzin, Wellbutrin XL) is usually taken once daily in the morning; doses of the extended-release tablet should be taken at least 24 hours apart. When bupropion is used to treat seasonal affective disorder, it is usually taken once a day in the morning beginning in the early fall, continuing through the winter, and stopping in the early spring. Sometimes a lower dose of bupropion is taken for 2 weeks before the medication is stopped. Take bupropion with food if the medication upsets your stomach. If you have trouble falling asleep or staying asleep, do not take bupropion too close to bedtime. Take bupropion at around the same time(s) every day.

August 9, 2019

11 hours ago, ChessieCat said:

Q: How many times a day are you taking it?

From https://medlineplus.gov/druginfo/meds/a695033.html

I'm taking it 3 times a day - 75 mg at 7:30 am, 37.5 at 1:30 pm and 37.5 at 5:30 pm. I do take all 3 doses with food.

August 10, 2019

It wouldn't have to be a meal. Just a small snack. Even 1 small savoury biscuit might be enough. You'll have to try different things and monitor the effects to see what works for you.

August 14, 2019

I didn't have any negative effects from reducing my caffeine dose, so I thought I'd be okay to reduce my Adderall dose, but that's apparently not the case.

Bad dizziness today, along with headache and some nausea.

The reason I reduced my dose was because I'm still struggling with heart palpitations, and on Monday my heart rate shot up to 140 bpm and freaked me out.

I know fast heart rate is a common side effect of Bupropion, but I don't understand why it seems to be getting worse lately. Maybe I'm just noticing it more now? I've tried some Magnesium Citrate (about 40 mg, dumping out just over half of a 100mg capsule) but I didn't notice any effects other than extreme tiredness. I just started trying Taurine yesterday, but haven't noticed any big changes from that either.

I have to work on Saturday (not able to call in sick), so I'm not sure if I should try and tough out the symptoms the next couple of days in hopes of improvement, or if I should just reinstate to my normal adderall dose tomorrow.

August 14, 2019

SA recommends making only one change at a time. Looks like you have/are making several changes within a short period of time. This will make it very difficult to know what is causing what, either by adding or subtracting something.

Please see Post #1 of this topic: Keep it Simple, Slow and Stable

August 15, 2019

1 hour ago, ChessieCat said:

SA recommends making only one change at a time. Looks like you have/are making several changes within a short period of time. This will make it very difficult to know what is causing what, either by adding or subtracting something.

Please see Post #1 of this topic: Keep it Simple, Slow and Stable

Hi ChessieCat, thanks for the reply and the reminder. You'd think I would have learned by now ... 😒

One thing I've noticed since the withdrawals is that my anxiety is a lot worse, especially around new / worsening physical symptoms. I need to find a better way to deal with the anxiety so I don't keep doing dumb stuff liking cutting my med doses in a panic about side effects/symptoms. Seeing a therapist every other week is helping, but it's a long road.

It is helpful seeing how many other people on this site have similar physical symptoms, so I know it's more likely a w/d effect and not something horribly wrong with my body.

August 15, 2019

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.

August 15, 2019

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

Acceptance

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.

August 18, 2019

Ended up reinstating the Adderall on Thursday - this was a dumb time to try and make any changes, with having to work today and a big trip this coming Friday.

Haven't been too bad the last few days - some dizziness/faintness, that comes and goes, along with heart palps and some chest and stomach pain.

Thanks, CC, for all the links. I'm going through the "health anxiety" module on Center for Clinical Intervention site.

On 8/14/2019 at 6:11 PM, ChessieCat said:

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

I definitely don't want to add any more drugs to the mix. I say a psychiatric nurse when I was going through the worst of the withdrawals and she was more than happy to offer me lots of new pills to help with the anxiety and withdrawal symptoms, but thankfully I was able to turn her down.

I still struggle with understanding why I'm getting the symptoms I am, and what they're coming from. I know that heart palpitations are a common W/D symptom, but I still fear that maybe I'm just reacting badly to the Bupropion IR and damaging my body in some way. Then I think about switching to the XR instead, but if I did that I'd have to switch back to the IR before tapering, and etc etc. So again, thanks for the anxiety resources, I'm definitely trying to put them to good use.

August 18, 2019

The getselfhelp.co.uk is also a good site. They have diagrams and videos. It has a lot of information but can be a bit difficult to navigate. If find the easiest way is to google. Eg: getselfhelp.co.uk health anxiety

September 26, 2019

I figure it's time for a quick update - I'm still hanging in there, and still doing better than I was during the spring.

We took an overseas trip for a week at the end of August. The first day there I was dizzy for a few hours, but it cleared up pretty quickly. The first day back home, on the other hand, was really miserable. I had a lot of my "usual" withdrawal symptoms - nausea, dizziness, feeling feverish, plus a bad headache. That lasted all day, and it took me about two more days after that to feel stabilized again. I'm guessing it was just the time change messing with the drug levels in my blood.

I'm still having bouts of dizziness / lightheadedness, but I think my anxiety has calmed down quite a bit (yay therapy and self-help). Digestion is so-so, and haven't had as much stomach pain lately, so we'll call that a win.

Still trying to figure out when I should start my next taper (likely a liquid, 10% one). I think I might wait until January when I have a few weeks off work, just in case I get w/d effects from even a small change...

September 26, 2019

Hi Luke

Good to see you are doing better.

It is such a slow process at times it feels never ending.

As for your taper I suggest you don't set any date in advance and only do it it when you feel that that moment is the right time

Your body will tell you

Keep improving.

Sassenach

October 12, 2019

Been struggling through a pretty rough wave the last couple of weeks.

Wednesday was the worst, symptom wise: bad nausea/upset stomach, brain fog, & dizzy. It discouraging because I started working again a few weeks ago, after having most of the summer off. I teach after school enrichment classes (along the lines of chess club or drama). I only work a few hours a day, so I'm usually able to push through despite symptoms, but I ended up cancelling Thursday's class due to how bad I felt on Wednesday. That meant I had to call the parents of 15 kids on Wednesday, and I'll have to refund everyone's money for that class unless I can reschedule it.

No school today, and doing a bit better, but had tremors and lightheadedness this afternoon, and heart palpitations have been more bothersome the last few days. Trying not to get too discouraged, but it's hard...

October 15, 2019

It was 6-months ago that I started having withdrawal symptoms out of the blue, probably related to tapering too fast last fall. I guess I'm better than I was in the spring, but it doesn't feel like much progress has been made.

On and off nausea this week, plus hot/cold flashes and digestive troubles. Started getting rashes again yesterday, but not too bad. Hoping to make it through work all week, plus a work gig on Sunday.

Sometimes I wish I had a "real" disease, with a concrete diagnosis and a treatment plan; then my wife would understand why I'm not getting better and can only work part-time, and my friends would understand why they don't see me anymore.

December 21, 2019

Looks like I'm past due for an update.

Still alive.

Haven't had to miss any more work, so that's been good (especially since I only work a few hours a day). I stopped eating yogurt, which has helped my stomach quite a bit. Still having some pains and upset stomach, but better than it was.

Still troubled by heart palpitations / fast heart rate; not sure how much is from w/d and how much is just from the meds themselves. Dizziness continues on and off - has been worse this week, along with headache and feeling feverish (another ongoing on/off symptom).

Traveling to the east coast on Christmas Eve to be with family, and coming back on the 28th. I'm worried about jet-lag, since I had such a rough time after my trip this summer. I'm hoping it won't be as bad this time around, because there's less of a time change (3-hours difference vs like 9 hours). I have to work on the 30th, so hopefully I'll be recovered by then...

I arranged it so that I have the first 3 weeks of January off, so I'm planning to start my taper then.

Taper plan

Currently, I'm taking 75 mg in the morning, then 37.5 with lunch and 37.5 with dinner. My plan is to cut the morning 75 mg tablet in half, and convert half of it to a liquid (while taking the other half normally). From there, I can start with a really small taper (5%?) and see how it goes.

January 23, 2020

Jet lag after the Christmas trip was thankfully much less severe than it was with my trip this summer.

Decided not to try a Bupropion taper in January after all, for 2 reasons; 1 - was worried there would not be enough time to convert to liquid, start taper and recover before I had to start work. And 2, we're currently trying to buy a house and I didn't want to be potentially couch-bound / unhelpful during the process.

I did decide to cut my afternoon Adderall dose in half. I ended up on that dose for a few days during my Christmas trip because I miscounted the medication I packed; I didn't notice any symptoms, so decided to stick with it. So far, so good!

I had a bit of a wave yesterday with nausea and dizziness, but I'm doing better today. I've generally been in a window the past few weeks which has been nice. I've been off work, so it probably helped getting extra rest. Back to work this week, though.

April 8, 2020

Still alive! Unemployed due to Covid-19, so I've decided to restart my taper.

My current Bupropion dosage is 75 mg morning, 37.5 afternoon and 37.5 early evening (150 total).

I've been converting my morning dose to a liquid, 1/4 at a time with 4 days between changes. I've noticed a bit of dizziness a few times, but nothing major.

Once my morning dose is all liquid I'll start tapering. Initially, I was planning to taper 10% of my total dose, but that would be a 20% taper of my morning dose which seemed like it might be asking for trouble. Instead, I'm going to start by tapering 10% of my morning dosage, and see how that goes. Wish me luck!

April 8, 2020

1 hour ago, CoolheadLuke said:

Still alive! Unemployed due to Covid-19, so I've decided to restart my taper.

My current Bupropion dosage is 75 mg morning, 37.5 afternoon and 37.5 early evening (150 total).

I've been converting my morning dose to a liquid, 1/4 at a time with 4 days between changes. I've noticed a bit of dizziness a few times, but nothing major.

Once my morning dose is all liquid I'll start tapering. Initially, I was planning to taper 10% of my total dose, but that would be a 20% taper of my morning dose which seemed like it might be asking for trouble. Instead, I'm going to start by tapering 10% of my morning dosage, and see how that goes. Wish me luck!

Unfortunate that you are unemployed. Things will get better on that front.

Glad to hear you are starting you taper though ! Best of luck on this You got it!

April 9, 2020

On 4/7/2020 at 7:05 PM, CoolheadLuke said:

Still alive! Unemployed due to Covid-19, so I've decided to restart my taper.

My current Bupropion dosage is 75 mg morning, 37.5 afternoon and 37.5 early evening (150 total).

I've been converting my morning dose to a liquid, 1/4 at a time with 4 days between changes. I've noticed a bit of dizziness a few times, but nothing major.

Once my morning dose is all liquid I'll start tapering. Initially, I was planning to taper 10% of my total dose, but that would be a 20% taper of my morning dose which seemed like it might be asking for trouble. Instead, I'm going to start by tapering 10% of my morning dosage, and see how that goes. Wish me luck!

Hi CoolheadLuke,

I'm glad your crossover to liquid is going well, so far.

How did you figure that? Why take the 20% off of your morning dose only.

If we want to take 10% off your total daily dose, it looks like this:

150 mg X .90 = 135 mg, which would then be your new daily dose

You could do 10% of each dose, and it comes out the same for the daily dose again.

67.5 mg for the morning dose(10% off of 75 mg)

And then 33.75 mg for each of the others (10% off of 37.5 mg)

Which again adds up to 135 mg.

Are all your doses immediate release Bupropion?

Thanks. L, P, H, and G,

mmt

April 9, 2020

On 4/7/2020 at 7:34 PM, Cocopuffz17 said:

Unfortunate that you are unemployed. Things will get better on that front.

Glad to hear you are starting you taper though ! Best of luck on this You got it!

Thanks for the encouragement - it's much appreciated!

1 hour ago, manymoretodays said:

Hi CoolheadLuke,

I'm glad your crossover to liquid is going well, so far.

How did you figure that? Why take the 20% off of your morning dose only.

If we want to take 10% off your total daily dose, it looks like this:

150 mg X .90 = 135 mg, which would then be your new daily dose

You could do 10% of each dose, and it comes out the same for the daily dose again.

67.5 mg for the morning dose(10% off of 75 mg)

And then 33.75 mg for each of the others (10% off of 37.5 mg)

Which again adds up to 135 mg.

Are all your doses immediate release Bupropion?

Thanks. L, P, H, and G,

mmt

Thanks for checking in. All my doses are immediate release, but right now I'm only converting the morning dose to liquid, so it's only the morning dose that I'm going to taper. As far as the percentages, 150 * .1 = a 15 mg reduction, but 15 mg is 20% of 75 (ie, just the morning dose). Does that make sense?

My thought was to taper just the morning dose until all 3 doses are equal, and then ... I guess taper 10% off each of them? I haven't made it quite that far with planning yet, since it's still a ways off.

April 9, 2020

Hi CoolheadLuke,

When did you start this present split with your bupropion?

And how are you doing now?

The best way to answer might be in the daily notes format

Take a look at that link, and you'll see a sample note. Do a couple of days, and post them please. That will help to advise you now. I just noticed that you are on the Adderall too.

Times on left, and then drugs by name, dosage, on the right, as well as symptoms throughout the day.

Luke, would you also do a DrugInteractions check and then link to it, or post it on your Introduction here. Thank you.

Drug Interactions-Drugs.com

Thanks. I would think it would make sense to even out all of your buproprion doses, before beginning to taper. As well, as having them all in liquid too, so you could do a taper off all 3 doses.

Let's have a look though and then go from there. Does that sound okay with you?

Best, L, P, H, and G,

mmt

Edited April 9, 2020 by manymoretodays

April 11, 2020

On 4/8/2020 at 9:05 PM, CoolheadLuke said:

Thanks for checking in. All my doses are immediate release, but right now I'm only converting the morning dose to liquid, so it's only the morning dose that I'm going to taper. As far as the percentages, 150 * .1 = a 15 mg reduction, but 15 mg is 20% of 75 (ie, just the morning dose). Does that make sense?

My thought was to taper just the morning dose until all 3 doses are equal, and then ... I guess taper 10% off each of them? I haven't made it quite that far with planning yet, since it's still a ways off.

Hi Luke,

I think if I were you, I'd just take the 10% off of each dose. 10% off each, is the same as 10% off the daily total. You may want to either take the time to liquify all 3 doses first, and/or:

Using a digital scale to measure doses

The scales are fairly cheap, Gemini 20, is the brand most use. Me, I didn't have a problem with liquefying my last medication, to taper. So you might just want to streamline that too. Up to you.

And okay, I saw that you switched to bupropion, intermediate acting, almost a year ago. That's good. And got your adderall dose decreased. And no need to worry about the higher dose in the morning right now, with the bupropion.

More worrisome is the combination of the adderall with bupropion. Drug interaction report Drugs.com. It looks like the 2 play off each other a bit too, whereas the bupropion increases the blood level of adderall.

How are you spacing doses now? And your sleep?

Any other drugs or supplements now? Even just one day of notes, gives a nice objective look at things, now.

Best, L, P, H, and G,

and keep us updated, hope all is well enough,

mmt

April 11, 2020

On 4/9/2020 at 11:01 AM, manymoretodays said:

The best way to answer might be in the daily notes format

Take a look at that link, and you'll see a sample note. Do a couple of days, and post them please. That will help to advise you now. I just noticed that you are on the Adderall too.

Times on left, and then drugs by name, dosage, on the right, as well as symptoms throughout the day.

Sure, I can post a daily note. I'll do at least one this weekend.

On 4/9/2020 at 11:01 AM, manymoretodays said:

Thanks. I would think it would make sense to even out all of your buproprion doses, before beginning to taper. As well, as having them all in liquid too, so you could do a taper off all 3 doses.

When I switched to the 3x daily (IR) bupropion, my thinking was I'd take the bigger dose in the morning, so that I'd be closer to the XR graph (below) where the amount of the drug in my system gradually decreased toward the end of the day. Since the smallest dose they come in is 75, and the pills are pretty small, it seemed too hard to try and cut them into 3 even sized (50mg) doses.

1 hour ago, manymoretodays said:

I think if I were you, I'd just take the 10% off of each dose. 10% off each, is the same as 10% off the daily total. You may want to either take the time to liquify all 3 doses first, and/or:

That makes sense; I'll slowly switch my afternoon/evening doses to liquid as well, and then go from there.

2 hours ago, manymoretodays said:

More worrisome is the combination of the adderall with bupropion. Drug interaction report Drugs.com. It looks like the 2 play off each other a bit too, whereas the bupropion increases the blood level of adderall.

Yeah, I was pretty upset when I saw that report, and realized that none of my many doctors or pharmacists over the years had said anything to me. I'm not too worried about the interaction now, just because I'm on a much smaller dose of adderall (3.75 vs 30 mg) and I never had issues when I was taking the larger doses.

I also (foolishly) used to drink quite a bit when I was on the higher doses, but I've been basically alcohol free for the past few years (maybe 1 drink socially every few months) so my hope is if I didn't have a seizure when I was taking the full doses and drinking too much, I'm probably not going to have one now that I'm taking much smaller doses and not drinking.

2 hours ago, manymoretodays said:

How are you spacing doses now? And your sleep?

Any other drugs or supplements now? Even just one day of notes, gives a nice objective look at things, now.

Right now there's about 2 hours between the bupropion doses and the adderall doses.

Sleep isn't too bad. I've always had trouble falling asleep, so I take doxlymine succinate before bed. Current supplements: Fish Oil, Vitamin D, Taurine and Magnesium.

I'll get those notes posted tomorrow so that it's all in one place.

CoolheadLuke: I am going to make it through this year ...

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