Healingnow: want to taper off bupropion SR 100mg

[Healingnow]

Hello- 

I tapered off Klonopin 1mg recently -  last dose was 6 weeks ago. Taper was 5 weeks long based on my psychiatrist’s advice. After I started having terrible withdrawal symptoms I found BenzoBuddies- helped a lot to normalize the hellish symptoms and find support. Wish I’d found BB before I tapered.  My view of mental health care and pharmacology has been shaken hard. 
I started on Ativan when I started having cluster panic attacks while working a stressful job and caring for my elderly mother. When she passed last spring I started on Klonopin. I started feeling better and the more I learned about Benzos the more I wanted to get off them.  My WD symptoms are mostly gone now. (Fingers crossed)

I want to get off Bupropion next, after I’ve given my CNS a couple more months to heal - so assuming I continue to be done with the miserable benzo WD symptoms I’m planning/hoping to start tapering off bupropion in January or February.

 

I take 100mg of bupropion SR once a day in the morning. I would appreciate advice on how to plan the taper and planning the doses - how I should cut the tablets,too. 

Thank you and wishing much healing to everyone else here. 
Healingnow

 

[Altostrata]

Welcome, Healing.

 

Good idea to let your nervous system rest for at least a couple of months more before making another drug change.

 

Why do you want to taper bupropion so soon? Are you getting adverse effects from it?

 

What times of day do you take your drugs, and their dosages?

 

FYI Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

[Healingnow]

Dear Altostrata,

Thanks so much for the welcome.  I've learned so much from browsing S/A already and I'm grateful to have found this great resource.

You ask really good questions.

 

1 hour ago, Altostrata said:

Why do you want to taper bupropion so soon? Are you getting adverse effects from it?

 

I want to taper off bupropion for a few reasons. 

One, because of what I suspect is an adverse effect: over the past several years I've notice an unpleasant surge of adrenaline (a physical feeling I associate with anxiety) and feeling uneasy around 1:30 p.m. everyday.  This lasts about 1 - 1 1/2 hours. I take the bupropion SR 100mg every morning around 8 a.m.  I wonder if the surge is a stimulating effect of the bupropion. My dose of bupropion was reduced a few years ago because of my concern about this weird early afternoon surge.  I don't think the reduction helped though.

 

Two. I originally switched to bupropion from Zoloft about 20 years ago because I didn't like the sexual side effects from the SSRI/Zoloft.  Bupropion at various doses worked for a while and then maybe 10 years ago I began having significant anxiety so citalopram was added.  It helped for a while. Anxiety became my biggest problem again in the past couple of years  in large part because of situational stress of caring for an ill, elderly loved one and working a very stressful job so buspirone was added about a year ago.   And benzos - see signature.  The sexual side effects that lead to my going on bupropion in the first place aren't a big concern to me anymore.  I feel the citalopram has me covered as an antidepressant.

 

Three. Getting off Klonopin was one of the hardest things I've ever done and I was pretty lucky, knock on wood. Being put on them and experiencing the cavalier attitudes and ignorance of my mental health providers who guided me to do a fast taper and dismissed my withdrawal symptoms, has instilled distrust in me about getting guidance from the medical community.   

Four. I'm in a better place than I've been in a while.  I've been mourning the loss of my loved one and done a lot of healing.  I've also retired.  I think I may have less need now for the level of medication I'm on. 

 

Five.  If it seems to knowledgeable people here like you that I should wait longer than 4 or 5 months after stopping Klonopin I'll delay it.  I feel like I'm on a lot of psych medications and I'm a bit concerned about the effects on my cognition, ability to feel, etc.  I already feel more alert and present since getting off the benzos. My goal isn't to get off psych meds completely - I don't think I would do well.  I've never done well going off antidepressants completely - I tried that twice about 20 or 25 years ago and crashed hard a few months later both times. I'd like to perhaps reduce the dosage of citalopram and buspirone eventually but I anticipate staying on them for the foreseeable future.

 

2 hours ago, Altostrata said:

What times of day do you take your drugs, and their dosages?

 

Current drugs:

8:00 a.m.   Bupropion SR 100mg

                    Citalopram 20mg 

                    Buspirone  20mg

 

6:00 pm   Citalopram 20mg

                  Buspirone  20mg

 

Thanks for the link.  I'd like to plan a thoughtful slow taper in advance so I can minimize problems once I start it.  Not sure how the 10% reduction of last dose would be applied to bupropion SR tablets.  I guess it's odd I only take bupropion once a day, too.

 

I hope this helps give a clearer picture of what's going on.  Thanks so much for paying attention.  As I'm sure you know, it can be a lonely road.

 

Healingnow

 

 

[Altostrata]

You're on a hefty cocktail. Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results or a link to them in this topic.

[Healingnow]

https://www.drugs.com/interactions-check.php?drug_list=679-0,441-0,440-0,1476-0

[Altostrata]

Since you take 3 drugs at 8 a.m., it's unclear which is causing the adverse reaction later in the afternoon. It's most like a drug-drug interaction of buspirone or buproprion with citalopram.

 

Given the high daily dosage of citalopram, it could also be too much citalopram.

 

You could very carefully start lowering the bupropion and see what happens. During any drug change, please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. You can post 24 hours of notes at a time in this topic, with a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

 

Did one doctor prescribe all these drugs?

[Healingnow]

Hi Altostrata,

 

One doctor prescribed all of the psych drugs. I've been seeing her for psychopharmacology for nearly 20 years.

 

The citalopram daily dose was 20mg; was raised in June 2019  to 40mg.  Same with buspirone dose.  

I had the early afternoon adrenaline surges for several years prior to these dosages being raised.  

 

I was planning to wait until January for my CNS to heal some more before tapering one of the other drugs.  Do you think it makes sense to do it sooner?  And should I start with tapering off bupropion before tapering the celexa and buspirone?

 

Thanks very much 

[Altostrata]

Yes, you could wait until January. After looking at the interaction report, I am concerned about your overall drug burden.

[Healingnow]

Would it make more sense to begin reducing citalopram first, or buspirone, and taper the bupropion after?

Not sure where to start. 

[Altostrata]

Might as well start with bupropion, since you think it's activating.

[Healingnow]

I’ll plan to start bupropion taper in January.  
 

Since I’m dealing with bupropion SR 100mg should I simply reduce the dose by 1/4 tablet  every 4 weeks?

[Healingnow]

Looking for help with details of my taper off Bupropion SR (generic Wellbutrin).  

I'm coming off a Klonopin taper and waiting a few months for my CNS to heal before I taper off in January.  I'd like to have a good plan in place so i don't taper too fast and end up suffering as much with WD symptoms as I did under my doctor's ill-informed guidance. 

 

I've read the tips on tapering off Wellbutrin but I'm still having trouble visualizing some details.  

• SA recommends decreases of 10% of your last dose.  How do you do 10% decreases with 100mg SR (sustained release) tablets?  Or since 100mg is a relatively low daily should I cut the tablets in quarters and reduce by 25% every four weeks
• My dosing is only once a day which is unusual.  Most people on SR take doses 2 x day.  When I taper should I stick to taking one dose in the morning?

Thank you and wishing everyone well in your healing journey.

[Healingnow]

@Altostrata Thank you for your help. I'm so thankful I found this resource. SA is a goldmine of helpful info.

 

I've been poring over tips for buproprion SR taper and have come up with the following plan.  I'm trying to find a balance between getting it done and not moving too quickly.  I understand I can also adjust as I go. I would be very grateful for your opinion and suggestions.

 

Current dose 100mg tablet in a.m.

 

Wk 1     Cut SR  100mg tablet in half- take 1/2 in a.m. and 1/2 in afternoon

Wk 2     Hold

 

Wk 3     1/2 tab in a.m. and 1/4 tab in afternoon

Wk 5     Hold

     

Wk 6     1/4 tab in a.m. and 1/4 tab in afternoon

Wk 7     Hold

Wk 8     Hold

 

Wk 9   1/4 tab in a.m. and 1/8 tab in afternoon

Wk 11   Hold

Wk 12   Hold

 

Wk 13   1/8 tab in a.m. and 1/8 tab in afternoon

Wk 14   Hold

Wk 15   Hold

 

Wk 16  1/8 tab in a.m.

Wk 17   Hold

Wk 18   Hold

 

Wk 19   Jump

 

Thank you very much!

[Altostrata]

I would start the reduction with 1/4 tablet (25mg) in the afternoon dose for daily total of 100mg and see how it goes. If you find it's too big a reduction, you'll need another plan, such as converting the afternoon dose to immediate-release bupropion to make a liquid. Please let us know how you're doing.

[Healingnow]

4 hours ago, Altostrata said:

I would start the reduction with 1/4 tablet (25mg) in the afternoon dose for daily total of 100mg and see how it goes.

 

Thanks very much Altostrata - makes a lot of sense.