Mary66

[Altostrata]

If Primadone is causing this, there's nothing anyone can do until you reduce or stop Primadone.

 

If you didn't experience withdrawal symptoms from Wellbutrin, there's no sense in reinstating Wellbutrin. 

 

This is a site for going off drugs. We don't offer services to counter adverse effects of drugs you keep taking despite adverse effects. Talk to your doctor about this, that's why they're prescribing antidepressants. You may also wish to see a psychotherapist to get coaching to manage your ruminations.

[Mary66]

On 2/11/2022 at 11:33 PM, ChessieCat said:

Hello Mary66 and welcome to SA,

 

Yes, it should be okay to stop taking the Effexor 37.5mg after only 7 days without tapering it.

 

It takes about 4 days for the dose of a drug to get to full level in the blood and a bit longer for it to register in the brain so stopping now would probably be the best thing to do.

 

You have been making very big reductions of the Wellbutrin so you might be experiencing withdrawal symptoms from that.  But  because you have made two changes in a short amount of time it is difficult to know what is causing any issues.

 

See:

 

But I only took it for a Week - immediate adverse reaction

 

immediate-adverse-reactions-to-an-antidepressant-or-within-a-few-doses-how-long-for-recovery

 

It might take some time for things to settle down and it would be best if you use non drug techniques:

 

Non-drug techniques to cope

 

It would also be best not to taper the Wellbutrin again until you are feeling stable. 

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

 

Please let us know how you are.  You might need to consider making a small updose of the Wellbutrin.  The staff can suggest what size increase you could try.  When SA suggests increasing the dose it is generally better to start with a small increase than to risk taking too much.

 

This is your own Introduction topic which is the best place to ask questions specific to your own situation and journal your progress.  This keeps your history in one place and means you do not have to repeat your story.

 

Hi chessie cat….

have continued my Wellbutrin taper by 1/4 of a 75 IR tab every two weeks.

I’m getting worse, just realized that the decrease in my mental health coincides with the Wellbutrin taper

why didn’t this occur to me? The doc says just to stop….and of course go on a new AD but I do want to recover without more drugs. But after 25 years on Paxil I’m so afraid I won’t get better.

I was never like this b4 Paxil taper, Mild depression yes, but this mental anxiety and anguish….no.

the Paxil decrease from 5 mg to 0 eight months ago, I realize now was basically cold Turkey…

Damn that psych!

obsessing, researching, analyzing, etc my mind is on fire 24/7. Can’t get out of the loop.

re-upping Wellbutrin…..scares me, my husband says just get on a new drug!!!

hypersensitive to sounds, smells, stimulation, conversation. Failing to thrive.

help

[Mary66]

19 hours ago, Altostrata said:

If Primadone is causing this, there's nothing anyone can do until you reduce or stop Primadone.

 

If you didn't experience withdrawal symptoms from Wellbutrin, there's no sense in reinstating Wellbutrin. 

 

This is a site for going off drugs. We don't offer services to counter adverse effects of drugs you keep taking despite adverse effects. Talk to your doctor about this, that's why they're prescribing antidepressants. You may also wish to see a psychotherapist to get coaching to manage your ruminations.

I wrote a reply….did I attach it?

symptoms are from Paxil taper and I’m getting worse as I taper Wellbutrin 

have researched everything about Primidone and it’s not good.

right now my concern is my mental health 8 months off a basically cold Turkey Paxil. 
Wanted to get off Wellbutrin and hopefully recover. Thinking Wellbutrin taper is causing more symptoms.

afraid  to re-up.

I thank you for your patience!

[Mary66]

On 2/13/2022 at 6:43 AM, Go2zero said:

Hello Mary66,

 

Do I understand well from your first post that you went down from 40 mg Paxil to zero in 3 months after using Paxil for 28 years? If so, that would be an extremely fast taper. Such fast tapers (certainly after long term use of a drug) may give heavy symptoms over longer periods after stopping the med. Therefor we always suggest to taper not more than 10% of the last taken dosage.

 

But lots of people who want to come off these meds do not know that. And most doctors do not know either.... So do not blame yourself for it. Lots of members here did not know before they came here. I made such mistakes several times also, before I found that slow tapering is the only safe way to go...

 

If I read your first post well, you stopped Paxil completely in July 2021. That is too long ago to reinstate the drug at a very low dosage in my opinion. Reinstating a very low dosage may help in "treating" withdrawal symptoms sometimes. But that should be done not later dan 1-2 months after a full stop of a drug. Reinstating later is not without risks, so not recommendable. 

 

Then the Wellbutrin. This drug can be tapered quite easily by some people and others may experience extreme difficulties and heavy WD (withdrawal) symptoms which can last for months sometimes.

 

Especially when combined with an SSRI (like Paxil) WD from Wellbutrin can be difficult for some people.

 

I understand that you tapered Wellbutrin extremely fast  (within 1 month?) from 300mg to 37,5 mg. This is way too fast !!!!

 

If I were you I would up-dose the Wellbutrin to 50mg and see if you will get some relief. Give it at least 1 week on 50mg. Maybe further up-dosing to 75mg is needed if you would not get any relief. But the lower the up-dosing the better. The more extreme one goes up and down in dosage the more the nervous system may be sensitized. Therefor better first to 50mg and hope that will help.

 

The extreme fast tapers of high dosages of these 2 meds, may already have sensitized your nervous system. This will heal, but it needs time. Before you can taper further you really need to be stable first. This may take a longer period of time. Nobody can tell how long since everybody reacts differently. 

 

Here is info how to make specific dosages by using scales that can weigh up to 1 mg. https://www.survivingantidepressants.org/topic/1596-using-a-scale-to-weigh-and-measure-doses/

 

If you need more info how to make 50mg amounts of Wellbutrin let me know. Also let me know which type of Wellbutrin you are using. Brandname, dosage of pills and type (IR , SR or XR)

 

Here is more useful info about tapering

 

https://www.survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/?tab=comments#comment-525233

 

https://www.survivingantidepressants.org/topic/23081-are-we-there-yet-how-long-is-withdrawal-going-to-take/?tab=comments#comment-492493

 

 

 

Signature

 

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

https://www.survivingantidepressants.org/topic/18343-please-summarize-your-withdrawal-history-in-your-signature/

 

Thank you….

Bupropion IR 75 mg. 2x/day

I think you can see that I was decreasing 1/4 tab every two weeks assuming that it would be good.

(my psych said I could just “stop” at 75)😫 but I wanted to taper.

My mind is getting worse the past few weeks and just realized it coincides with the Wellbutrin taper.

am now on day 12 of 1/4 tab in the morning. Was planning to stop at two weeks….alas, I don’t know what to do.

You suggested going back up to 50.

this is what I did am/pm every two weeks ….starting January 11

300 xr to 150 xr for two weeks 

150xr to 75 Ir 2x/day for two weeks 

75/37.5 for two weeks 

37.5/37.5 for two weeks 

37.5/18 for two weeks 

18/18 for two weeks

18 now for 12 days

I can’t cut the pills any smaller than 1/4.

I am realizing that continuing to decrease while my symptoms increased is bad.

 

 

[Altostrata]

What are the symptoms you attribute to the Wellbutrin taper?

 

The confounding of your symptom pattern with Primadone adverse effects has been an issue since you joined this site.

[Mary66]

4 hours ago, Altostrata said:

What are the symptoms you attribute to the Wellbutrin taper?

 

The confounding of your symptom pattern with Primadone adverse effects has been an issue since you joined this site.

Decreased mental symptoms….

Apathy, flat affect, ruminating, tingly scalp, depression, increased anxiety, insomnia, fear, despair.

[Altostrata]

13 minutes ago, Mary66 said:

Apathy, flat affect, ruminating, tingly scalp, depression, increased anxiety, insomnia, fear, despair.

 

Which of these symptoms appeared while you were tapering Wellbutrin starting in January? When did they appear?

 

Which have changed in the last month? How have they changed?

[Mary66]

13 hours ago, Altostrata said:

 

Which of these symptoms appeared while you were tapering Wellbutrin starting in January? When did they appear?

 

Which have changed in the last month? How have they changed?

I’ve had them since the Paxil stop 8 months ago….they slowly improved and then started again after tapering Wellbutrin 😕

I started feeling a bit better b4 Wellbutrin taper, darn it

[Mary66]

Damn…

just realized that I made a drop in Wellbutrin after ONE week rather than two weeks….😞

from 1/4 tab am and 1/4 pm to 1/4 am.

And am on day 14 of that drop.

absolutely coincides with my worsening mind.

I can’t believe it, I’ve been so faithful to drop every two weeks.

and hadn’t connected my worsening mind to the taper.

 

[ChessieCat]

  

On 4/10/2022 at 1:04 AM, Mary66 said:

Wondering your thoughts on the Walsh protocol…..saw a functional doc this winter as my WD from Paxil has me in terrible shape. I’ve always been a mainstream medical person …all the supplements would be taking over 10 pills/day! Gi mapping, high copper, undermethylated, pyrroles and all kinds of stuff….I’m so skeptical and my nervous system is already on hyper alert 😫

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

[Mary66]

Post moved from horowitz-2019-tapering-of-ssri-treatment-to-mitigate-withdrawal-symptoms

 

On 3/16/2019 at 1:02 AM, dcrmt said:

It made the New York Times
https://www.nytimes.com/2019/03/05/health/depression-withdrawal-drugs.html

 

Discussion of this has been largely confined to forums like this one, even though people discovered they needed to taper to tiny fractions of the therapeutic dose to get off paxil more than a decade ago - now it's out there and it's finally being regarded as credible.

 

What can I do now?

I’m in a really bad state mentally 8 months off a terrible Paxil taper.

Followed psych’s orders to drop 5 mgs every two weeks from 40.

I didn’t question it. Was on for 25 happy years until depression crept in.

I see now that dropping from 5 mgs to 0 was basically cold Turkey.🤬

Do I go on a different SSRI until I’m better and then taper again?

I did a Genesight test and no SSRI’s are in my green zone. Pax is in my yellow but worked with no side effects until it didn’t.

I so want to not be on meds, but am non functioning going over and over all of this in my mind, can’t eat, can’t sleep.

 

Edited April 13, 2022 by ChessieCat
added topic title before moving post to member's intro topic

[Mary66]

13 hours ago, ChessieCat said:

  

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

Thank you….will not be adding anything as I’m in bad shape.

My last drop from Paxil 5 mgs to 0 was basically cold Turkey last summer, it makes me so angry that my dr did that and that I had no clue about tapering or WD.

so 8 months later and what should I do?  I wanted to get off Wellbutrin too so started a taper in January. Doc said no worries, I’ve been cutting in 1/2 and 1/4 and realized my mental health is getting worse and THEN realized that is is coinciding with the Wellbutrin taper. Dammit! What was I thinking?  That’s once again a 50% cut

So my questions are….

-should I re-up the Wellbutrin?

-should I stop Wellbutrin and start an SSRI to stabilize and then taper that?

and if so, go back to Paxil or try a different SSRI?

-or continue to persevere and pray for healing?

your thoughts are of value to me.

thank you for your time and patience.

I am better in the evenings.
My mornings are rough after 4-5 hrs/sleep and then thinking about this for hours. I try so hard to redirect my thoughts with guided meditations, walking, knitting but it is all consuming. I never had anxiety b4 WD.

[Mary66]

On 7/16/2011 at 3:28 PM, Altostrata said:

Wellbutrin (bupropion) is an atypical antidepressant with a lower reported rate of withdrawal syndrome compared to the SSRIs and SNRIs such as Paxil, Effexor, or Cymbalta.

However, patients have reported withdrawal symptoms, sometimes severe, from too-short tapering.

Bupropion is a bit of an oddball because it "is thought to be" a dopamine and norepinephrine reuptake inhibitor and a nicotinic receptor antagonist, which is why it is sometimes used to help people stop smoking - Zyban.
 
Bupropion adverse effects
Like Chantix, as a smoking cessation aid (Zyban), bupropion has been found to cause suicidal thoughts or actions and displays an FDA black box warning accordingly.

Bupropion tends to be energizing and often causes anxiety, agitation, nervousness, loss of appetite, and insomnia as side effects. Bupropion usually is not an appropriate treatment for withdrawal symptoms, as it can aggravate them.
 
While it is less likely to cause sexual dysfunction like other antidepressants, other side effects are: lowers the seizure threshold (very bad for brain zaps), increases blood pressure, tremors, tinnitus, unusual behaviour changes, agitation, and hostility.
 
Bupropion as an adjunct to antidepressants to counter sexual side effects
Way back in ancient history, around the year 2000, it became apparent these fabulous wonder drugs, the SSRIs, which were supposed to alleviate depression with almost no side effects, had a huge drawback that might slow sales: They caused sexual dysfunction in a high percentage of those who took them.
 
This caused great consternation among the pharmaceutical companies, who went through varying cycles of denying that sexual dysfunction was a frequent consequence of SSRIs, claiming the sexual dysfunction was due to the underlying depression, and searching for pharmaceutical solutions to this adverse effect.
 
It was also observed that bupropion had fewer sexual side effects and that some patients found it sexually stimulating. Seizing the opportunity to preserve their sales, the drug companies initiated campaigns to educate doctors that, in the rare cases where sexual dysfunction was a problem, bupropion might be added to an SSRI to alleviate the problem.
 
It did seem to help some, but its usefulness for this purpose is mostly a product of drug company propaganda. Also, to preserve sales of SSRIs, the drug companies neglected to inform doctors that being an antidepressant itself, Wellbutrin might replace the SSRI, and there was no reason to keep people on two drugs when one drug would do.
 
(Later, when Viagra and Cialis became available, much research and furor was generated to recommend them as adjuncts to SSRIs -- adding yet another profitable drug. Alas, they proved to be ineffective for women.)
 
Bupropion, unfortunately, comes with a few common adverse effects of its own, such as jitteriness, agitation, nervousness, anxiety, fast heartbeat, and sleeplessness. Doctors were advised to add benzodiazepines to the mix for these symptoms. (Later, these symptoms were judged to be possible symptoms of bipolar disorder, indicated the addition of antipsychotics such as Seroquel.)
 
This ushered in the era of the common combination of an SSRI, bupropion, and a benzo (or low-dose Seroquel) for many people complaining of any kind of "depression." As all of these drugs incur physiological dependency, this cocktail is very well represented on this site.
 
But some doctors noticed bupropion was also an antidepressant as effective or ineffective as any other, without the sexual side effects. They began to prescribe bupropion first, before resorting to an SSRI. Wellbutrin or its generic bupropion is a very popular antidepressant. And that is why our Tips for tapering off Wellbutrin, IR, SR, XR, XL (bupropion) is the most frequently viewed topic in the Tapering forum. (Tips for tapering off Pristiq (desvenlafaxine) is a distant second, probably because tapering Pristiq is so difficult.)
 
There are 3 buproprion formulations: IR, SR, XL or XR
Name-brand Wellbutrin or generic bupropion is available in 3 variations with different half-lives -- the amount of time they last in your body (see below).
 
From the manufacturers' and the FDA's information (see below), the different versions are bio-equivalent. The only difference is the frequency of the dosage:

• Immediate release (IR): 3 times a day dosing Available in generic in 75 mg, 100 mg tablets
• Sustained release (SR): 2 times a day dosing Available in 100 mg, 150 mg, 200 mg sustained-release tablets
• Extended release (XR or XL): Once a day dosing Available in 150 mg, 300 mg capsules (brand-name only); 450mg generic

 

Name-brand Wellbutrin XL was manufactured by GlaxoSmithKline but is currently manufactured by Valeant Pharmaceuticals. Name-brand Wellbutrin SR is still manufactured by GlaxoSmithKline. Generic manufacturers also make their own versions of IR, SR, and XR or XL bupropion.
 
There may be slight differences in formulation between brand-name Wellbutrin and the generic versions, and among the generic versions. For exact information about formulation of a generic version, you would have to contact the generic manufacturer.
 
Bupropion half-lives
It is metabolized by P450 cyp2B6 liver enzyme, and conflicts with alcohol metabolism. Its half-life is complicated because it has a number of active metabolites and various versions that prolong release of the active ingredient.
 
From http://psychopharmacologyinstitute.com/antidepressants/bupropion-psychopharmacology/
 
How gradually should I taper buproprion?
There is little information about tapering off Wellbutrin, probably because it is assumed not much of a taper is needed.

As with all other psychiatric medications, do not skip doses to taper. If you're susceptible to withdrawal symptoms, this is an excellent way to trigger them.
 
Start with a 10% reduction per month, as we recommend with other antidepresssants. Base your decrease on the last dosage: The amount of the decrease keeps getting smaller.
 
If you find 10%-per-month decreases cause no problem, you may wish to make them more often -- but no more often than every 2 weeks. If you get any kind of withdrawal symptom, stop tapering! You are either tapering too fast or making reductions that are too large.

(Personally, I found a 50mg taper per week to be sufficiently gradual. I had been taking 150mg-200mg for about a year and had serious adverse effects:  blood pressure spikes. Although I had Paxil withdrawal syndrome at the time, quitting Wellbutrin in this fashion did not increase my symptoms. Getting off Wellbutrin was a relief. I found ramping up on it a lot harder.)

 

If you are taking the extended-release (XR)  form, you will want to taper as low as possible using a combination of the XR tablets and SR tablets, finally ending up with immediate-release tablets at the end. If necessary, you can make a liquid of the IR tablets, you can't make a liquid of the others. (See details below.)
 
How to taper off Wellbutrin XR or XL or Budeprion XL (extended release)
From FDA information Wellbutrin: http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=c7b80939-0b2d-4dbc-b921-2081cfd5ae3e
- Available as brand-name Wellbutrin XR or XL in 150 mg, 300 mg extended-release tablets; 450mg in generic
- To be taken once a day. This is equivalent to 3-times daily immediate-release buproprion or twice-daily bupropion SR.

 

 

From the manufacturer, GlaxoSmithKline http://public.gsk.com/products/wellbutrin-xr/further-information/
 

 

If you cut up Wellbutrin or bupropion XR, what's inside is regular immediate-release bupropion. When you break the time-release coating, the tablet loses its extended-release characteristic and you would be taking immediate-release bupropion.

 

According to GSK regarding Wellbutrin XL http://us.gsk.com/products/assets/us_wellbutrinXL.pdf:
 

This suggests a taper of 50% for two weeks, then quit at 150mg. We recommend a more gradual taper than this.

Tapering methods for extended-release versions:

• Cut up Wellbutrin XL or XR tablets
  If you cut up a Wellbutrin XL or XR tablet, you get immediate-release bupropion.
  
  Since the smallest XL/XR tablet is 150mg, we recommend converting to bupropion SR or immediate-release bupropion so you can cut up the tablets to make reductions by 25mg or less.
  
  If you cut up a 150mg or 300mg XL/XR tablet into quarters to taper, you will need to take some 3 times a day, as it's become immediate-release bupropion. (We do not recommend tapering this fast, do this at your own risk.)
• Switch from Wellbutrin XR/XL to other types of bupropion
  This may be a little bumpy at first. A switch from XR/XL to SR probably would be smoother than a switch to immediate-release bupropion. (See Example: Tapering off 300mg Wellbutrin XL, below.)
  • Switch to the SR version and cut up tablets, take 2x a day
  • Switch to the immediate-release version and cut up tablets or, for lower dosing, make a liquid with water, take 3x a day
• How to taper off Budeprion XL (extended release)
  From FDA information: http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=2ab4878e-cbe0-46f8-a9fc-e70945a352ed
  - Available as brand-name only (Budeprion XL) in 150 mg extended-release tablets
  - To be taken once a day. This is equivalent to 3-times daily immediate-release bupropion or twice-daily bupropion SR.
  
  Same as tapering Wellbutrin XL or XR, above.

 

Example: Tapering off 300mg Wellbutrin XL
Remember that if you cut up a Wellbutrin XL or XR tablet, you get immediate-release bupropion. You probably will not want to do that right off. If your system is used to the extended-release version, it may not react well to the "dumping" of immediate-release.
 
Probably the easiest way to go off 300mg Wellbutrin XL is to get your prescription filled with 150mg Wellbutrin XL tablets and 75mg Wellbutrin IR (immediate-release) tablets. (The prescription would be written for "one 150mg Wellbutrin XL tablet and two 75mg Wellbutrin IR tablets per day, taken in divided doses, for a total of 300mg per day.")
 
By cutting the 75mg IR tablets in quarters, you can taper by a smaller amount than 10%, approximately 18.75mg (splitting tablets is not as precise as using a liquid). for the first part of the taper, you can remove one-quarter of a 75mg tablet at each step.
 
As you are tapering by less than 10%, you may be able to go faster than monthly decreases. The minimum tapering interval we recommend is every 2 weeks.
 
For example, to taper from 300mg Wellbutrin XL:
 
Reduction 1: 281.25mg per day -- a 150mg Wellbutrin XL tablet in the morning, a 75mg Wellbutrin IR tablet in the afternoon, and 3/4 of the second Wellbutrin IR tablet in the evening.
 
Reduction 2: 262.5mg per day -- a 150mg Wellbutrin XL tablet in the morning, a 75mg Wellbutrin IR tablet in the afternoon, and 2/4 of the second Wellbutrin IR tablet in the evening.
 
Reduction 3: 243.75mg per day -- a 150mg Wellbutrin XL tablet in the morning, a 75mg Wellbutrin IR tablet in the afternoon, and 1/4 of the second Wellbutrin IR tablet in the evening.
 
As you're down to 1/4 of a tablet in the evening, you may wish to take the next quarter out of the first 75mg tablet to balance your daily dose.
 
Reduction 4: 225mg per day -- a 150mg Wellbutrin XL tablet in the morning, 3/4 of 75mg Wellbutrin IR tablet in the afternoon, and 1/4 of a Wellbutrin IR tablet in the evening.
 
Reduction 5: 206.25mg per day -- a 150mg Wellbutrin XL tablet in the morning, 2/4 of 75mg Wellbutrin IR tablet in the afternoon, and 1/4 of a Wellbutrin IR tablet in the evening.
 
Reduction 6: 187.5mg per day -- a 150mg Wellbutrin XL tablet in the morning, 1/4 of 75mg Wellbutrin IR tablet in the afternoon, and 1/4 of a Wellbutrin IR tablet in the evening.
 
Reduction 7: 168.75mg per day -- a 150mg Wellbutrin XL tablet in the morning, 1/4 of 75mg Wellbutrin IR tablet in the late afternoon.
 
Reduction 8: 150mg per day -- a 150mg Wellbutrin XL tablet in the morning.
 
After you are down to 150mg per day, you may wish to make your next decrease by getting your prescription filled with 100 mg Wellbutrin SR (sustained-release) tablets and 100mg Wellbutrin IR (immediate-release) tablets. (The prescription would be written for "one 100mg Wellbutrin SR tablet in the a.m. and one 100mg Wellbutrin IR tablet in the p.m., for a total of 200mg per day.")
 
Then you would make a liquid from the 100mg Wellbutrin IR tablet to make further reductions of 10% (based on current dosage; the amount of the decrease gets smaller and smaller) until you are down to one 100mg Wellbutrin SR per day.
 
After you are down to 100mg per day, you may wish to make your next decrease by getting your prescription filled with 100mg Wellbutrin IR (immediate-release) tablets (or use the ones you have left) and make a liquid from them to continue tapering at 10%.
 
To make a liquid from immediate-release bupropion:

• Get a prescription from your doctor for a liquid from a compounding pharmacy
• Make a liquid yourself with water, see How to make a liquid from tablets or capsules

 

How to taper off bupropion SR (sustained release)
From FDA information: http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=b5d286ce-e23f-4dde-b400-cb4832172ece
- Available as brand-name or generic in 100 mg, 150 mg, 200 mg sustained-release tablets
- To be taken twice daily, "at least 8 hours between successive doses." (This is equivalent to 3-times daily immediate-release bupropion.)

According to Merck http://www.merckmanuals.com/professional/print/lexicomp/bupropion.html
 

 
In the name-brand Wellbutrin SR, the sustained-release quality is in the binder, the glue that holds the tablet together. Generic versions (which would be called bupropion SR, not Wellbutrin SR) may be made differently. Contact the manufacturer to find out exactly how the tablet is formulated, or talk to a pharmacist specializing in psychopharmacology.
 
I personally found you CAN cut Wellbutrin SR (sustained release) tablets up -- the timed-release mechanism is mixed in with the drug. Put the pieces in a water-tight container and use them up within 24 hours because the time-release binder can absorb humidity and degrade.

For a short time, I cut up generic 100mg bupropion SR and took 50mg in the morning, Wellbutrin XL 150mg a couple of hours later, and another SR 50mg in the early evening for a total of 250mg/day. (I never tolerated Wellbutrin very well.)

To taper, convert your dosage to 100mg SR tablets, cut up the 100mg tablets, make reductions by 25mg or less, take 2 times a day.
 
(Note: If you cut an SR tablet in very small fragments or crush it, it won't to continue to be sustained-release -- the binder is extensively damaged. Take in divided doses as though it was immediate-release.)

Taper with a mix of sustained-release (SR) and immediate-release (IR) tablets
As immediate-release tablets come in the smallest dosage of 75mg, which can be quartered into pieces of 18.75mg, you might want to convert part of your daily dose to IR tablets.

This will enable you to taper by 18.75mg at a time.

You might be able to get by with taking the SR tablet in the morning and the IR tablet at night.
 
Taper with immediate-release bupropion
From FDA information: http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=9251cc4c-33c5-e05c-9b8d-647855c53dbb
- Available in generic form as 75 mg, 100 mg immediate-release tablets
- Half-life of 10 hours, plus some extension with the active metabolites, for a total half-life expressed as 21 (±9) hours
- "Bupropion should be administered 3 times daily, preferably with at least 6 hours between successive doses."

To taper, cut a 75mg or 100mg tablet into quarters, make reductions by 18.75mg-25mg, take 2 or 3 times a day.
 
If you get withdrawal symptoms at any point, slow down.
 
Taper with a liquid

Using a liquid for tapering is very convenient, especially if you wish to taper more cautiously. Using a liquid to taper makes measuring very small decreases much easier and precise.

 

You can only make a liquid from immediate-release buproprion (the other types contain binders that will not dissolve well):

• Make a liquid yourself from immediate-release bupropion with water, see How to make a liquid from tablets or capsules
• Get a prescription from your doctor for a liquid from a compounding pharmacy (can be expensive)

 

Using a combination of tablets or capsules and liquid

Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.

 

If your doctor prescribes compounded liquid and tablets or capsules at the same time, most likely he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

 

Weigh capsule fragments with a digital scale
If you can't do any of the above, you may wish to cut up tablets and weigh the fragments with a digital scale to control your tapering rate. This could apply to any type of bupropion -- remember that, when cut up, an XR tablet becomes immediate-release and an SR tablet may retain some of its sustained-release quality.
 
See Using a digital scale to measure doses

 

 

Dear allostrata….

300xr Wellbutrin to 150, then switched to IR. Continued cutting 1/4 tabs every two weeks. My last 18.75 yesterday.

I see you were also tapering Paxil.  I’m 9 months from my last Paxil. Per psych dropped 5 mgs every two weeks and stopped at 5. Am in acute withdrawal mentally…getting worse as I drop, I guess it was doing something. my family and drs tell me I need to start a new AD.  The despair and rumination in my mind is killing me.  Hoping I don’t need to go to the hospital where they will put me on a million drugs.  Would re-instatement of Paxil help? Or a different AD? Then slower taper?
I’m not functioning mentally, can’t eat, can’t sleep 

[Altostrata]

@Mary66 please post questions about your personal situation in this Introductions topic.

 

On 4/11/2022 at 6:09 AM, Mary66 said:

I’ve had them since the Paxil stop 8 months ago….they slowly improved and then started again after tapering Wellbutrin 😕

I started feeling a bit better b4 Wellbutrin taper, darn it

 

Why are you reducing Wellbutrin? Please stop reducing it.

[Mary66]

23 hours ago, Altostrata said:

@Mary66 please post questions about your personal situation in this Introductions topic.

 

 

Why are you reducing Wellbutrin? Please stop reducing it.

Sorry I don’t know how to post in the right places….cog decline

I’m tapering off Wellbutrin cuz I want to be off all meds…..

(January Mayo psych recommendation was to taper off Wellbutrin, wait a week then Start a different AD.) 
I just want to not start another AD and be able to be ok .

still doing 18.75 am, my brain is unable to cut the tablet further or grind or measure or weigh…

I’m afraid to re-up 😫

[Mary66]

On 2/2/2022 at 5:22 PM, ChessieCat said:

 

 

Q:  Did the doctor suggest the dose changes of escitalopram?

 

(Please do not tag me)

 

It might be that taking 10mg escitalopram was too much when you started it and it is again, or it might be that your system has become sensitised after all the recent changes you have made so that going back to 10mg was too high a dose.

 

Escitalopram is a VERY STRONG drug.  It might be better to reduce to 7.5mg escitalopram.

 

Post #1 of this topic explains how to get non standard doses:

 

Tips for tapering off escitalopram (Lexapro)

Which SSRI is less strong than lexapro?

[ChessieCat]

6 minutes ago, Mary66 said:

Which SSRI is less strong than lexapro?

 

Q:  Why are you asking?

[Mary66]

9 minutes ago, ChessieCat said:

 

Q:  Why are you asking?

Should I answer here?

[ChessieCat]

Yes. Answer in your Intro topic please.  This is where your history is.

[Mary66]

1 hour ago, Mary66 said:

Should I answer here?

 

My mind is in a dark and non-functioning place 9 months off a bad Paxil taper. Last drop was 5 mgs per Mayo psych from 40 end of July After 25 years of a great life on Paxil (didn’t even think about it all those years) depression crept in, then cancer surgery fall 2020, then anxiety and tremors. 

 

I Had no clue what was happening to me. He also doubled Wellbutrin to 300. And neuro put me on Primidone barbiturate for essential tremor also then (last March/April).

 

I wanted  to be off all meds so started Wellbutrin taper in January. Am down to 18.75 1/4 of a 75 IR in the am and I figured out I’m getting worse as I decrease it, I guess it must have helped?  Or doing it while in Paxil WD is the wrong thing. (I’m not able cognitively to crush or measure anything smaller and afraid to re-up.)

 

saw a different Mayo psych in January who wanted me to go on Effexor after tapering off Wellbutrin that’s why I started that taper.  Fell apart early February and agreed to try Effexor per my pcp, had 2 days in bed then burning throat. Stopped after 7 days. I must say I did experience a bit of clarity after a few days. Then read about that drug and all the others, had my Genesight test done, etc.

 

researched way too much on CYP450’s and how my body reacts to these drugs, etc and am so scared.

I’m a teacher/artist (was) and now I need to know about all of this! 

 

My pages of physical symptoms have greatly diminished but my mind won’t stop. I can’t eat, can’t sleep or do much of anything these months. 

try to make myself eat (organic but not many dense calories, boost), walk 1-2x/day to try to get out of my head.

 

guided meditations, I try distractions, qi qong, etc all the right stuff but am getting worse and hope I don’t end up in the hospital.

 

late afternoon/eves I’m better and am sure I can pull through this without meds. Then I sleep for only 4 hours and mornings are terrible and I’m sure that I do need to start a different AD.

 

My husband, family (all professional nurses, PA, attorneys, etc) and my doctors all tell me I need to start an antidepressant asap.

 

My mind is constantly going over and over and over what to do. Muddle through this for years or go back on a Med. And if a Med, which one? Afraid of an snri as it would screw up another receptor, then thinking if a different SSRI might work to help me out of this despair and then do a very slow taper.

Then…. I think maybe I need something for anxiety instead to get my mind calm…if only I could sleep and slow my mind. Made a decision!

 

I have never ever experienced anything like this anxiety and I know it’s the WD….my family is with the old medical model and won’t even read any of the info here or Inner Compass.

 

I’m so afraid I may end up in the hospital 😢

 

So  I asked because lexapro was also recommended to me and I didn’t know if a different SSRI than Paxil might help me stabilize.

 

so afraid of serotonin syndrome, kindling.

 

also saw an integrative doc who wants me on a zillion supplements, Niacinamide and how my high copper levels are creating my poor mental health. My nervous system is on such alert that there is no way I will do that. I can hardly take an omega 3.

 

I don’t know which way to go. It is frightening to be in this mind after being a high functioning, creative happy woman. I can’t even make a meal.

 

sorry to unload on you, I see that people post so often when they are in deep despair and I guess I am, too.

 

Thank you for your patience.

 

 

Edited April 20, 2022 by ChessieCat
added spacing

[ChessieCat]

Q: Did you see what Alto wrote before:

 

On 4/19/2022 at 2:47 AM, Altostrata said:

 

Why are you reducing Wellbutrin? Please stop reducing it.

 

 

If Alto has said this it would probably be because you have been reducing it too quickly which may be what is causing the current issues.

 

If you are experiencing withdrawal symptoms from reducing Wellbutrin too quickly, then adding a new drug is not the answer.  Adding a new drug could makes things worse.

[Mary66]

2 minutes ago, ChessieCat said:

Q: Did you see what Alto wrote before:

 

 

If Alto has said this it would probably be because you have been reducing it too quickly which may be what is causing the current issues.

 

If you are experiencing withdrawal symptoms from reducing Wellbutrin too quickly, then adding a new drug is not the answer.  Adding a new drug could makes things worse.

I did read it and won’t decrease any more Wellbutrin. But your thoughts on pushing thru ? Could helping my serotonin with a different SSRI for a bit help? I know you said it could make things worse

but…..desperation here

[ChessieCat]

You have already tried Effexor and that didn't work.  What makes you think that trying a different antidepressant would be any different?

 

January 2022, wanting off meds, per Mayo psyc, drop Wellbutrin xl 300 to 150 for 2 wks. Then 75 IR 2x/day for 2 wks, then 75 IR am/ 37.5 pm for 2 wks  And continue to decrease.

 

Look at how fast you have reduced your Wellbutrin.  You have gone from 300mg to 37.5mg in about 6 weeks from what I can work out from your drug signature.

 

Sometimes after tapering too quickly it is possible to updose by a SMALL amount which might help to reduce the withdrawal symptoms.

 

Please carefully read ALL of Post #1 of this topic, much of which relates to updosing:

 

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms

 

[Mary66]

27 minutes ago, ChessieCat said:

You have already tried Effexor and that didn't work.  What makes you think that trying a different antidepressant would be any different?

 

January 2022, wanting off meds, per Mayo psyc, drop Wellbutrin xl 300 to 150 for 2 wks. Then 75 IR 2x/day for 2 wks, then 75 IR am/ 37.5 pm for 2 wks  And continue to decrease.

 

Look at how fast you have reduced your Wellbutrin.  You have gone from 300mg to 37.5mg in about 6 weeks from what I can work out from your drug signature.

 

Sometimes after tapering too quickly it is possible to updose by a SMALL amount which might help to reduce the withdrawal symptoms.

 

Please carefully read ALL of Post #1 of this topic, much of which relates to updosing:

 

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms

 

Thank you for your reply, continued patience and guidance.

Doesn’t it say in the alto info above on reinstating that you could try a different drug in the same class…or did I read that wrong? It talked about going from Paxil to Prozac…or is 9 months too late to try it?

Ok….

….how would I go about going back up on my Wellbutrin exactly?  I know Wellbutrin is a different class than an SSRI so could increase be faster?

I never completely went off it.

In my calendar it looks like I was better when I was taking 37.5 am 37.5 pm.

Do I go up the same way as I went down?…every two weeks?  I’m Now at 18.75 am, if so, it will take weeks
 It would look like this…or do I make a larger increase ?  

should I….

Now at 18.75 am

 

18.75 am and 18.75 pm then

37.5 am and 18.75 pm then

37.5 am and 37.5 pm 

Please advise. I have some cognitive impairment and memory issues so it’s often hard to follow detailed instructions.

 

[ChessieCat]

11 minutes ago, Mary66 said:

Doesn’t it say in the alto info above on reinstating that you could try a different drug in the same class

 

That is if someone has difficulties tapering a drug.

 

You may still be experiencing withdrawal symptoms from stopping Paxil too quickly BUT now you are experiencing withdrawal symptoms from reducing Wellbutrin too quickly as well as the possibly experiencing Paxil withdrawal.

 

If you re-start Paxil or start a new antidepressant now and things get worse there will be no way of working out what is causing what.

 

Taking a psychiatric drug is not like taking a headache tablet.  When we take a psychiatric drug the brain gets used to getting that drug and when the drug is taken away too quickly the brain has to get used to not getting as much of or not getting any of the drug.  That is what causes the withdrawal symptoms.  That is why the recommendation is to taper the drug slowly; sneaking it away a little bit at a time so that the brain doesn't have to make lots of changes all at the same time.  It gives the brain chance to get used to getting a little bit less of the drug.

 

Post #1 of this topic explains how to get non standard doses:

 

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

[Go2zero]

On 2/13/2022 at 1:43 PM, Go2zero said:

Then the Wellbutrin. This drug can be tapered quite easily by some people and others may experience extreme difficulties and heavy WD (withdrawal) symptoms which can last for months sometimes.

 

Especially when combined with an SSRI (like Paxil) WD from Wellbutrin can be difficult for some people.

 

I understand that you tapered Wellbutrin extremely fast  (within 1 month?) from 300mg to 37,5 mg. This is way too fast !!!!

 

If I were you I would up-dose the Wellbutrin to 50mg and see if you will get some relief. Give it at least 1 week on 50mg. Maybe further up-dosing to 75mg is needed if you would not get any relief. But the lower the up-dosing the better. The more extreme one goes up and down in dosage the more the nervous system may be sensitized. Therefor better first to 50mg and hope that will help.

 

The extreme fast tapers of high dosages of these 2 meds, may already have sensitized your nervous system. This will heal, but it needs time. Before you can taper further you really need to be stable first. This may take a longer period of time. Nobody can tell how long since everybody reacts differently. 

Mary, I completely agree with ChessieCat that the symptoms you are suffering from, most probably come from a much too fast taper of Paxil and the also too much fast taper of Wellbutrin. I explained before that Wellbutrin can be easily tapered by some. But for other people it can be very very difficult. Wellbutrin is an amphetamine like drug and it can also cause withdrawal symptoms as with amphetamines. 

 

I am also tapering Wellbutrin and even the smallest drops of 2-3% are causing heavy symptoms. 

 

Do not underestimate the withdrawal from both drugs you are/have been taking. These symptoms can last very long when one tapers too fast. 

 

If I were you I would not take any other antidepressant. As ChessieCat says, this will most probably make things worse. 

Another thing I would do, is going up in dose of Wellbutrin a bit. This might help with the WD symptoms. Simply because you tapered much too fast. Going up in dose (not too much!) often helps then.

 

I would go up to 25mg and see if that helps. Give it 1 week. If symptoms do not improve, I would  go up to 35 or 37,5mg. 

Edited April 20, 2022 by Go2zero

[ChessieCat]

Q:  What dose of Wellbutrin are you currently taking?

 

Please state the total daily dose.

[Mary66]

On 4/10/2022 at 10:46 AM, Mary66 said:

If I were you I would up-dose the Wellbutrin to 50mg and see if you will get some relief. Give it at least 1 week on 50mg. Maybe further up-dosing to 75mg is needed if you would not get any relief. But the lower the up-dosing the better. The more extreme one goes up and down in dosage t

I’m using 75 IR tablets and cutting them. As in my notes I’ve been cutting in 1/2 and 1/4, so 75, 37.5, 18.75

now 18.75 am.

you recommend 50? Wouldn’t I go up to 37.5? I’m confused….I’m on IR not extended release. Unsure how to proceed.

[Mary66]

1 hour ago, Go2zero said:

would go up to 25mg and see if that helps. Give it 1 week. If symptoms do not improve, I would  go up to 35 or 37,5mg. 

I’m using Immediate release 75., cutting 1/2 and 1/4, now on 1/4 (18.75 am only)  can’t go up to 25 with these tabs….how  do you recommend I go up to 37.5? As slow as I decreased?
add an 18.75 pm to make 37.5?

or go right to a 1/2 tab 
oh god my brain can’t handle this. 
it’s so complicated please be gentle

 

[Go2zero]

13 minutes ago, Mary66 said:

oh god my brain can’t handle this. 

This could very well be a symptom of withdrawal of Wellbutrin. Memory and concentration problems can occur. This has to do with dopamine levels that go down after dropping in dose. This will heal but that takes time. Going up in dose (temporarily) may help there.

 

Please be exact and clear. Please answer the question of ChessieCat.

 

Q:  What dose of Wellbutrin are you currently taking?

 

Please state the total daily dose.

 

 

Is this 18,5mg (only AM)?

Or do you take more dosages per day?

 

Please keep the answer simple. What is the TOTAL DAILY dose you are taking at the moment?

 

 

[Mary66]

14 minutes ago, Go2zero said:

This could very well be a symptom of withdrawal of Wellbutrin. Memory and concentration problems can occur. This has to do with dopamine levels that go down after dropping in dose. This will heal but that takes time. Going up in dose (temporarily) may help there.

 

Please be exact and clear. Please answer the question of ChessieCat.

 

 

Q:  What dose of Wellbutrin are you currently taking?

 

Please state the total daily dose.

 

 

Is this 18,5mg (only AM)?

Or do you take more dosages per day?

 

Please keep the answer simple. What is the TOTAL DAILY dose you are taking at the moment?

 

 

18.75 am

[Mary66]

26 minutes ago, Mary66 said:

18.75 am

[Mary66]

1 hour ago, Mary66 said:

 

2 hours ago, Go2zero said:

would go up to 25mg and see if that helps. Give it 1 week. If symptoms do not improve, I would  go up to 35 or 37,5mg. 

I’m using Immediate release 75., cutting 1/2 and 1/4, now on 1/4 (18.75 am only)  can’t go up to 25 with these tabs….how  do you recommend I go up to 37.5? As slow as I decreased?
add an 18.75 pm to make 37.5?

or go right to a 1/2 tab 
oh god my brain can’t handle this. 
it’s so complicated please be gentle

 

How often and much should I increase

[Go2zero]

11 minutes ago, Mary66 said:

How often and much should I increase

You would not want to go higher in dosage as needed to find a reasonable level of stability. If you would go up too much that could give other problems. The more we go up and down in dosages and/or change meds, the more our nervous system become sensitised!

 

You went down way too fast with the Wellbutrin. So now it is important to create some more stability. Since you are using Wellbutrin, it would be better to divide the daily dose over 2 or 3 dosages.

 

You are taking 18,5mg now once a day. I would go up to 25mg per day. Try to divide this 25mg over 2 dosages of approximately 15 mg (AM) and 10mg (PM). It does not have to be 100% exact over 15 and 10mg, when that would be too difficult. But is IS important that you take measure the 25mg as accurately as possible.

 

Try this for 1 week and report  here if there is improvement. Then we will advise further. In theory one could raise the dose of Wellbutrin faster, but as explained above here, one should not up-dose more than needed, to prevent other problems.

 

Be careful not to add any other meds or supplements. You need to find stability!

[Mary66]

2 minutes ago, Go2zero said:

You are taking 18,5mg now once a day. I would go up to 25mg per day. Try to divide this 25mg over 2 dosages of approximately 15 mg (AM) and 10mg (PM). It does not have to be 100% exact over 15 and 10mg, when that would be too difficult. But is IS important that you take measure the 25mg as accurately as possible.

I can only work in 18.75 increments, 😣cutting the 75 IR into quarters…

so if I add back a 1/4 tab in the evenings it would be 37.5 total per day…. I felt the best at 75 /day dosing  37.5 am and 37.5 pm

[Go2zero]

1 minute ago, Mary66 said:

! can only work in 18.75 increments, 😣cutting the 75 IR into quarters…

Increments of 18,75 would not be clever. These are much too high. I work with changes of around 1mg. And even then I have WD symptoms...

 

To start with; You could cut the pills in 1/3 (which is 25mg) and after that you could cut every 1/3 part in 1 bigger (15mg) and 1 smaller piece(10mg).

 

It is very advisable to buy a set of scales that can weigh up to 1mg. You can find them on Amazon. Such scales are very useful and important for dosing accurately. Especially for lower dosages.

 

This one could be a good choice https://www.amazon.com/-/es/Smart-Weigh-GEM20-precisión-calibración/dp/B00ESHDGOI/ref=sr_1_4?__mk_es_US=ÅMÅŽÕÑ&crid=3SY7PJGD74JUS&keywords=scales+1+mg+gemini&qid=1650463513&sprefix=scales+1mg+gemini%2Caps%2C181&sr=8-4&language=en_US

 

Here you can find how to work with the scales: