joshkilp: tapering antidepressants after 15 years

[joshkilp]

Starting Dosage: 20mg Escitalopram & 300mg Bupropion 

 

Background: I started escitalopram when I was 30 years old. A added bupropion at 35 years old. I've been on both daily for the past 15 years. I started to taper Bupropion from 300mg to 150mg 2 months ago. Then for the past three weeks I've been halving a 150mg tablet for a 75mg dose daily. 

 

Questions: I heard Bupropion would be the easiest to stop, but I definitely felt a change in my mood when I dropped the dose. Since bupropion is an extended release tablet, I was reluctant to cut the tablet, but my Psychiatrist told me it was fine for tapering. I have a few questions: 

 

1. Is it really ok to cut the bupropion extended release tablets? 
2. Is bupropion usually easier to stop? 
3. I'm really discouraged by the change in my mood. When does it get better? How can I use this site for encouragement and advice? It's so extensive and detailed, I struggle to use the site. I get overwhelmed. 

 

Josh - from Seattle, living in Mexico

 

 

[Onmyway]

Dear Josh, we recommend that you don't lower your dose by more than 10% of your current dose every 4 weeks. That means that it would take you years to come off of these meds but hopefully with minimal symptoms. That means that you would go from 300 to 270mg and then in 4 weeks reduce by another 10% to 243mg etc. Anything faster risks withdrawal effects. Some people have to go even slower if they get symptoms. 

 

Your doctor is wrong about the extended release tablets. If you do cut them into smaller doses you need to take them multiple times a day. Otherwise your body goes into mini withdrawal every time which makes your nervous system more sensitized to future cuts.

 

Bupropion is in general easier to get off of compared to paxil or venlafaxine but plenty of people still suffer from withdrawal with it so caution is definitely warranted.

 

You can updose now and your symptoms will likely get better and then slowly taper on the 10% principle.

 

Can you please create a drug signature so that we can get a better idea of your drug history and advise you better.

 

OMW

[joshkilp]

@Onmyway Thank you for your message. I appreciate your response. My current drug signature (new phrase for me) is: 

 

• 20mg Escitalopram
• 75mg Bupropion - immediate release once a day

As I have been halving my Bupropion every 4-5 weeks, in the first week after a dose change, I feel some symptoms. By the second week, they dissipate. I've added more exercise and outdoor activity to my schedule to help with symptoms. Since I am currently feeling stable, I plan to continue with my current plan. I will drop the 75mg Bupropion in 4 more weeks. I expect to have some symptoms that will abate after a week or two. I have an appointment with my Psychiatrist in November for a checkin. 

 

Once I have finished the Bupropion, I will wait 1 year to check my stability before starting a slow taper of escitalopram. I am considering using the "taper strips" product that I read about through "Let's Talk Withdrawal" website (https://www.letstalkwithdrawal.com/about-me/) to accomplish a really slow taper. Have you heard of people having success with that? 

 

One thing I've found really challenging about this website is that the information on how to accomplish a slow taper with readily available products is scattered around in posts. I've had a hard time getting my head around how I would accomplish a slow taper. 

[Onmyway]

Hi Josh,

It's good that your symptoms are not bad and go away quickly. I would still caution for a slower taper - sometimes things accumulate. Lower doses are also harder to come off (most of the effect of the drug starts at the lower doses already). Please also don't forget about the windows and wave dynamic of symptoms.

 

We don't have many people who have done the strips but they are usually faster than SA would recommend and with bigger drops. Escitalopram is one of the harder drugs to come off of. I'd suggest caution again.

 

The problem is that when things break down we don't really have things to restore the balance. Reinstatement works sometimes but not always. That's why we recommend caution before. Instead of resting for a whole year after Wellbutrin, do it slower. In the in a race slow and steady is more likely to win.

 

OMW

[joshkilp]

@Onmyway Thanks for the advice. Tell, me, at this point, what would you do? Would you advice increasing my dose of Welbutrin or simply going slower to eliminate the final 75mg? Is there a post you can refer me to with the best advice on how to manage a taper of Bupropion XR (that's what I started on)? Figuring out how to taper it that slow feels daunting. Would I crush the pills into powder, use a scale, and build up my own pills? Do I need to split doses into multiple times a day? I want to balance caution with ease of implementation. 

 

For the escitalopram, do people crush up the medicines and measure out the minute reductions? Do I need to buy a special scale? 

 

 

 

[ChessieCat]

Post #1 of these topics explain how to get non standard doses:

 

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

 

Tips for tapering off escitalopram (Lexapro)

[j1290]

Hi Josh!  A fellow traveller with the Bupropion, I see!  You were on 300mg for 15 years, and went to 75 in a few months?   You think it's worth considering a hold there for a month or two to give the body a chance to catch up and just monitor for symptoms?   I did everything wrong when I began tapering, and wound up going too fast and crashing after a few months.    I started keeping a daily WD checklist, there's a PDF somewhere on this site.  it's been a huge help for me to see trends and whatnot.   

 

Good luck!

[joshkilp]

@j1290 Thank you for reaching out to me. When I started, I was halving my dose every 4 weeks. I had not been educated on the slow, 10% taper method advocated on this site. Since I feel pretty stable right now, I plan to stay where I am for a couple months then I'm considering using Tapering strips to decrease from 75mg to zero over 4 months. 

 

I read that bupropion is a much easier antidepressant to stop. What has your experience been? I'm also on Escitalopram, and I'm more concerned about the withdrawal from that. I currently take 20mg daily. My plan is to initiate a taper of Escitalopram in late 2023 or early 2024. 

 

Can I ask you what is your motivation to remove these drugs from your routine? 

[j1290]

5 hours ago, joshkilp said:

@j1290 Thank you for reaching out to me. When I started, I was halving my dose every 4 weeks. I had not been educated on the slow, 10% taper method advocated on this site. Since I feel pretty stable right now

 

 

Not gonna lie, I'm totally jealous you were able to reduce so easily!   You don't have any Withdrawal symptoms at all?  Maybe I'm just one of the unlucky few, but I've found it a real bear to get off of.  I wound up switching to IR for my taper.

How do you feel now that you have lowered your dose?  Did it reduce any of your Wellbutrin headaches or anything like that?  Everybody is different, of course.  Based on my 2 tapers at 10% or so, I feel real definite WD effects for the first week, increased head pressure and headaches and such, then the next couple weeks that settles and I get vivid dreams and emotional, before things start getting back to WD Normal the 4th week.   

 

In about a week I'm going to start to gradually switch to 10% of my total in liquid form, then when I get stable on that, reduce by 1/3rd of the liquid every week or two in an attempt to minimize WD side effects.   

 

I've read about people that were on AD long term, and after they get to zero they potentially have a rebound and have to reinstate within a year or so.  My goal with my taper is to get to a tolerable dose as soon as I can, and then more gently taper so I don't even have side effects, and hopefully it will be slow so I maybe don't get that rebound.   Some people get it no matter what they do. 

 

I can't tolerate the side effects of Wellbutrin anymore, headaches and pressure and whatnot, plus I just want to be off of them to experience what that's like.  How about yourself?   

[joshkilp]

@j1290 I life in Mexico and I can barely find Bupropion XR. Sometimes the pharmacy has it, other times they don't and say they have no idea when it will be back. This is the reason I want to remove this medicine from my routine. Since it's hard to find here in any form, I definitely can't get liquid or IR; so, tapering ultra slow has seemed impossible. So, I just cut the pills in half, then waited to stabilize before doing another reduction. 

 

My experience of withdrawal has had a few phases. After about 3 weeks of reducing from 300 to 150, I started to notice mood shifts. I never had any headaches or physical symptoms. I just began to feel very demotivated and uninterested in social interactions. Little things that are normally easy for me, felt daunting. I was taking big long maps during the day. This phase eventually went away and I felt more normal.

 

The symptoms repeated with each dose reduction. When I reduced 150mg to 75mg and again when I reduced from 75mg to 33mg, I experienced one to two weeks of symptoms then began to feel getter. Since reading more, I'm worried about the final reductions since I read at lower doses, each reduction has a bigger impact. Based on what my original psychiatrist advised, I thought halving the dose every 4 weeks WAS slow. After reading more on this site, I realize I'm going fast. Of course, I'm worried about a return of depression. My plan is to stabilize on my current does of Escitalopram (20mg) for a year after eliminating bupropion.  If I can have a year of reasonably stable mood, I will begin to work on reducing Escitalopram. Escitalopram is readily available here in Mexico; so, I'm not as worried if I need to stay on it. 

 

I've never been bothered by Bupropion (my body tolerates it well), and the main motivation for stopping is that it's hard to get reliably here in Mexico. Now that I've started the taper and reading more on this site, I've developed a new motivation to reduce this medicine just to see if I really need it now. My life changed a lot 1.5 years ago when I left my work. I have less stress now, and I'd like to understand more how may body and mind function in this new situation. Once I'm done with Bupropion and stable, I'm exited to start tapering Escitalopram. I'm very eager to see if I can return to a more normal sexual function after 15 years of being impaired by escitalopram. 

 

Questions: 

I notice lots of people have information about their medicines that appear below their posts. It looks like a schedule of adjustments. How do I add that to my profile? 

 

I'd like to know how our lives compare. Can you tell me about yourself? I'm 45 years old. I started meds at 30 due to depression. Looking back, I've always been a person with mood shifts over the year. As a young man, I was able to just adjust my life to my moods, but after college when I added an unrelenting and stressful career (software development), I started to hit new lows. I always thought, "I think I can deal with and adjust to mood shifts, but it's the need to keep going at work as though nothing is different that crushes me." I started on Escitalopram at 30. I added Bupropion at 35ish. 

[j1290]

I hear you about difficulties getting XR.  That's one of the reasons I want off this stuff, I always run out on vacation, etc.  I make the liquid solution myself using IR tablets.  I've never used international pharmacies myself, but one time I tried to get my doctor to send a script to one in Canada that ships to the US.  You know what, I think @Go2zero has  a similar situation and splits XL pills into very tiny pieces with a very sharp exacto knife or something.  

 

>I never had any headaches or physical symptoms. 

Fascinating.  Gives me hope that one day when I get that low I may not have them any more!

> I was taking big long maps during the day. 

So glad to know I'm not the only one LOL!   I thought maybe I'm getting lazy or old and have to take naps now in the afternoon.  I would also feel paranoia or anxiety in the mornings  very strong.  

>I thought halving the dose every 4 weeks WAS slow.

Yes, I completely understand.  I thought I was going slow, thought Bup would be easy to taper for me, so I would do a second reduction after a few days, all sorts of things I no longer do.   

>My plan is to stabilize on my current does of Escitalopram

After I spent 2 or 3 years tapering off Effexor, I stayed with the Bup for a few years while I dealt with other life stressors.   I guess my long taper off that worked, nothing dramatic changed I don't think.   

>I notice lots of people have information about their medicines that appear below their posts. It looks like a schedule of adjustments. How do I add that to my profile? 

I don't explain well but if you go to settings  in the upper right :  account settings :  signature you can add it.  Makes it much easier for people to understand someone's situation.   There's a post somewhere that tells you how to write it properly.   

 

I'm a little older than you, but more or less a duplicate of your experience.   I got on these at age 22, told they were harmless and could stop anytime, or just take for the rest of my life with no consequence (hah!).   I was maxed on 450mg XL, then added max dose of Effexor, which I finished tapering 5 or so years ago.   I really thought I could reduce the first 25-50% quite easily, but I was wrong, and about 1.5 years after starting I am now down 17%, which for me, is quite a lot.   This website really made it possible.  

[Onmyway]

 

[joshkilp]

@Onmyway thanks for posting the tips about how to post a drug profile in my signature. 

 

@j1290 chatting with you here has been a valuable interaction for me. That doesn't always happen these days on support user groups and social media. I'm grateful for that. Would you tell me how you are making your bupropion liquid? Is it made with that 0.9% saline solution? What do you use to dose it out after it's liquid? Do you crush up your pills first? If I understand correctly, I can't crush up my XR tablets, and I don't have access to IR tablets here. That's why I'm considering ordering from this pharmacy Their order form says they can make up a strip of little pill packets for you numbered 1 - 28 days for a 4 week taper. They have a 4 week packet for moving from 35-25, 25-15, 15-10, 10-5, 5-0. So, that works out to 30%, 40%, 33%, 50%, 100% dosage changes over each 28 day period. Those are larger percentage changes than this site advocates, but what I like is that the change is spread slowly over 28 days not all at once. So each day, your dose is only changing by 1%.  I'd like to see how I respond to this. 
 

[j1290]

4 hours ago, joshkilp said:

Would you tell me how you are making your bupropion liquid? 

It's a pleasure to discuss tapering off Bup!  It's rare I have the opportunity to hear someone's story but my own.   

I haven't officially done a successful crossover to liquid, but I'm optimistic.  I tried last year while doing everything 

else wrong so I abandoned it, but I know the drill.  There's a whole thread on making a liquid solution that can give you 

better directions than I possibly could, but I plan to use water and the pill just dissolves.  It's a little front heavy with the 

apparatus to get going, but once that's out of the way it's really not a big deal.  I think good record keeping will really be

an asset with this as well.  Best thing I ever did.  

 

I don't know much about tapering strips, to be honest, but I've considered giving them a try.   I like the idea of a 

liquid taper allowing me to really fine tune my reduction precisely.  If I'm successful with it, I plan on using it for the 

remainder of my taper.  I can see how microdrops  could be really beneficial.  

 

How are you feeling these days?  Any noticeable side effects?  That's a huge gift that things have gone smoothly for you.   

 

 

[joshkilp]

Update Oct 27 2022. It's been 30 days since my last dose reduction of Bupropion (75mg -> 37mg). For the first couple weeks, I felt a drop in mood, but then things leveled off. I started to feel energetic and motivated. Unfortunately, this week (week 5), I have experienced a shift downward. I've started to feel demotivated, overwhelmed, and with lots of negative self-talk. It feels like nothing is working right in life. Small obstacles feel big. These are the fingerprint feelings I associate with my depression. Is it just a residual adjustment to the reduced Bupropion? What else has changed? 

 

Last week (week 4), feeling more motivated and happy, I bought a pack of fancy loose Mexican tobacco to enjoy for the week. I was rolling my own cigarettes with a little cannabis and enjoying daily afternoon smokes. Some days I felt a little high and others I just felt relaxed. I was using it as a therapy for relaxation and a mood boost.

 

At the start of this week (week 5), I discontinued the use of tobacco and cannabis, and I've really felt deflated. Sunday through Wednesday, I nearly slept all day long. I had very low energy and I felt dizzy. I thought I had an ear infection or allergies, but a visit to the doctor ruled out an infection. Today is Thursday, and I felt good doing exercise this morning. Thinking about it, I don't think I've ever used cannabis daily for 7 days straight in all my life; so, maybe I experienced a flood of that drug in my system and threw off my equilibrium. I know THC builds up in fat cells and slowly releases if you consume it regularly. Maybe after another week cannabis free, I will feel more settled. This week, I've felt very stuck inside my apartment and uninterested in doing anything that requires effort.

 

 

[Onmyway]

@joshkilp

We see here that any psychoactive substances in withdrawal can set people back, sometimes even years after they have started feeling better - this includes alcohol, pot, steroids, some vitamins, herbs etc. I'd advise that you put these aside for a while.

 

Many here find magnesium and Omega-3 helpful for relaxation.

 

OMW 

[joshkilp]

Mid November Update

After a 3-month trial at lower doses of Bupropion, I am returning to my original dose due to symptoms. 

 

I'm sharing this post to represent my own story which, at least in this chapter, is a failed attempt to reduce/eliminate Bupropion. I've learned a lot along the way, and I'd like to share my results. Unfortunately, I was not successful in this attempt to reduce/eliminate my medication, but I think it's valuable to keep a good record of the successes and failures. 

 

I originally decided to discontinue Bupropion in July of 2022 because I had moved to Mexico and was having trouble reliably acquiring the medicine. I was also curious to see how my body and mind would respond without the medicine. I'd had a lot of changes in my life since my early 30's when I first began treatment, and I hypothesized that I could enjoy a stable life without medicines. 

 

Using the advice of my doctor, I reduced Bupropion from 300mg to 150mg in July. I remained this dose until September (2 months). I felt very little side effect when reducing from 300mg extended release to 150mg extended release. This matches what I'd expect from reading on this site that these drugs have a hyperbolic impact - higher doses have less impact on your system than lower doses. By September I was feeling strong and energetic. I had noticed some increase energy levels which surprised me. 

 

In September I reduced to 75mg for 2 weeks and then to 37mg at the end of September. Both of these doses were accomplished by cutting 150mg extended release tablets. With each of these reductions, I felt a significant drop in energy levels and interest in normal activities. In both cases, the symptoms abated in 1 week. By early October, I was feeling pretty "ok". I was keeping up normal activities, but I had noticed a drop in my overall interest in social activities. Being with people started to feel like a chore during September. This worried me because it was a symptom I had felt before when I first sought treatment. I decided to wait it out and see how the symptoms evolved, but then I had a sudden drop in mid October. 

 

In mid October, I woke up on a Sunday with plans for the day, but as soon as my partner and I left the house, I started to feel dizzy and disembodied. I was finding the commotion, noise, and traffic of normal life very jarring and irritating. I had a strong urge to get back home and to be quiet and still. I ended up returning home shortly after lunch and taking a 4 hours nap. From that day forward, I was sliding rapidly downhill. 

 

Over the next two weeks, I began to take long 4-5 hour naps mid-day and lost interest in almost everything. Nothing sounded fun or comfortable. The only way to sooth myself was to be inside, alone, and often asleep. I thought I might have an infection and went to the doctor to verify I was well, but after 2 weeks, I was certain it was a result of adjusting my medications. 

 

In early November, one day after my birthday, I returned my dose to 150mg - one 150mg extended release tablet. Today, about 2 weeks later, the symptoms are starting to life. My interest in activities is returning and my energy level is coming back to normal levels. I met with my psychiatrist today, and my plan is to return to 300mg extended release tomorrow (November 15). 

 

In all, my experiment lasted 4.5 months. As the information on this site would suggest, my taper was too fast or I had a relapse. One reason I didn't change to a slower taper schedule after finding this site is that the instructions for tapering Bupropion (dissolving tablets or purchasing immediate release) seems unworkable for me. I did not want to put in the work to make my own tinctures, and neither instant release or small dose tablets are available in Mexico. 

 

From my experiment I have learned that a traditional taper that halves doses was too aggressive for me. I noticed the largest impacts after I started to cut pills. I hypothesize that there could be two things that went wrong besides the aggressive schedule. First, it could be that spending only 2 weeks at 75mg was the nail in the coffin. I'm not sure why I dropped to 37mg (1/4 tablet) so quickly. Maybe it was the schedule my doctor have given me or maybe I was just impatient. I can't recall. The second possible glitch is that the cutting the extended release causes rapid metabolization of the drug, and I can't cope with the lower levels of the drug in my system for the second half of the day. 

 

If I ever attempt this again, I would probably buy a scale crush tablets, and build my own capsules in order to go slower. I do feel I could drop the dose by 5mg per month safely.  I would also follow the advice of staying at a given dose for at least 4 weeks before subsequent reductions.  

 

This will probably be my last post for a while. I will make another post in a couple months to report how I am responding to my new higher dose of bupropion. 

[ChessieCat]

Q:  Did you split your dose once you were cutting up your tablets?  If not, then you might have also experienced interdose withdrawal with the regular withdrawal.

 

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.)

[joshkilp]

@ChessieCat, yes, it may have been that once I was cutting the XR tablets, the resulting immediate release was not sufficiently sustaining the drug in my system through the day. Unfortunately, I can't get my hands on real immediate release tablets or any tablet lower than 150mg; so, cutting up and taking multiple times a day was a challenge. I was not willing to take a drug three times a day. I know my personality, and I would not be able to keep that up for long. 

[NardilTime]

You didn’t have a “relapse”. Your nervous system is completely disordered. 

[j1290]

Hi Josh!   Thank you so much for typing this all out.  Personally, I got it all wrong when I began my taper and had to reinstate.   That's great you caught it so fast, it took me a year to figure it out!  

 

I tapered off Effexor, but Ive found Wellbutrin to be much trickier, with the different generics and time releases and whatnot.  

 

I also have problems keeping to a 3 x day doseage schedule, but figured it out and now Ive never been better at keeping up with everything.   Its a small inconvenience but once I got the hang of it no big deal.

 

Looking forward to your next update, and be well.

[joshkilp]

@j1290, thank you for your kind words. Can I ask you, how have you tapered your dose of Bupropion IR? Do you cut and measure the pills? Do you desolve in a solution? 

[j1290]

Over about 4 weeks I switched from 3 x 150mg XL in the morning, to 2 x 75 mg IR, 3 times per day, 6 hours apart.  

 

So far Ive tapered half a pill every 4 weeks and been successful.  This last drop I first switched to taking 1/2 pill in 80ml of water, and after a week or two of no noticeable side effects I reduced to 60ml of solution.  

 

It also took me a while to get hold of generic IR that didnt give me headaches.  

 

Like I said, its been quite a lot of experimenting to get to where I am, and I am certain there will be more changes to make.  This has been anything but a straight path for me.

[j1290]

Hi Josh!  I circled back to this thread and re-read your story.  I sure appreciate the info.   How's things?  

[joshkilp]

@j1290 , thank you for checking in on me. After a couple months back at my normal dose of Bupropion, I am feeling MUCH better. I began to improve within a few weeks of initiating my normal 300mg dose, and now after 2 months, I feel 100% back to normal. I may not have realized how bad I was feeling over that 4 month period. I recall struggling a lot to get out of bed or to have interest in social gatherings. Now I'm finding pleasure in being social, getting out of bed at normal hours, and enjoying my days fully with only occasional naps during the week (more energy). 

 

Generally speaking, I would draw two conclusions. First, I definitely feel and function better using my current combination of medicines. Second, if the anti-depressant discontinuation syndrome really is a deep, prolonged syndrome and it's not just a relapse, I would say it's very powerful and quite costly to manage. For me, other than the mild philosophical dilemma, my medicines haven't caused problems at their current dosages. They blunt my sexual pleasure a little and are hard to acquire overseas, but other than that, on average they have improved my life. I originally started my journey to stop the medicines because they were hard to get here in Mexico, and I wasn't sure if I still needed them anymore. It was worth the experiment. 

 

I do believe that the medical community and the pharmaceutical companies haven't done enough research or provided adequate tools/help for people who want to stop these medicines. That does make me angry, but it's hard for me to know the difference between withdrawal symptoms and relapse of depression and anxiety. For me, for now, I am happy to be feeling better. 

My two favorite articles from this experience were: 
 

Maintenance or Discontinuation of Antidepressants in Primary Care
Gemma Lewis, Louise Marston, Larisa Duffy, Nick Freemantle, Simon Gilbody, Rachael Hunter, Tony Kendrick, David Kessler, Dee Mangin, Michael King, Paul Lanham, Michael Moore, Irwin Nazareth, Nicola Wiles, Faye Bacon, Molly Bird, Sally Brabyn, Alison Burns, Caroline S Clarke, Anna Hunt, Jodi Pervin, & Glyn Lewis , 2021 , New England Journal of Medicine , 385 (14) , 1257--1267
https://www.nejm.org/doi/full/10.1056/NEJMoa2106356

 

Cost-Utility Analysis of Discontinuing Antidepressants in England Primary Care Patients Compared with Long-Term Maintenance
Caroline S Clarke, Larisa Duffy, Glyn Lewis, Nick Freemantle, Simon Gilbody, Tony Kendrick, David Kessler, Michael King, Paul Lanham, Derelie Mangin, Michael Moore, Irwin Nazareth, Nicola Wiles, Louise Marston, & Rachael Maree Hunter , 2021 , Applied Health Economics and Health Policy

https://pubmed.ncbi.nlm.nih.gov/34748164/

 

In a New York Times article the author was quoted 

"... The medical profession has no good answer for people struggling to stop taking the drugs — no scientifically backed guidelines, no means to determine who’s at highest risk, no way to tailor appropriate strategies to individuals."

“Some people are essentially being parked on these drugs for convenience’s sake because it’s difficult to tackle the issue of taking them off,” said Dr. Anthony Kendrick, a professor of primary care at the University of Southampton in Britain.

 

 

[j1290]

4 hours ago, joshkilp said:

After a couple months back at my normal dose of Bupropion, I am feeling MUCH better.

Congratulations!   I'm glad to hear you swiftly caught this and are feeling like yourself again.   

 

4 hours ago, joshkilp said:

It was worth the experiment. 

I understand completely.   I'm not sure myself if I can get off of these pills, but I know I have to try.  

 

4 hours ago, joshkilp said:

That does make me angry, but it's hard for me to know the difference between withdrawal symptoms and relapse of depression and anxiety. For me, for now, I am happy to be feeling better. 

It's just not simple, that's for sure.   I'm going to read the articles you just referenced.  Are you thinking of tapering again maybe a little at a time, just to see if you can get to a lower level?   That's my goal, if I can't get off them altogether, to get to a lower dose.  

 

Really glad to hear you're doing welll, friend!

 

EDIT:  Read the articles.  Fascinating reading.  I have to think there's something to this quote:"Some people are essentially being parked on these drugs for convenience’s sake because it’s difficult to tackle the issue of taking them off,” said Dr. Anthony Kendrick, a professor of primary care at the University of Southampton in Britain.

 

Reading those papers makes me realize there really isn't much for doctors to study to really know what we're going through with tapering.  It explains a lot.  

 

[joshkilp]

@j1290 Hello, my friend. I wanted to check in on you and ask how 2023 has been? Have you made any progress with adjusting your medicines? I stayed steady with my doses through 2023, and it's been a good year. I got married to my partner, and we have developed some nice travel plans for 2024. 

 

I continue to think about my "dependence" on antidepressants. I don't really mind taking a medicine for the rest of my life, but I do know that it is affecting my energy. When I say, "energy", I initially want to refer simply to my physical stamina. Thought I know there is no rulebook, at 47, I feel a lot older than I would want. I am usually getting pretty tired by 9:30pm and often in bed by 10:00pm. But physical energy aside, I also know that my emotional energy and mood are a bit dulled. I feel I still live a passionate life and many people tell me I'm a source of positive energy for them, but I know that I'm not experiencing pleasure or pain like I did in my 20's. I suppose this is the effect of these drugs which I originally sought to help me cope with depression and stress. Back then, I wanted to calm my "thinking-racing" mind and reduce the intensity with which I experienced my emotions. Largely, these medicines have helped me as far as I can remember myself in my 20's. I was definitely more volatile. 

 

It's possible that I'm doing quite well now, but that burning question as to whether the "me" I experience when I am changing these medicines is really "me" or a version of me under the powerful influence of withdrawal from pharmaceuticals that have altered my brain and endocrine system. Overall, I feel happy and am choosing to stay the course. 

 

I will be interested to hear how you are doing and what 2023 has taught you. 

[Onmyway]

@joshkilp

if you want to ever come off the drugs, you now know the proper way to do it - very slowly - at 10% of your previous dose or less every month. 

The only thing I want to say is that the dose of escitalopram you are on is high and as you get older it can cause heart issues - you may want to get an EKG to check your QT interval as it is known to prolong that and increases the risk of cardiac arrest (still rare but worth checking). If you can go down on that medicine at least a bit, it may benefit your overall health. 

 

Wishing you an easier sailing. 

 

OMW

PS. You say you are not like in your 20s but are now 47 and only started the drug in 2022. Are we missing some relevant drug history there? 

[joshkilp]

@Onmyway Thanks for your response, advice, and question.

 

Starting with your question, you mentioned 2022 as the date I started medications. Where did you read that? It's an error and I will correct it. My actual history is that I started my medicines in 2006. I recently tried to reduce my doses in 2022. That's when I made my posts on this message board originally. Now a year later, I was checking back to read my history and say hello to another user I had connected with. 

 

Moving on to your response and advice. I agree with you that the preponderance of information from this forum supports slow tapers as an effective way for some people to reduce side effects. I also read in the forms lots of examples of drug dose alterations not working well. Who went slow enough, who was too eager, who thought "they knew better" is also a theme I read which, in my view, is counterproductive. 

 

What we can all agree on is that these medicines are hard to stop. I wish our medical community had more motivation to study this problem, find effective solutions, and propose drug concoctions to help people slowly and safely merge off these medicines. It does not surprise me that many people can't achieve success with some of the tedious home-pharmacy methods we have available today. 

[Onmyway]

@joshkilp

Your drug history starts in 2022, it should cover your psych drug history including all prior stops and starts. 

 

You don't need to fix it now but if you want advice in the future from us, pls make sure to fix it.