Kenzie85 Looking for tapering advice

[Kenzie85]

Hi there!

  Im new here. I’m looking for tapering advice off Buproprion 150xl. I have been on it for 2 months. I’m just at the very beginning of tapering off .5mg of Ativan which is going to take me 3-4months. I don’t plan on touching the buproprion until I’m done the Ativan taper, but I know I want off all these drugs! They have done nothing for me, and now I have to suffer through long tapers. I’d love to prepare myself how to successfully get off the buproprion when the time is right. I don’t believe my doctor will know the proper tapering technique as she told me I could be off the Ativan in about a month. Thanks for the help! 

[LotusRising]

Hi @Kenzie85 and welcome to SA,

 

We recommend tapering by no more than 10% of your previous dose. See Why taper by 10% of my dose?

 

When did you start tapering the ativan?

 

Could you please provide us with a signature:

 

 

Once we have more information, we may me able to help with more advice.

 

Best,

 

MedRN

[Kenzie85]

I just started tapering the Ativan 10days ago. I’m doing a water taper, decreasing .005mg a day. Things were going well but today I’ve hit a bump. I’m going to hold a day or 2…see how it goes. I may have to decrease the rate at which I’m tapering. 

[LotusRising]

@Kenzie85

Thank you for updating your signature. 
 

What do you mean you’ve “hit a bump”?
 

How many times a day are you dosing?

 

Is there a reason you’ve chosen to taper the Ativan first?
 

 

[Kenzie85]

Increased symptoms. Higher anxiety, dizziness, increased heart rate. The first 9 days had been pretty smooth sailing. I decided to get off the Ativan first because I didn’t want to hit tolerance and have to up my dose. 

[LotusRising]

I would definitely continue to hold until symptoms decrease. Daily micro-tapering can sometimes get away from you, resulting in symptoms piling up on top of eachother.

 

Were you experiencing any other symptoms prior to starting your taper?

 

You may also want to review:

 

We typically recommend starting with the most "activating" drug, which would be the buproprion.

[Kenzie85]

No I was pretty stable when I started. I was bumping around from .5mg to 1mg for a little bit. I held at .5mg for 2 weeks before I started tapering and I felt ok. 
 

[Kenzie85]

Oh man. After reading about which drug to taper first I’m confused now. I thought the benzo was best once I realized I was dependent on it. My doctor is all for me doing my own slow taper off the Ativan, but I’m quite sure she wasn’t stoked on getting me off the buproprion yet. But I want off all. 

[LotusRising]

10 hours ago, Kenzie85 said:

I was bumping around from .5mg to 1mg for a little bit

When you say bumping around, was that because .5mg was no longer working the same way?

 

10 hours ago, Kenzie85 said:

I’m confused now.

Yes, I understand there is a lot of information being thrown at you. One of the main reasons is that it can help to preserve sleep, which helps with overall healing. 

 

10 hours ago, Kenzie85 said:

I’m quite sure she wasn’t stoked on getting me off the buproprion yet

Why do you think this?

[Kenzie85]

My directions in the beginning when prescribed the Ativan and buproprion was to take my Ativan with my buproprion in the morning together. I had bad anxiety about using an antidepressant and my doctor wanted me to get onto it because she thought it would really help me feel better. Her words…”honestly use the Ativan! It will help! You can use up to 3mgs a day.” Thank god I only listened to part of her advice. I’d use .5mg in the morning and if my anxiety got bad I’d take another. Sometimes I’d take a full extra mg, but I only did that like twice in 2 months. 
 

I was prescribed an antidepressant because I had/still am dealing with vestibular issues after a sinus cold. The vestibular issues brought on extreme anxiety for me, like housebound, could not cope anxiety. I think my CNS just went completely haywire. 
 

My doctor just didn’t seem to jump at the idea when I said I’d like to get off the buproprion. She even talked about upping the dose. But that’s not even an option for me. I said I’d like to see how I feel on it without the Ativan. I was put on it for anxiety and I had to use the Ativan the whole time to combat my anxiety. I do think the buproprion possibly helped with my overall mood? I did get out of the house once I started using it. And I continue to. But I’ve also been going to therapy, and I think I’m getting more comfortable with being uncomfortable and I’m just getting better at pushing through. I think? 

[LotusRising]

2 hours ago, Kenzie85 said:

You can use up to 3mgs a day.

In my opinion, this is not good advice. Did she speak anything of dependence? 3 mg is a very high dose of ativan.

 

2 hours ago, Kenzie85 said:

But I’ve also been going to therapy, and I think I’m getting more comfortable with being uncomfortable and I’m just getting better at pushing through

It's good that you're going to therapy, this will help you in the long run. 

 

Have you had vestibular issues before? Have you tried physiotherapy for it? We have a topic that you might find helpful. It's for those experiencing vestibular symptoms when coming off psychiatric drugs, but you might find some of the information useful. 

 

 

In any event, you should figure out if you want to taper the buproprion first.

 

 

[Kenzie85]

I think I’m just going to stick to tapering off the Ativan first. I’m already doing it, so I’ll just finish this first. I’m definitely in a wave right now, and I’ve only been tapering for 11 days. 
 

No this is my first time experiencing vestibular issues. It started in May and I’m still struggling with it. I am going to a vestibular therapist starting next week. 
 

No the doctor didn’t say anything about dependence. In fact when I realized I was dependent on it, I told her I want off and she said I want you to continue using it, it’s helping you. You’re on such a low dose, you won’t have any problems coming off of it. I booked in with another doctor who’s working with me to get off the Ativan. 

 

Anyway…I looked at that tapering buproprion post and it’s so confusing to me. 

[LotusRising]

@Kenzie85

 

45 minutes ago, Kenzie85 said:

I’m definitely in a wave right now, and I’ve only been tapering for 11 days.

 

As mentioned, please be careful with the microtaper, since it's easy for it to get away from you. Holding is a great idea until you stabilize on your current dose. You may benefit from keeping a journal to keep track of your symptoms and reductions. 

 

47 minutes ago, Kenzie85 said:

I am going to a vestibular therapist starting next week. 

 

Good to hear. 

 

54 minutes ago, Kenzie85 said:

Anyway…I looked at that tapering buproprion post and it’s so confusing to me. 

 

We can help you with this when you get there  

[Kenzie85]

Awesome! Thank you so much for your help. I did just realize I dropped 10% of my dose in 10 days so that’s probably a little too quick. I’m pulling 1ml a day from 100ml. So decreasing .005mg daily. 

[Kenzie85]

Question….how long do you think my taper off the 150xl after 2 months of use would take? 

[Altostrata]

Hello, @Kenzie85 We don't know. Suggest you try a 10% reduction of bupropion after your system settles down.

[Kenzie85]

It’s best to not touch the buproprion until I’m done with the Ativan correct? I keep having a super elevated heart rate and I’m wondering if it’s from the withdrawal or from the buproprion.

 

[Altostrata]

On 10/5/2023 at 4:40 PM, Kenzie85 said:

Increased symptoms. Higher anxiety, dizziness, increased heart rate. The first 9 days had been pretty smooth sailing. I decided to get off the Ativan first because I didn’t want to hit tolerance and have to up my dose. 

 

Most likely, these are withdrawal symptoms from your Ativan taper. These indicate you are already physiologically dependent on Ativan. Continuing to taper at this point is likely to bring on more withdrawal symptoms.

 

Bupropion itself may cause those symptoms. Were you prescribed the 2 drugs together to mask adverse effects of bupropion?

 

Generally, we recommend reducing the more activating drug -- in your case, bupropion -- first. One reason is that continuing the benzo may help you get through common antidepressant withdrawal symptoms such as insomnia. Another is that if you are taking the benzo to counter activating effects of bupropion and you go off the benzo, you're left having to cope with activating effects of bupropion while you taper.

[Kenzie85]

I was prescribed them together. Yes the Ativan was for the increased anxiety and I was told to take it daily until the buproprion kicked in and was doing its job. After 2 months I quickly found out I was dependent on the Ativan. Would it be smart to hold the Ativan taper where I’m at and taper the buproprion?? I’m worried about reaching tolerance with the Ativan. I’m having to dose the Ativan 3 times a day right now because I do feel interdose withdrawal. I don’t get a lot of relief from the Ativan these days 

 

 

[Altostrata]

13 minutes ago, Kenzie85 said:

Would it be smart to hold the Ativan taper where I’m at and taper the buproprion??

 

Yes.

 

On 10/5/2023 at 3:40 PM, Kenzie85 said:

I just started tapering the Ativan 10days ago. I’m doing a water taper, decreasing .005mg a day. Things were going well but today I’ve hit a bump. I’m going to hold a day or 2…see how it goes. I may have to decrease the rate at which I’m tapering. 

 

How much Ativan are you taking now? 

 

14 minutes ago, Kenzie85 said:

I’m having to dose the Ativan 3 times a day right now because I do feel interdose withdrawal. I don’t get a lot of relief from the Ativan these days 

 

Did this occur prior to your tapering Ativan?

[Kenzie85]

I’m at .45mg of Ativan. Started tapering from .5mg 12 days ago. Yes I’d say I probably hit tolerance before tapering, but I only started splitting my dose since tapering. 

[Altostrata]

You may have mistaken withdrawal symptoms from overall dosage reduction for interdose withdrawal. Please do not worry about tolerance. All it means is that the benzo doesn't deliver calming or whatever any more. But you can still be adapted to it, which is what the withdrawal symptoms indicate.

 

If I were you, I'd go back to 0.50mg Ativan per day, only 2 split doses, 12 hours apart. Get settled on that, then taper bupropion. 

 

Please let us know how you're doing. 

[Kenzie85]

And how do I taper from 150 xl from the buproprion? I read the tapering suggestions on here, but I find it very confusing.

[Kenzie85]

Something that I could possibly show my doctor. Because I know I’m going to need different prescriptions. 

[Altostrata]

You'll have to convert part of your prescription to immediate-release bupropion or get a small scale to weight tablet fragments. If you cut a bupropion XL tablet up, it becomes immediate-release and you will need to dose twice a day.

[Kenzie85]

I have a scale and a pill cutter. 

[Kenzie85]

How long do you think my taper of buproprion would take? Do you think only using it for 2 months I could taper off quicker? I’m learning the hard way with the benzo that it doesn’t matter how long you’ve been on it, you need to go sloooowwwww. 

[Altostrata]

4 hours ago, Kenzie85 said:

How long do you think my taper of buproprion would take? Do you think only using it for 2 months I could taper off quicker? I’m learning the hard way with the benzo that it doesn’t matter how long you’ve been on it, you need to go sloooowwwww. 

 

Also true of bupropion. We cannot predict how long a taper will take.

[Kenzie85]

I’m considering stopping the benzo taper and doing the buproprion instead. Would you mind sharing the steps how to taper off? 

[Altostrata]

You will need to figure out how you want to measure a 10% decrease. 

 

On 10/7/2023 at 3:24 PM, Altostrata said:

You'll have to convert part of your prescription to immediate-release bupropion or get a small scale to weight tablet fragments. If you cut a bupropion XL tablet up, it becomes immediate-release and you will need to dose twice a day.

 

[Kenzie85]

How often do I decrease 10%? Can I speed it up if I’m feeling ok? 

[Altostrata]

It depends on the results of the prior decreases.

[Kenzie85]

Ok. What’s the recommended rate of decrease? 

[Altostrata]

10%

[Kenzie85]

@Go2zeroHi! I was wondering if you could help me with tapering off Wellbutrin 150xl. I’ve been on it for 3 months and I want to get off. Im also in the middle of tapering off my .5mg Ativan, also used for 3 months (2 months before starting taper). Thanks! 

[Go2zero]

Since you have not taking Wellbutrin very long, it may be possible to taper faster than people who have been taken it much longer. There is no guarantee, but you can try if you want. 

 

In the higher dose regions (above 75mg) it is often much easier to taper faster than in the lower dosage regions (under 75mg). So you could try to cut more than 10% as long you are above 75mg. If withdrawal symptoms should occur, you should hold until the symptoms are gone or have become clearly acceptable.

 

Here you can find a video how Wellbutrin XL can be cut. In this way the XL becomes Instant Release.

 

https://www.survivingantidepressants.org/topic/877-tips-for-tapering-off-bupropion-wellbutrin-ir-sr-xr-xl-zyban/?do=findComment&comment=633436

 

I prefer dividing my daily dose over 3-4 portions.