nancy2 introduction

[nancy2]

Hi! So glad to have found this site and forum... I'm taking Venlafaxine and Buprioprion and would like to start tapering on one of them soon; just found out that there is a negative drug interaction between them.

 

I'd like to hear from others and their experience about which to taper first.

 

Also, I currently have a doctor who I've come to believe is more of a pill pusher than I originally thought. She also doesn't seem to be very well informed -- she still believes that Chronic Fatigue Syndrome (which I have) is an imaginary illness, and there's an incredible amount of research and information out there now, including from such "far out" (sarcastic) organizations as the Natl Institutes of Health, Center for Disease Control and even the Dept of Health and Human Services. I've applied for Social Security disability, and they also have a fact sheet about the illness. So, do I tell her about the tapering?? Do I try a new doc and tell them?? Or can I just start on my own? (I'm on Medicaid since Obamacare, thank GOD for that, but I do have a limited choice of docs.)

 

Thanks!

nancy

[Meimeiquest]

Welcome, Nancy! Very strange drug combination there...I guess the doctor was trying to energize you . Generally speaking, people find it easier to come off Wellbutrin than Effexor. At least theoretically, Wellbutrin slows down a liver enzyme that processes Effexor. So if you bring down Wellbutrin, it will allow (theoretically, at least) your liver to also process Effexor more quickly, which is like a dose decrease. So you need to go slowly. Someone more knowledgeable will be along soon with more helpful information.

[nancy2]

Thank you for your reply, Meimeiquest. I see you tapered Wellbutrin in six months. Did you do that alone, using this forum, or have a doctor's supervision? How did it go? Did you experience much withdrawal? Just curious. I really appreciate your post! at least you are getting me started...

 

And, yes, the doctor DID want to both energize me and push the dose of Effexor because I have both Chronic Fatigue Syndrome and depression. Docs are using Effexor off-label in this way now.... though it's okay for SSRIs, I guess she forgot that Effexor is not an SSRI.

[Meimeiquest]

I did it very new to the forum. My problem was I had just come off Zyprexa, an antipsychotic, and was very hypomanic, overstimulated, or something. Which is why Alto recommends stopping the most stimulating drug first. Plus, without major sedation, I have a real problem with anything that increases dopamine, epinephrine, or norepinephrine...that would include Wellbutrin. Hence a very rapid, bumpy, but not unbearable, taper. My doctor at that time gave me whatever scripts I wanted (I had every dose and form of Wellbutrin by the end), but he had no ideas. I think he was watching in horror, lol. I left his practice at about 100mg, it made me anxious to go, but I found all pdoc's make me anxious now.

 

I had one bout of depression in my twenties, but restarted Prozac at 38 for fatigue. I do think I have mild CFS (without an immune component) although my official diagnosis in my early 40's was fibromyalgia. Which has not been healed by tapering, but why would it.

 

Have you decided a strategy yet?

[Altostrata]

Welcome, nancy.

 

Any doctor can write prescriptions to help you taper, it doesn't have to be a psychiatrist.

 

Since your psychiatrist didn't know about the Wellbutrin-Effexor interaction, you might as well say good-bye to her. Very few doctors know anything about tapering and it's unlikely she'll be able to guide you.

 

That combination of drugs can't be doing good things for your sleep, which is so important in CFS.

 

You might as well go off Wellbutrin first. See Tips for tapering off Wellbutrin, IR, SR, XR, XL (bupropion)

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.
 

[nancy2]

Saw my doc today.  I also had to ask her to fill out a form for disability, so that kind of took precedence in terms  of remaining firm.... She did fill out the form in a way that expresses my day to day reality (even though she doesn't believe that the disease of CFS is real) -- so that was great.

 

The tapering Wellbutrin, not so great....  I told her several times I thought her ay was much too fast. She simply didn't want to hear it. This is what she suggests:

 

She gave me a new rx for 100 mg SR. She said, "take it 2x a day for about a week.

 

Then 100 once a day for about a week.

 

Then 100 very other day for about a week. And that will be that."

 

GACK!!!!!!

 

I'm trying to figure out whether I can start working with these 100 mg pills -- knowing her, she won't kick up a fuss about my getting more for the taper I'm doing when I need them. I can do that by email and don't have to get in a discussion.

 

I had been taking XL -- my understanding is the SL are still sustained release, right? ANd they can be cut?

 

So how about 200 mg in the morning (I take the whole 300 in the morning now), and 75mg in the afternoon to start??  That would be a 25mg reduction, a bit less than 10%.

 

I'm also going to see the psychiatrist next week, so I could talk to him about it also.

 

Thanks so much for all your help and support. This thread is great information!

 

What do you all think of my taper idea?

[Altostrata]

Hi, Nancy, I moved your post here since it's about your own personal taper plan.

 

So how about 200 mg in the morning (I take the whole 300 in the morning now), and 75mg in the afternoon to start??  That would be a 25mg reduction, a bit less than 10%.

 

 

This makes sense to me.

 

Please see my post above -- you do not have to see a psychiatrist to get prescriptions for tapering.

[nancy2]

I am doing 150 mg in the AM (half of the XL, which I know makes it immediate release), and then 100 mg SR in the afternoon, for a total of 250 mg, a taper of 17%. I started yesterday, will do that for at least two weeks.

 

Feedback and comments welcome.

[Fresh]

Hi nancy , welcome to the site.

 

Starting with a decrease of 17% is almost double what is recommended. It may be more fiddly , but I'd try a 10% decrease first time round. If you have a minimum of withdrawal symptoms you may them wish to make a bigger cut the next time.

 

Some people find even 10% quite debilitating , and do better tapering in 5% cuts.

 

Best wishes , Fresh

[nancy2]

Thank you, Fresh, for weighing in. I am concerned about this, too. I decided to start that way because the Tapering off Wellbutrin post started with the administrator saying he went off 50mg (25-30% to start) at a time and it was fine. So I thought that 25 mg 17% might be a prudent amount.

 

Only been doing it four days, so far, so good.

 

My doc insisted on giving me 100 mg SRs (60 of them), and then I have quite a few 150 mg XLs left.

 

Is there anything safe I can do with these to start?? Do you think that the cut 75 XL (now IR) in the morning might be giving me too much of a burst? I have not been experiencing that so far, though it's a little hard to tell as I can sometimes feel  happier and lighter in the summer, and this winter was esp difficult emotionally and physically due to circumstances outside my control so I may be having a natural burst of relief.

 

All feedback and experience welcome.

 

Thanks!

[nancy2]

Oops! I forgot how much I had been taking  -- it was 300 mg XL, so I'm taking 150 half of that in the morning, then 100 in the pm.

[Altostrata]

Let's see how you do for a few weeks with this reduction.

[Iamfine]

Hi Nancy. I have had a brief experience with Wellbutrin, but was only on it one month. Some people are extra sensitive to med reductions, that's why I think the 10% rule applies. You don't know if you're one of them until you try. Just be careful and listen to your body and soul. They will definitely tell you if you're going too fast.

[nancy2]

Thanks for your feedback.

 

I notice that I am feeling more of my feelings, which I am pleased about. Numbness and inability to cry were some of the reasons I did not like being on antidepressants at all.

[nancy2]

Hi. just wanted to check in -- halfway through week 3 on 250 mgs (-50 from where I started) and doing well. Going to take one more week and then reduce again.

 

Thanks for all your help.

 

Nancy

[nancy2]

Almost through week 4 on 250 mgs. All is well so far.

 

My head starts swimming when I consider next step and read the Tapering Wellbutrin thread...

 

Seems like 225 mg would be sensible, a cautious 10%. I could take 125 mg in the morning and 100 SR in the afternoon. (Gee, I did the math, even with my head swimming; with the CFS, guess I'm used to functioning in a fog! ha ha)

 

I could do that for a few weeks. Does that seem OK?

 

Nancy

[Altostrata]

Yes, that seems right.

[nancy2]

Hi. Have  been taking 225 mg /day for three weeks, 125 mg in the AM and 100 in the afternoon. A day or two of squirrely-ness, nothing major, generally fine. Would like to go to 200 mg now -- 100 mg SR in the morning, and 100 mg SR in the afternoon. Does that seem OK to you??

 

Thanks.

 

Nancy

[Fresh]

Glad to hear it's going well nancy.   Yup , sounds good to me.   

[Altostrata]

That would be a somewhat larger decrease than 10%.

[Fresh]

10% of 225 = 22.5.    225 - 22.5 = 202.5    

 

11% of 225 = 24.75   225 - 24.75 = 200.25    

 

I thought 200 was close enough.

[ang]

Welcome nancy, well done.

 

When u get to the effexor taper  take it real slow and cautious ....effexor has been called the devils tic tacs,  That doctors would prescribe this off label is horrific, the fact they prescribe it to anyone is horrific.

You r doing well.....

[Altostrata]

Nancy's nervous system is the final decision-maker of the rate of decrease.

[nancy2]

Thanks to all who replied. I decided to start with the 200 mg today. I really appreciate your support and concern.

 

Nancy

[Altostrata]

Please let us know how you're doing, Nancy.

[nancy2]

Hi, again. Have been taking 200 mg for three weeks. Now going to 175 mg for three weeks -- 100 in the AM and 75 in the PM -- a 12% reduction.  Very happy with how this is going. I was able to cry on Monday when my cat died. Haven't cried since I started these pills, and I'm a cry-er, usually cry in movies and stuff, and I like to be able to cry when I'm sad, find it releases a lot of stress.

 

Nancy

[Altostrata]

Very sorry about your cat.

 

Good to hear your taper is going well.

[nancy2]

The taper is going well. Other stuff, not so much. My mom fell and broke her hip and was in ICU for 10 days with pneumonia following surgery -- then got a hospital-based infection. Aargh. Thank God, she seems to be recovering.

 

Going to 150 mg/day -- 100 in AM and 50 in PM.

 

Sooo glad this taper is very boring. My life is way too exciting already, ha ha.

 

Nancy

[nancy2]

... continuing on here.... Going to go to 125 mg after two weeks on 150.  Morning 75mg and afternoon 50.

 

Experiencing onset of winter depression. I use a SAD light 3-5x/week and walk 4-5x/week, do some extra journalling in the morning and take some extra supplements, which has worked well for 20 years (except a few years ago when I wanted to die, and then accepted doc's suggestion of Venlafaxine/Effexor).  Sometimes it's hard to keep up all this self-care activity on top of taking care of life stuff. Been neglecting myself a bit, and feeling blue on top of CFS pain. Will probably feel better after I remember my SAD light in the morning.

 

Glad to be here. Glad to be moving past the halfway mark.

 

Nancy

[Petunia]

I'm sorry your mom hasn't been well, but its good she's recovering now. Its great to hear how you are taking extra care of yourself through winter and managing your SAD. Thanks for updating and congratulations with reaching half way mark with the taper.

[nancy2]

Hi! I have been continuing on my happily boring taper here.... Lowering dose 25 mg every two weeks seems to be working fine. At this point I'm on week 2 of 25 mg a day, so next week will go to zero!

 

Nancy

[nancy2]

Hi. I finished my completely symptom-free and boring (thank God!) taper of Buproprion (Wellbutrin) in January. Did mostly 25 mg per week reduction and it worked great. Took 7 months.... I'm sure any of my docs would say that is an insane amount of time -- I am very, very happy I did it this way.

 

Thanks again for all your help.

 

Nancy

[Fresh]

Well done nancy ,    lovely to hear you did it so smoothly.

 

You will probably want to have a good long hold now before thinking about tapering Effexor.  

 

Give your brain a couple of months to stabilize and recover from the recent changes.

 

bw ,  Fresh