soylec: Bupropion XL and fluoxetine plus lifestyle changes

[soylec]

26/F. Depression/anxiety. History of being somewhat underweight. Family history of severe mood disorders. My brother killed himself about 6 months ago.

 

2007-2013: Lexapro 10-20 mg. Took this on and off, with 2 cold turkey "quits." I remember it took about 7-8 days of sleeping and withdrawal symptoms both times. Luckily this time around, my SSRI has a much longer half-life, and wellbutrin has been pretty tame so far in terms of withdrawl side effects. 

 

2015: Moved out of state by myself. Lived alone. Started seeing psychiatrist regularly. After trying: citalopram, sertraline, and the SR version of bupropion, my stable prescription has been 150 mg bupropion XL (wellbutrin) and 30 mg fluoxetine (prozac) in the morning everyday. Wellbutrin was my "Godsend." I was crying for 12 hours a day for no reason. Wellbutrin made it possible to get out of bed.

 

2017: Moved back with family. They're feeding me and taking care of me. I'm trying a taper because of side effects. There are so many "mild" ones that it's difficult to even identify them anymore - I've accepted them as just "normal". The dizziness, the foggy brain, the random "blank" moments when I forget what I'm saying mid-sentence. GI symptoms...  Etc. I stopped the wellbutrin earlier this week. According to this website: https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants it should be out my system 99% by now. Keeping the prozac consistent. I have a ~10 or so pills of .025 generic xanax that I'm keeping for panic attack emergencies or acute withdrawal symptoms. I'm taking 3 capsules of 10mg each. I might try dropping one whole capsule for a week and see how I do. I will be of work for a few weeks so it will be a good time to experiment.

 

I'm trying to add lifestyles changes that will help me manage depression. Here is what I am trying right now, in approximate order of perceived efficacy: 

1. exercise: 3-5 days a week, trying to get 150min of moderate cardio and 2 days of full body strength (per CDC recommendation). Has helped with mood, self-esteem, dramatically improved sleep quality and appetite.

2. meditation: using an app for this. started with 3 minutes, went up to 10. Haven't done it the last few days, will start again tonight. 

3. sleeping hygiene - work in progress.

4. diet: avoiding processed foods and junk foods, eating 3 good meals a day, lots of water. I have been experiencing huge pangs of thirst since stopping wellbutrin. I'm taking a few supplements (curcumin, probiotics, among others) but I don't know if that's doing anything.

 

I'm interested in "gut health" - apparently there's a huge connection between the gut and the brain, eh? Trying to take care of it. I'm also reading some books. Currently reading Upward Spiral. Has anyone read it? Here's the description: "Depression can feel like a downward spiral, pulling you into a vortex of sadness, fatigue, and apathy. In The Upward Spiral, neuroscientist Alex Korb demystifies the intricate brain processes that cause depression and offers a practical and effective approach to getting better. Based on the latest research in neuroscience, this book provides dozens of straightforward tips you can do every day to rewire your brain and create an upward spiral towards a happier, healthier life."

 

Here's to managing symptoms... of the meds, withdrawal symptoms, and depression. 

 

 

[Gridley]

Hello, Soylec and welcome to SA.  You have a great attitude, which is much of the battle, and have instituted some excellent lifestyle changes.

 

If I understand your post correctly, earlier this week you cold-turkeyed 150mg Wellbutrin earlier this week.  You said:  "According to this website: https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants it should be out my system 99% by now."

 

Unfortunately, that is not the way it works with antidepressants.  Unlike, for example, aspirin, which ceases to have an effect once it is out of your system, antidepressants actually change the brain, and the fact that it is "out of your system" does not alter this.   I urge you to read the following link:

 

Brain Remodelling

 

I am concerned that your cold-turkey is going to cause you some unpleasant withdrawal symptoms.  At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.  Please read these links:

Why taper by 10% of my dosage?

What is Withdrawal Syndrome?

 

I know you are anxious to get off this drug.  Even so, you should consider reinstating a small dose of Wellbutrin.  The fact that you only recently discontinued the drug is to your advantage.   At this time, reinstatement of a small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  Then, after you stabilize (after your symptoms become manageable) you can begin a 10% taper to get the rest of the way off the Wellbutrin.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months to many years.  

 

This link explains reinstatement:

 

About reinstating and stabilizing to reduce withdrawal symptoms ...

 

We ask all of our members to fill out a signature so that all of your information can be read at a glance.  This helps moderators determine you current situation and give informed advice.  We would ask that you follow the instructions at the link below.

 

Account Settings – Create or Edit a signature

 

 •    Please leave out symptoms and diagnoses.
 •    A list is easier to understand than one or multiple paragraphs. 
 •    Any drugs prior to 24 months ago can just be listed with start and stop years.
 •    Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
 •    Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.

 

Is reinstatement something you would consider?  If so, after you have posted your signature, I will ask the other moderators what amount of Wellbutrin would be advisable to reinstate.

 

 

 

 

 

[soylec]

Hi Gridley, thanks for the welcome and the informative post.

 

I am willing to reinstate the wellbutrin if I experience any noticeable withdrawal effects. If it gets harder to get out of bed, I'll reinstate it as well.  Somehow I am unscathed, but it has only been 7 days.I'm  in a relatively safe space - off work, living with family. I'm just feeling gutsy enough to go for it. Wellbutrin is also just unusual, as it doesn't "fit" into the other categories of antidepressants. So far, have not experienced anything unpleasant. The only symptom I have noticed was on day 2, I felt extremely sleepy. Somewhat increased thirst.

 

I am planning on tapering the prozac, as it is an SSRI and I have experienced withdrawal effects with those before. I will likely not do a 10% taper unless I have to. I understand that the 10% rule has been is considered the golden standard in terms of safety and limiting risks of withdrawal symptoms and other severe side effects. What I'm gambling on is essentially that maybe I am/will be "one of the lucky ones" who does not experience severe repercussions. 

 

I am keeping a log and will continue to monitor for symptoms.

[Altostrata]

Welcome, soylec.

 

What are the side effects you've been experiencing from Prozac and Wellbutrin? Has this symptom pattern changed since you went off Wellbutrin?

 

Please be aware that, aside from those who were told by their doctors to go off too fast, every person here who went off a drug too fast and developed withdrawal syndrome was counting on being "one of the lucky ones."

 

Going on and off drugs can make your system sensitive to reductions. Since you just went off Wellbutrin, if I were you, I'd wait a couple of months before tapering Prozac, to make sure your system was not upset by going off Wellbutrin.

[Kristine]

Hi Soylec and welcome to SA.  I love your list of lifestyle changes 🙂 I'll take note! I'm also interested in gut health but have only scratch the surface at this point in time. K

[soylec]

Hi everyone. Quick update. I have not experienced any significant withdrawal symptoms from stopping wellbutrin. Talked to a friend of mine, and she actually quit taking hers because she ran out of a prescription! She has a master's in nursing... Lol. Doesn't take care of herself sometimes. Anyway, looks like she is doing fine, and didn't report any side effects either.

 

I am starting to taper off from the fluoxetine. Last 2 days I've taken 10mg vs the 30 mg. I have noticed increased sleepiness and thirst. I feel weird and foggy, but it's like a 1 on a scale of 1-10.

 

Continuing to exercise. I am doing ok. 

 

Interesting how getting off medication is just as much of a relief as getting on them? I guess my life situation has changed and the increase in other supports (especially family support and not living alone) and a relatively low stress job (as compared to a competitive graduate program) has allowed me to reduce medicines. For now. I am more than willing to take them again should the need arise. 

 

I understand that this is peer support or people experiencing withdrawal symptoms, so I am not sure if my posts are useful here. So far I am fine. 

 

Has anyone research withdrawl symptoms by age and exercise levels? I know younger people heal much faster, so maybe my brain is bouncing back faster than it would if I were 56 or even 46. There's just so little understood about these drugs... I am grateful that they helped me get through graduate school. I truly don't think I would've made it without them.

[soylec]

Some side effects that may be related to reducing prozac:

• strange feelings of coldness in the legs, especially at night (not due to temperature changes)
• dreams - anytime I start/stop an antidepressant, I notice changes in dreams.
• continuing brain fog and sleepiness.

overall feeling "fine".

[soylec]

Had a crying spell last night. The meds definitely prevented/minimized those...

[soylec]

Update: My depression symptoms returned with a vengeance. I'm back on Wellbutrin 150 mg and Prozac 20 mg. I am also doing intensive group therapy. I have 1 or 2 more weeks of this therapy. It seems to be helping.

[ChessieCat]

Please update your signature:  Account Settings – Create or Edit a signature

[soylec]

I tried tapering 10% of the Prozac using liquid. I took 18 mg for 4 days (instead of 20 mg). Today I went back to 20mg because the headache was driving me nuts. Low mood. Anxiety, irritable. I thought I had learned my lesson and that I should follow the 10% rule. Looks like either I'm not ready to taper, and when/(if?) I am, I might need to taper even more slowly. Also... I think I need to quit the Wellbutrin first. That is much more complicated due to the XL... I just don't have the energy to do that. Even making the liquid of Prozac seemed like a lot of work. Last few nights I have had some weird nights - not being able to sleep, feeling too hot. It's bizarre. 

 

I guess I need to continue to work on boosting up other areas off my life before I try to reduce any of the meds. My psychiatrist said that I need to take these drugs for 2 years before considering a taper. Which is super discouraging... There is a lot of side effects...

[Carmie]

19 hours ago, soylec said:

I tried tapering 10% of the Prozac using liquid. I took 18 mg for 4 days (instead of 20 mg). Today I went back to 20mg because the headache was driving me nuts. Low mood. Anxiety, irritable. I thought I had learned my lesson and that I should follow the 10% rule. Looks like either I'm not ready to taper, and when/(if?) I am, I might need to taper even more slowly. Also... I think I need to quit the Wellbutrin first. That is much more complicated due to the XL... I just don't have the energy to do that. Even making the liquid of Prozac seemed like a lot of work. Last few nights I have had some weird nights - not being able to sleep, feeling too hot. It's bizarre. 

 

I guess I need to continue to work on boosting up other areas off my life before I try to reduce any of the meds. My psychiatrist said that I need to take these drugs for 2 years before considering a taper. Which is super discouraging... There is a lot of side effects...

 

 

Hi Solec, 

 

You need to stabilise first before you reduce again. I can’t reduce by 10%. It’s way too high for me, I’ve been reducing by about 4% to 5% . I still get withdrawals though, but they are bearable. I do still get waves when I’m tapering even by small amounts. You will get some symptoms. 

 

The mods here will give you advice about tapering. I dont know anything about the different meds and which to taper first etc, but they always have excellent advice. 

 

Sending hugs🤗

 

 

 

 

 

 

[soylec]

Here we go again.

 

Haven't taken wellbutrin in a few months. More tired. But less stomach issues.

 

Today is day 2 without prozac. I actually just ran out... whoops. ordered refill. Will try to botch some sort of taper together...  I'm off work for 2 weeks. Big gamble.

[soylec]

Feeling sleepy and tired. Didn't make it to the pharmacy but went to therapy and saw a friend. 

[soylec]

Found my brother's old Prozac 40mg. Dumped out approx Half the capsule and took it. 

 

Have been taking Xanax .25 mg at night and that has improved my quality of sleep 

[soylec]

I guess this is day 24.

 

Some lessons learned for my future self, should I find myself in this position again.

1. If taken Wellbutrin and Prozac, wean off Wellbutrin first.

2. Prozac is a lot easier to wean of when compared to Lexapro and Zoloft. 

3. Watch out for hormones/PMS. 

 

I ended up doing a Prozac "self-taper" and it was generally okay-ish so far. This have been complicated because I have been on break, I have been sick (head cold/etc). I don't know if I should just start taking it again? I need to exercise and eat better.

[soylec]

Disappointed. Dizzy. Still have a cold. I'm sick off these withdrawal symptoms.The reality is that I wanted this to be a quick and easy process. Now I'm just angry that none of my doctors ever warned me about the withdrawal process. Head is so off.

[soylec]

Surviving. Definitely feeling windows of "completely okay" and "not okay". Was consistently fine until few days ago. Last night felt like I was going to die from grief/panic. One breath at a time. 

 

EDIT: PMS window

[Carmie]

 

On 12/15/2018 at 9:14 AM, soylec said:

Here we go again.

 

Haven't taken wellbutrin in a few months. More tired. But less stomach issues.

 

Today is day 2 without prozac. I actually just ran out... whoops. ordered refill. Will try to botch some sort of taper together...  I'm off work for 2 weeks. Big gamble.

 

On 12/17/2018 at 5:34 AM, soylec said:

Found my brother's old Prozac 40mg. Dumped out approx Half the capsule and took it. 

 

Have been taking Xanax .25 mg at night and that has improved my quality of sleep 

 

On 1/7/2019 at 10:18 AM, soylec said:

I guess this is day 24.

 

Some lessons learned for my future self, should I find myself in this position again.

1. If taken Wellbutrin and Prozac, wean off Wellbutrin first.

2. Prozac is a lot easier to wean of when compared to Lexapro and Zoloft. 

3. Watch out for hormones/PMS. 

 

I ended up doing a Prozac "self-taper" and it was generally okay-ish so far. This have been complicated because I have been on break, I have been sick (head cold/etc). I don't know if I should just start taking it again? I need to exercise and eat better.

 

Hi soylec, 

 

Wow! You’ve made a lot of changes, no wonder you felt in a state of panic.  Could you please update your signature with the dates and the changes you’ve made. Thanks.

 

How are you feeling now?💚

[soylec]

I'm doing fine. It's the hormonal changes  (PMS/PMDD) that really mess everything up. I don't know how to change signature on mobile. 

[soylec]

Sigh. Deeply considering getting back on meds. Haven't had therapy since 2019 due to new insurance plan.