MoreMeditateLessMedicate: goodbye to Wellbutrin, then Prozac

[MoreMeditateLessMedicate]

Hello everyone,

 

I'm here because of the recent New Yorker article on quitting ADs. It's something that I have thought about doing for quite a while. The last time I tried weaning off anything was back in 2015-16 and it was a total **** show. Not until this past week have I mustered the courage again to think I can quit again.

 

I've been on a lot of meds over the past decade, but there are two that have become a fundamental part of my neurochemistry: Wellbutrin and Prozac (SSRIs since 2009).

 

After reading through the Tapering articles, the prudent thing to do is quit the Wellbutrin first. I've only ever handled the XL pills well, so I will talk to my psychiatrist tomorrow about switching to a lower dose SR or IR in order to help my weaning process. If she's not agreeable to that, then I will make do crushing the XL pills for my 10% taper.

 

The last time I tried to weaning was under the direction of my old psychiatrist. Bless her heart, but she took me off the SSRI instead of Wellbutrin first. I went from 60mg to 20mg in a few months and was ready to fight the world. My uptick in aggression, anger and anxiety scared the **** out of both of us, and I haven't visited the idea of weaning again until now.

 

Thank you for this community of support. I look forward to making my attempt again with all of you getting my back.  

 

David

Georgia, USA

 

PS: I will record Friday as my first day of weaning. If my formulation doesn't change on the Wellbutrin, then I will taper from 150mg XL to 135. 

 

Aug-2014 to present: 

Prozac (avg. 50mg)

150mg Wellbutrin XL (with intermittent 75mg IR adjunct)

Previously: 

TCA: Imipramine (2011-12)

SSRI: Zoloft (2009-14)

Atypicals: Wellbutrin XL/SR 300mg (2012-14), Mirtazapine (2012-14), Buspar (2013-14), Trazadone (2014)

Stimulants: Vyvanse (2013-14), Provigil (2013), Straterra (2014), MDMA (2000-01)
Antipsych: Abilify (2016)

Benzos: Xanax (2019), Serax (2012-13)

[Gridley]

Hello, MMLM, and welcome to SA.  Thank you for completing your signature.

 

As you've seen, we recommend tapering at no more than 10% of current dose every four weeks.  Some have to taper more slowly. We strongly advise against skipping doses (alternate day dosing).  This method is very destabilizing to your central nervous system, which craves stability.

 

Preparing to taper

 

Why taper by 10% of my dosage?

 

These links explain the importance of a slow taper.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

These links are about slower tapers than the 10% method.  A micro taper is the gentlest way to come off these drugs.

 

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide is a way of making micro-taper reductions weekly, as opposed to a larger reduction once a month. 

 

The Brassmonkey Slide Method of Micro-tapering

 

This link is specifically about tapering Wellbutrin, including how to obtain the smaller doses you will need for your 10% (or less) taper.   

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

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

These links should be helpful for when you talk to your doctor.  Perhaps you are lucky, but generally doctors, including psychiatrists, are woefully ignorant about tapering and withdrawal.

 

How do you talk to a doctor about tapering and withdrawal?
 
What should I expect from my doctor about withdrawal symptoms?

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

Edited April 3, 2019 by Carmie
Removed white space

[MoreMeditateLessMedicate]

  Thank you for those great links, Gridley! I’ve been drinking up as much as the information as I possible can the past 48 hours. 

 

Saturday will be my first official day as opposed to tomorrow. All of the supplies get here tomorrow.

 

ive also opted to crush my XL tablets and take them at the IR intervals. Could be a little jarring at first since I’ve been XL for so long. In fact, I’m going to stay at 150 as a conservative measure for 1-2 weeks so I can adjust to the dosing interval.

 

more to follow! 

 

Edited April 9, 2019 by Altostrata
Removed long quote

[MoreMeditateLessMedicate]

Update 1: I probably didn’t read all

of the tapering articles but I had to take into the account the mass of inactive ingredients when divvying up the whole pills. A 150mg dose tablet of Wellbutrin actually weighed 203.5mg (based on the average of 10 tablets). At a 10% taper I had to divide 183mg of crushed tablet into three times daily doses of 61mg. Luckily all of my pharmacy supplies arrived and I prepared the medication for the next 8 days. This takes a while! Which means you really have to want it when starting the weaning process!

 

[Altostrata]

Welcome, MMLM.

 

It looks like you've got your Wellbutrin tapering in hand.

 

You''re taking a fairly high dose of Prozac, why was the Wellbutrin added? Why have you occasionally been taking more Wellbutrin?

[MoreMeditateLessMedicate]

I’ve been on high doses of the SSRIs since 2011. I was a 200mg Zoloft hero before becoming a 60mg Prozac warrior. The higher doses have been given for OCD. 

 

Even though the providers have never come out and told me directly, they keep me on Wellbutrin to help me stay sober. I self-referred into an outpatient substance abuse (alcohol and stimulants) program in 2010-11. I relapsed in 2014-15 and have been doing better since going back on Wellbutrin. The intermittent higher doses were given whenever the major depression intensified. 

 

The last doctor-supervised taper had me coming down from Prozac first. Never ever ever ever again. I’ll get this Wellbutrin out of the way first before going after the SSRI. 🙂

[MoreMeditateLessMedicate]

By having to turn the XL into IR Wellbutrin, I've kinda shocked the system this past week. It's been harder to go to sleep (luckily, I have the 0.25 mg Xanax still on board). I'm not bouncing off the walls yet, but I get short bursts of hypomania. We're talking very short durations, but enough to notice. I'm wondering if I should decrease by another 10% next week instead of running 135mg for an entire month. I know the guidance is go slow, but Wellbutrin truly is a different animal. My worry is that if I keep it at 135mg spread out over the day, I'm going to be stuck with this uptick in anxiety/manic bursts and delayed sleep onset. 

I need to make this decision in the next 24 hours because Friday night is Pharmacy Night in which I prepare the pills for the upcoming week.

[MoreMeditateLessMedicate]

Hello ya’ll- I’m thinking this three divided Wellbutrin doses a day isn’t sustainable. The third dose, which I can’t get in any earlier than 5:30 pm each day is interrupting my sleep. Badly. I either can’t get to sleep, wake up in the middle of the night and can’t go back to sleep or both. I’m in sleep deprivation mode right now because psychotic symptoms are ramping up fairly quick - don’t trust anyone, everyone’s against me, easily angered, mild hallucinations etc. 

 

I didn’t take my third dose tonight which means I got 90mg instead of 135mg today. Question is should I switch to twice a day- taking 67.5mg early am and then 67.5mg after lunch??

 

ALSO, is it possible that my doctor cutting my Prozac from 60 to 40 mg six weeks ago could be compounding these problems?? 

 

Thank you all. 🙏🏼❤️

[MoreMeditateLessMedicate]

Two weeks in and I'm dropping my dose down another 15mg to 120mg. Plan on dropping 15mg every two weeks until I hit the threshold wherever and whatever that may be.

I seem to be okay thus far. But then again, I started taking my low dose Xanax again to smoothe out the anxiety spikes. 

I'm also six weeks into being on 40mg Prozac after doc dropped me down from 60mg. It's actually nice not to have my emotions flattened so much. I missed my passionate nature - although I'm sure it'll get me in trouble in due time. 😐

[Gracee]

Please be careful with your dose reductions.

 

Remember:   Just like there is no magic pill, there is no speedy recovery.

[MoreMeditateLessMedicate]

Thank you for responding Gracee 🙂

 

I definitely plan on following the 10% rule for the other two med drops. I had read on a different thread that Wellbutrin can sometimes we reduced at a higher rate. But, indeed, no need to hurry. If this next drop in Wellbutrin gets bumpy, I’ll definitely  wait a full four weeks before the next drop. 

[MoreMeditateLessMedicate]

I haven't checked in for a while. I'm 9 days into my 4th drop of the Wellbutrin and things are starting to get... challenging. Assuming the theory is correct and Wellbutrin is an NDRI, would a downregulation in my dopamine neurotransmission be part of my uptick in rapid mood cycling and impulsivity? As it stands, I'm starting to deal with issues that I havent had to deal with in quite a while - namely trouble concentrating, eating due to boredom or for pleasure,  restlessness, and sleep issues. In fact, I've been dipping my toe in the Pool of Hypomania the past few days. 

Curious for y'alls input. Thanks!

[ChessieCat]

On 4/20/2019 at 11:54 AM, MoreMeditateLessMedicate said:

Two weeks in and I'm dropping my dose down another 15mg to 120mg. Plan on dropping 15mg every two weeks until I hit the threshold wherever and whatever that may be. 

I seem to be okay thus far. But then again, I started taking my low dose Xanax again to smoothe out the anxiety spikes. 

I'm also six weeks into being on 40mg Prozac after doc dropped me down from 60mg.

 

Please update your drug signature so we can see your tapering dates and doses at a glance:  Account Settings – Edit a signature

 

It may be that your quick tapering is catching up with you.  It might be a good idea to hold for 2-3 months and let your brain catch up.

[MoreMeditateLessMedicate]

Starting Over ...

 

Well, it appears that I'm one of those folks who will have to taper as conservatively (or more so) as the recommendations on this site. I had my ass handed to me. And since I was reducing a super long lasting SSRI (Prozac) with a reformulated Wellbutrin (had to crush up XL into IR to enable gradual dose reductions), I have no idea what was causing the reactions. Given my previous experience with a RAPID reduction of the Prozac under a different doctor, I'm inclined to say that the sudden drop from 60mg of Prozac down to 40mg was probably the dominant variable. Although, I do acknowledge the simultaneous reduction in Wellbutrin could have exacerbated the issues with the Prozac drop.

 

I'm humbled and quite disappointed. I wanted to make it work the first go at it. And I caved in once again. I've been on these medications for over a decade and I underestimated how difficult this process would be.

 

I'm also in the process of finding a new doctor. The next time I make a go at it will be in partnership with a doctor, which means it could take a little while until I find a provider that I develop a good rapport with and trust. 

 

I'm still exhibiting symptoms of mild psychosis which has me feeling better about the decision to go back up to baseline. If I would have let the situation deterioriate, then I could have jeopardized aspects of my life that I have grown to hold dear - mainly my peace of mind and peace with my family and home life. I have gone through too much to jeopardize any of that, so here I am, starting over after getting my ass kicked.

Edited June 9, 2019 by ChessieCat
added topic title

[ChessieCat]

merged 2 Intro topics

[MoreMeditateLessMedicate]

thanks @ChessieCat

 

I also cleaned up the medication signature.

 

"Starting Over" wasn't the post I was hoping to make. Past botched tapering experiences have scared the **** out of me enough that I tapped out earlier rather than later. And it's better that I did it earlier in this forum/community so I don't beat myself up as badly as I have done in the past (at least I hope I don't).

[RichT]

Hi MMLM,

 

There’s no shame in starting over. Especially if you’re going for a slower taper next time. If the mods recommend a reinstatement of a lower dose, I can tell you that approach worked very well for me.

 

best wishes,

 

Rich

[MoreMeditateLessMedicate]

@RichT

Thank you for the words of encouragement!

 

At first I was kinda happy I was going to taper off Prozac because of its long half-life. So many rough experiences I read about the ones metabolized fast. But the problem with Prozac is that it's like a trainwreck in slow motion. Weeks after any adjustment the warning signs start to pop up and even then they don't all hit at once. And then one day you're sitting at the kitchen table in a very disturbing headspace and you think "where on earth did this come from!?"

 

Going forward, I'm taking the mentality that I have the rest of my life to quit. In other words, there's no need to impose an artificial timeline onto this process. 

 

Take care!

 

[Gridley]

50 minutes ago, MoreMeditateLessMedicate said:

 Prozac is that it's like a trainwreck in slow motion. Weeks after any adjustment the warning signs start to pop up and even then they don't all hit at once.

 

Prozac definitely has a long half-life (the longest of the AD's) but what you're probably experiencing is delayed onset withdrawal symptoms.  Not that it makes any real difference, but it's good to know what's going on.

 

Delayed onset of withdrawal symptoms

[RichT]

9 hours ago, MoreMeditateLessMedicate said:

@RichT

Thank you for the words of encouragement!

 

At first I was kinda happy I was going to taper off Prozac because of its long half-life. So many rough experiences I read about the ones metabolized fast. But the problem with Prozac is that it's like a trainwreck in slow motion. Weeks after any adjustment the warning signs start to pop up and even then they don't all hit at once. And then one day you're sitting at the kitchen table in a very disturbing headspace and you think "where on earth did this come from!?"

 

Going forward, I'm taking the mentality that I have the rest of my life to quit. In other words, there's no need to impose an artificial timeline onto this process. 

 

Take care!

 

 

I had a similar experience with Abilify. I had some symptoms straightaway after stopping (almost) cold turkey, but after 7 weeks worse symptoms started appearing, and eight weeks in I suddenly developed severe symptoms. This pattern is very common from what I see on this site.

 

Rich

[MoreMeditateLessMedicate]

I gave up trying to taper a year ago. I have been playing musical chairs with doctors and drug classes since then. I don't think these doctors have my best interests at heart even if they have good intentions. I have been battling some HORRIBLE akathisia (isn't ALL akathisia horrible, though?) the past 72 hours following a recent journey into antipsychotics. Since I was just starting it, I have discontinued Latuda until I find out if the akathisia is acute and then I am going to assess where to re-start my tapering journey.

 

This is my SECOND time posting that I'm starting over. I'm just glad my stubborn pride and ego let me come back in here. I am feeling a bit hopeless today, but I know that this too shall pass.

 

[ChessieCat]

It looks like you have updated your drug signature.  Thank you.

 

Q:  Do you have a particular question or are you just posting an update?

 

 

[MoreMeditateLessMedicate]

Just wanted to update and check back in. I haven't given up on a Life After Meds. 

[ChessieCat]

👍☺️

 

Thank you for coming back to update us.  We do appreciate it and hope you continue to do so.

 

This topic was recently updated:

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

[ChessieCat]

This website has some excellent self help resources.  Scroll down the page to see a list:

 

https://www.getselfhelp.co.uk/selfhelp.htm

 

And these might be helpful too:

 

Important topics in the Tapering forum and FAQ

 

Non-drug techniques to cope with emotional symptoms

 

Acceptance

[MoreMeditateLessMedicate]

Thank you @ChessieCat! These are wonderful resources and I'll be digging into each of them in the weeks ahead. The first link helped me wrap my head around the idea that the actual process of tapering can/will/shall not be rushed... no matter how special I feel I am. 

[MoreMeditateLessMedicate]

Third time is a charm?

 

Fact is that my psychiatric deterioration over the past 12-18 months was exacerbated by an addiction to kratom. I was a daily user for 2.5 years and got as high as 22 grams per day. I am now 90 days clean from kratom (after a rapid taper) and I want to attempt the slow, gradual process of coming off of my Prozac/Wellbutrin combo once another 90 days passes. I wanted to check back in to let you know that my profile is still active, and I will start the AD tapering process again this April/May timeframe.

Best to all of you!