LondonGal: wants to taper Bupropion & Amitriptyline

[LondonGal]

Hi all, I am new. I am unsure how to add my drug history in my signature, apologies - I added info to my profile but that's not working. Any guidance as to how I do this welcome.

 

I am going to start a Bupropion 150mg XL taper. I have been taking it for 30 months. 

I am also taking Amitriptyline 50mg nightly

Diazepam 5 - 10mg, 3-4 times a week (try not to take daily, am mildly physically dependent) 

 

My goal is to come off everything (I have already stopped a cocktail of psych meds this past 2 years, having been polydrugged at an inpatient rehab in 2019, including 2 anti-psychotics which I did not require but that's a whole other story!) and I am still experiencing withdrawls, much has improved in the past year thank goodness as I almost didn't make it through but I still have issues with memory, motivation and cognitive functioning. I plans to taper in the order of: Bupropion, Amitriptyline and finally the Diazepam. I do not want to multiple taper. 

 

Regarding my Bupropion taper, I will be asking MD to switch from XL as I am aware it is not recommended to try and cut XL tablets since it switches to IR. Should I ask for scored SR at 2 x 75mg tablets (assuming scored 75mg are an option)? I do not have MD support with taper but he will change my prescription. I am not able to obtain liquid from a compound pharmacy.

 

I experience no symptoms if I miss one dose of Bupropion, however, I missed 2 recently and felt awful - brain zaps, headache and strange head sensations, burning sensations in my body, unable to sleep, restlessness, air hungry. Given this I want to do a safe slow taper. If anyone can point me to good threads on here and share any personal stories with a Bupropion taper I would be most grateful. As I am to find this community after feeling alone with all this for 2 years. 

 

Thank you so much, LondonGal (living in the USA!)

Edited August 17, 2021 by Go2zero

[Go2zero]

Hi LondonGal,

 

Welcome to this support site. Before we can answer your questions, please give us more information first. Good that you came here. There is a lot of knowledge to be found and shared here. Also the members can support each other here.

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

https://www.survivingantidepressants.org/topic/18343-please-summarize-your-withdrawal-history-in-your-signature/

 

So sorry to read what you all have been going through! 

 

I am tapering Wellbutrin myself and I am one of the persons having quite some problems to get off them. For a lot of people it can be quite easy to stop. For others it can be hell...

 

https://www.survivingantidepressants.org/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-zyban-buproprion/

 

One of the very nasty things with wellbutrin is, that the use of it has a big effect on the metabolism of other drugs. One of these drugs is Amitriptyline...

 

This means that taking Wellbutrin in combination with Amitriptyline flowers the metabolism of the latter one. Which gives the effect of taking a (much) higher dose of Amitriptyline.

 

https://www.drugs.com/interactions-check.php?drug_list=440-203,168-0

 

If you would start tapering Wellbutrin first, this will have an effect on the Amitriptyline as well. It would give the effect as if you were tapering both drugs at the same time.

 

Tapering 2 drugs at the same time (which would be the result when tapering only the Wellbutrin) is asking for trouble in withdrawal. Also you would never know what WD symptoms would come from which of these 2 drugs.

 

I suggest it would be a better idea to start tapering the Amitriptyline or the Diazepam first and leave the Wellbutrin at the current dosage. 

 

I also looked for the metabolism for diazepam. This does not seem to be influenced by wellbutrin. Staying long on diazepam is not a good thing, since it is highly addictive. 

 

So maybe taper the diazepam first, then the Amitriptyline and as last the wellbutrin.

[Go2zero]

9 hours ago, LondonGal said:

I experience no symptoms if I miss one dose of Bupropion, however, I missed 2 recently and felt awful - brain zaps, headache and strange head sensations, burning sensations in my body, unable to sleep, restlessness, air hungry.

Normally withdrawal symptoms of wellbutrin start after 4-7 days. If you already get such heavy reactions after 2 missed dosages, this might proof that it has direct effect on the Amitriptyline metabolism. So you might experience a mix of WD symptoms from both meds then.

[LondonGal]

Thank you so much for your quick response G02zero!

 

I have I believe now added my drug history to my signature. Please let me know if you can't see it

 

Thank you for enlightening me! I did not know about the bupropion / amitriptyline interactions and wanted to hit bp first as I have been on Amil for so many years I figured it would be better to do the bp first. Also, I have no real issues with being on Amil (apart from severe insomnia if I don't take it and dry mouth), where as I believe I have more side effects from the bp (insomnia, uncomfortable body and head sensations, body tension, lack of focus and concentration, possibly emotional blunting, racing thoughts, panic when trying to go to sleep and more). But what you say, and having researched, I am thinking I should maybe start with Amil first. I already self tapered from 70mg to 50mg over the past 18 months, it was unintentional and because I was running low and had no access to more at the time so I stuck with the 50mg dose which I can easily get as individual 10mg tablets. 

 

Re the diazepam, I don't take it everyday as prescribed for a while now, since I am aware how addictive it is and that it is not designed for long term use. I try to take as and when needed and not every day but sometimes when I get anxiety, body tension or have been without restful sleep I do take it. Approx 3 days a week and usually 7.5mg never more. I know benzo withdrawal is horrific but also aware I am low dose and do not abuse it. Also due to the bp nighttime panic I get I am scared to taper without diazepam if things get bad. Not the best thinking maybe but I have to stay functional. Needs a bit more thought and unsurprisingly the one I want to let go of the least. I am dreading the bp taper.

 

I am also interested to know if anyone feels they have permanent cognitive impairment from psych drugs, especially antipsychotics. As well as any insight you might be able to share on the bupropion withdrawal. Thank you again. I am so happy fo have found people in the same boat. When I was on antipsychotics and when I cold turkeyed from them, I thought I was going crazy, I was such a zombie and wanted my life to be over. 

 

Thanks again, LondonGal 

Also in case my drug history is still missing it's:

 

1992- Prozac brand (20mg/40) - 18 months ish

1998- Citalopram- can't remember dose or duration

2005- Current-  Amitriptyline 50mg - self taper from 70mg

2015- Current- Diazepam 5mg 

 

All prescribed in Feb 2019:

Bupropion 150mg XL daily for 30+ months, still on it

Risperidone 1 to 2mg - 12 months - Cold turkey

Trazodone 50mg - 12 months - Cold turkey

Visteril can't place dose - 7 months

Quetiapine 50mg daily - 5 months - Cold turkey

Buspirone 10mg twice daily - 2 months 

Mirtazapine 15mg daily - 4 weeks

 

[Go2zero]

Hi LondonGal,

 

I am so glad you found this website! I truly believe you will get away from these drugs.

 

As said it would be the best thing to taper the amitriptyline first. But I also read that you suffer from the bupropion use. It is a quite stimulating drug.

 

There is something you can try f you do it carefully. It is based on my personal experience and I cannot tell if it will work for you. But as said if you try it carefully it may be worthwhile trying.

 

I was taking Lexapro (escitalopram 2,5 mg  and bupropion 150 mg) some years ago. I could taper the bupropion down to approximately 70mg without much problems while taking the lexapro. The interaction in metabolism between lexapro and bupropion is comparable with amitriptyline and bupropion.

 

My (quite extreme) withdrawal started when I came under 70 mg bupropion. We all react different, so there is not any proof that this will work for you in such a way. You might get WD after goin down only 10% in bupropion. But it is also possible that you can taper down a lot without much WD symptoms. If that works, you may get rid of (a part?) of the side effects of bupropion, before starting to taper the amitriptyline.

 

One VERY IMPORTANT thing. Do never taper two or more meds during the same period! If you would there is a change of interference and we will not be able to tell from which tapering the problems are coming.

 

What do you think!

 

Good that you are careful with the diazepam. Although it would be better to take it less than 3 times a week. 

 

I found a quite good alternative for diazepam in ORGANIC essential lavender oil. Put 2-4 drops in a glass of water and drink it. This works good against anxiety and stress.  If you want to try, be sure you only use 100% pure ORGANIC quality. It does not give side effects. I use it only when needed.

[LondonGal]

Dear Go2zero,

 

Thanks so much again for getting back and all the info. I will try the lavender for sure. I am still amazed that I was on so many medications at any given time that increase/ed the chances of seizures and not one doctor has ever mentioned it. Not once! It's maddening. 

 

Is there such an approach as tapering say a cut in one drug for say 3 months and then a cut in another, so never 2 at the same time but intermittently? 

 

The other concern for me and I guess for many when psych drugs are used off label to treat other conditions, is that without the Amil, I will have neuropathy pain and stomach pain and headaches, which the Amil does keep at bay. My dose increased as I started at 25mg and increased to 70mg. But honestly I have so many strange aches and pains (the Trazodone made me feel awful physically, flu like symptoms constantly) that I don't know what is what anymore!

 

The biggest question for me is if the emotional blunting is caused by the BP or that I have never recovered fully from the antipsychotics. I don't have anhedonia or the 'not wanting to exist', staring into space for hours feelings anymore, thankfully they were worse when I was on them all went away after around 6 months of stopping the APs. But like I said I still have some cognitive impairment, memory and motivation challenges. Did you find any of this with Seroquel?

 

Also did you find BP caused laboured breathing?  I have read others who say they experience it with BP. For me I feel like I breathe in a more shallow way and often have to take a big sigh because I feel I need to open up my lungs. This is why I have sleep anxiety. I feel like I am gasping for air or that I might simply stop breathing and I feel an adrenaline /cortisol (?) rush. It's horrible. 

 

Sorry for all the questions and hope they are not too strange. 

 

Thanks!

 

 

[Go2zero]

10 hours ago, LondonGal said:

I am still amazed that I was on so many medications at any given time that increase/ed the chances of seizures and not one doctor has ever mentioned it. Not once! It's maddening. 

Yes this happens everywhere in the world. Doctors describe meds without really knowing what the effects and interactions are. And without knowing or accepting that there is something like the need for slowly and careful tapering.

 

10 hours ago, LondonGal said:

Is there such an approach as tapering say a cut in one drug for say 3 months and then a cut in another, so never 2 at the same time but intermittently? 

 

 

I would not suggest to do that. Especially since our body and nervous system often need much longer periods than a few months to REALLY adjust to tapering.

 

The only reason that I mentioned the possibility of first tapering a part of the bupropion, is that you say that you think that you suffer a great deal from taking this med. I suggested that you could TRY if it works on you. There is a CHANCE that you can lower the dose of bupropion with careful tapering without getting (directly) in trouble with withdrawal. There are members here who could stop bupropion quit easy while taking meds that where influenced in metabolism by bupropion. 

 

Others may feel WD symptoms from bupropion and the other (influenced) meds immediately from the first taper of bupropion. It is all try and (hopefully not) error. Since we all react differently.

 

But as said, you can try. If you want. If you would start to taper the bupropion by 10%, you can see what happens. Wait for 4 weeks if it goes OK and taper another 10%. If it goes well, you can continue. If you might get WD symptoms, you should stabilize. And after that hold you could start tapering the amitriptyline. 

 

When you are lucky you tapered the bupropion down by then where the side effects of bupropion are less then now. 

 

Does this make sense to you?

 

 

10 hours ago, LondonGal said:

The other concern for me and I guess for many when psych drugs are used off label to treat other conditions, is that without the Amil, I will have neuropathy pain and stomach pain and headaches, which the Amil does keep at bay. My dose increased as I started at 25mg and increased to 70mg. But honestly I have so many strange aches and pains (the Trazodone made me feel awful physically, flu like symptoms constantly) that I don't know what is what anymore!

Did you already feel the neuropathy before you started the several meds you took from 1992 until now. Neuropathy often comes as a side effect of withdrawal symptom from these kind of meds... Treating it with other psychiatric meds is not the solution. In that way our nervous system will never heal....

 

10 hours ago, LondonGal said:

The biggest question for me is if the emotional blunting is caused by the BP or that I have never recovered fully from the antipsychotics. I don't have anhedonia or the 'not wanting to exist', staring into space for hours feelings anymore, thankfully they were worse when I was on them all went away after around 6 months of stopping the APs. But like I said I still have some cognitive impairment, memory and motivation challenges. Did you find any of this with Seroquel?

I do not know too much about antipsychotics to be honest.... I took seroquel just for a few weeks on a very low dose (12mg). I could not sleep for months because of WD. I was almost getting psychotic because of the insomnia. It helped me to start sleeping again. But after 4 weeks I had to taper it carefully. I found it a terrible drug and experience. I would never take it again.

 

I did have memory problems when going down on bupropion when I came under 40mg. I decided to hold on 33 mg until I am fully away from Prozac which is also influenced bu the bupropion. So in effectively I was tapering both meds when only tapering the bupropion, because of the effect on metabolism of prozac.

11 hours ago, LondonGal said:

Also did you find BP caused laboured breathing?  I have read others who say they experience it with BP. For me I feel like I breathe in a more shallow way and often have to take a big sigh because I feel I need to open up my lungs. This is why I have sleep anxiety. I feel like I am gasping for air or that I might simply stop breathing and I feel an adrenaline /cortisol (?) rush. It's horrible. 

 

 

I also know this and experience it. Lately less, since I am doing a longer hold on both meds. What helps me is treating exercises. Like 5 seconds breathing in and 5 seconds breathing out. When you imagine you are breathing through your heart this may give an extra positive effect.

 

Look on youtube or elsewhere for Heartmath Breathing. It is a simple technique which is extremely effective and easy to learn. You do not need to follow a course or something. Just do it. It helps me and others a lot!

[LondonGal]

Hi friends,

 

I told my doctor I want to taper from Wellbutrin 150mg XL (extended release) that I have been on for 21 months.

 

He switched me from XL to Wellbutrin SR (sustained release) and wants me to go back in 30 days and said I shouldn't experience any real side effects. 

 

I am on day 6 and since yesterday I am a bit shaky all over and from the start of the switch my head and jaw has felt especially tight. Like a vice grip from ear to ear and dull pain in base of brain and a headache and tingly sensations all over my scalp and a bit into my face. It's not unbearable (I've had worse withdrawals) but I don't want it to get worse.

 

Has anyone else experiences this with a switch from XL to SR?

Anything else I could keep in mind that might come up?

 

Warmly. LondonGal

 

 

[Altostrata]

Twice-a-day dosing with Wellbutrin SR is needed. Why did you switch to SR for tapering? 

 

See 

 

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[LondonGal]

Hi Alostrata, thanks for your quick response. 

 

I was only ever on 150mg XL Wellbutrin/Bupropion taken once daily in the morning. It's a low dose (but I was on a ton of other meds including APs when I started) I just have this and Amitriptyline and then I am drug free which is my goal.

 

So I told my doc I wanted to come off / taper from 150mg XL and he said I should switch to 150mg SR once in the morning instead. It is my understanding that SR only comes in 100mg, 150mg and 200mg. So he swapped like for like on dosage. I am not exactly sure what else he could have done. I don't want immediate release since I think it will make me jittery and I've read the side effects are worse. Doctor made no mention of immediate release. I believe his thinking is that I would move to 100mg SR eventually after a couple of months and then stop.

 

He kept emphasising what a low dose I am on so I shouldn't get any withdrawals but we know from forums like these that's not always the case. 

 

Is it not the right approach to taper by switching from XL to SR? I am not able to access or afford any kind of compounding and I know I couldn't taper from XL since when you cut it, it becomes immediate release. Too risky.

 

I feel a bit confused to be honest. 

 

Warmly, LondonGal 

[LondonGal]

Withdrawal symptoms from Wellbutrin / Bupropion taper

 

Hi friends, 

 

I have been tapering from a cocktail of drugs (poly-drugging) since 2018 and have three to go. I feel thankfully I am through the worst (tapering anti-psychotics was a special kind of hell and I still have some effects which I fear may be permanent). Anyway, I have followed my doctors tapering regime for Bupropion, somewhat reluctantly, to date as follows:

- Starting point - 150mg Bupropion XL for 30 months 

- He put me on 150mg SR for 30 days (people ask why the switch from XL to SR, it probably makes no sense but honestly I just want this out of the way so did it) - no real withdrawals or symptoms for the 30 days. Actually felt a lot better for the change. 

- Next, he moved me down to 100mg SR which I have taken for almost 30 days. He then advised me to do a two weeks of 100mg SR every other day and then stop. I AM NOT GOING TO DO THIS!! I will stay on 100mg SR and slowly taper over time as per guidance and wisdom on here. I have two questions:

 

1) I noticed little change and actually (surprisingly) felt better switching from 150mg XL to 100mg SR for 30 days. 

However, the reduction from 150mg SR to 100mg SR I feel has hit me harder. Not emotionally or mentally (although I am under no illusion this could come) but for now, I still feel the mental and emotional fog lifting from the reduced dose even though I sometimes get hit with consuming mental overwhelm at times it is not unmanageable. The symptoms I am experiencing with this 50mg reduction are mainly physiological and seem to be increasing as follows:

- Strong sense of my heart pounding very hard all the time, even when I am calm and still, so much so, I have stopped any cardio exercise.

- Heart flutters and sensations which are increasing in frequency and intensity, also feels like a vice grip around my heart (what I would associate with anxiety)

- Extreme muscle and whole body tension, I become rigid with tension without realising and have to consciously relax. Calf muscles very uncomfortable. 

- Tension headaches (I suffer from tension headaches anyway but they have doubled in the past month) and extreme tightness and soreness on scalp and in face.

- Brain zaps and weird sensations in my brain - feels like blood vessels bursting, I swear I can hear them popping sometimes (I know unlikely but none the less) and I have had this on SSRIs way back but never ever on the Bupropion - until now. 

- Jaw clenching

- Tinnitus

- Shallow breathing often and air hunger at night when falling asleep (to be fair I have had this on and off since I started the cocktail in 2018 so it could be rollover from something else or related specifically to Bupropion. I did not have it with the remaining two drugs I am on, Amitriptyline and occasional Valium 5mg, so I know it is not from them). Still it is very unpleasant to the point of scary. 

- Nausea 

 

Has anyone else experienced these (knowing that would make me feel better I do not to see a doctor, they won't believe me anyway as we know) and I don't want to google it and any tips / reassurance on this process?

 

2) I will taper down from 100mg SR. Any tips on how to do this - over how long and at what pace to reduce? - I am aware that getting to smaller amounts can sometimes be more difficult and I certainly don't want that since I have been in permanent withdrawal trauma for over 2.5 years - bless us all).

 

Thank You Warmly, LondonGal

 

 

Edited October 29, 2021 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

I have merged your new Introduction topic with your original Introduction topic.  Please note that each member only has 1 Introduction topic.  Your Introduction topic is the best place to ask questions about your own situation and where you can journal your progress.  It also means that your history is in one place and you will not have to repeat yourself.

 

Please edit your drug signature:

• remove the bolding
• make the font a smaller size

Please also update if you have made any changes.

 

Account Settings – Create or Edit a signature

 

Thank you.

[ChessieCat]

1 hour ago, LondonGal said:

Has anyone else experienced these (knowing that would make me feel better I do not to see a doctor, they won't believe me anyway as we know) and I don't want to google it and any tips / reassurance on this process?

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

There are many SA topics about specific symptoms where members have posted about/discussed their own experience.

 

You can either use the site search function; go to the symptoms-and-self-care forum, type the symptom in the search bar, and click on This Forum from the drop down then click on the magnifying glass.

 

The other way to find topics is to use a search engine and add:  site:survivingantidepressants.org to the search term. 

 

Search for each symptom one at a time.  If you don't get any results try changing the search term, eg migraine > headache.

 

[LondonGal]

30 minutes ago, ChessieCat said:

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

There are many SA topics about specific symptoms where members have posted about/discussed their own experience.

 

You can either use the site search function; go to the symptoms-and-self-care forum, type the symptom in the search bar, and click on This Forum from the drop down then click on the magnifying glass.

 

The other way to find topics is to use a search engine and add:  site:survivingantidepressants.org to the search term. 

 

Search for each symptom one at a time.  If you don't get any results try changing the search term, eg migraine > headache.

 

Thank you so much ChessieCat. I am still quite new so I didn't realise I get one intro subject. It makes sense. I also changed my signature. Thanks for the pointers on how to use the site to find info. Appreciate it a lot

[LondonGal]

On 9/15/2021 at 5:11 PM, Altostrata said:

Twice-a-day dosing with Wellbutrin SR is needed. Why did you switch to SR for tapering? 

 

See 

 

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

I'm sorry I missed this last month Allostrata. Thank you. I am struggling to navigate the site and I don't know how to reply without quoting the message. As per my post earlier today, I started to follow my Dr's Bupropion taper guidance and it was going well until now. My post explains where I am at today. Dr obviously has no clue to switch me from XL to SR and then cut dose. I will figure the rest of the taper on my own and do it gradually. Warmly, LondonGal

[Altostrata]

2 hours ago, LondonGal said:

Has anyone else experienced these (knowing that would make me feel better I do not to see a doctor, they won't believe me anyway as we know) and I don't want to google it and any tips / reassurance on this process?

 

Please read Tips for tapering off buproprion (Wellbutrin, SR, XR, XL) thoroughly.

 

You have withdrawal symptoms from the decrease from 150mg SR to 100mg SR. This is a big change, amounting to a 33.3% dose reduction, where we generally recommend 10%. In addition, SR needs to be taken twice a day.

 

If I were you, I'd continue to take 100mg SR at the same time each day in the morning, and 25mg (1/4 of a tablet) 8 hours later, in the afternoon. Updosing is a technique to use when you've made too big of a reduction, to reduce withdrawal symptoms.

 

The quarter tablet will be the same as immediate-release bupropion, but will help keep the drug blood level more steady over 24 hours. Please let us know how you're doing.