SonSetFree: starting my journey of healing (Wellbutrin, Cymbalta, Trazodone)

[Altostrata]

Hello, @SonSetFree

Quote

Currently on Trazodone 50mg and Remeron 7.5mg.  Cymbalta 1 Bead (0.1mg) 2X Day 10AM and 4PM.  Wellbutrin 10mg AM / 6mg Mid day / 6mg Early Evening

 

Is this your current drug schedule? You are still taking 2 beads of Cymbalta?

 

Have you accidentally skipped any doses of any of your drugs in the last month? Had any alcohol? Taken antibiotics?

 

What times o'clock do you take each of your drugs, with their dosages? Have you been sticking to a regular drug schedule?

 

How do you feel before and after taking each dose?

 

How's your sleep?

 

I would not increase Wellbutrin. It may be causing some of your symptoms. If you're taking trazodone and mirtazapine for sleep problems, Wellbutrin counteracts this. It tends to be stimulating and can cause sleep problems and anxiety.

 

With Cymbalta, you were taking 4 antidepressants! Doesn't that seem excessive to you?

[SonSetFree]

Hi @Altostrata thank you so much,

 

Yes I am on the same drug schedule.  Here is the schedule, I've religiously held to. I Have an alarm set and take it at precise times;

7:00 AM 10mg Wellbutrin and 1 Bead (~0.1mg) Cymbalta

12:30 PM 6mg Wellbutrin

5:00 PM 6mg Wellbutrin

6:15 PM 1 Bead (~0.1mg) Cymbalta

10:50 PM  7.5mg Remeron and 50mg Trazodone

 

I haven't skipped a dose, had alcohol or antibiotics in the last month (or at all).  I had been playing with my Wellbutrin dosing between 20-25mg around 6 weeks ago.  Then, I changed my schedule slightly about 2 weeks ago, not dosages, but times of day.  All I did was move the times out 30 minutes later with the exception of the bedtime Remeron and Trazodone.  So maybe that stirred things up a little.  

 

I don't feel a huge difference before and after each dose now. The Anxiety, Depression and DR are hardest in the mornings and let up in the evenings, around 6 o'clock.  Not to say I never have anxiety at night as I have had episodes but they are less common.

 

Initial WD phase I was sleeping less than 2 hrs a night.  I was prescribed Remeron by Psych doc, even though I was already on Trazodone.  I wish I didn't get on but was desperate for sleep.  It did help at first but then I was back to <2hrs sleep within a week or so. 

 

Surprisingly, the first night I reinstated Cymbalta, I got 8 hrs of sleep.  That kept up for a couple of days but then dropped to around 4-5 hours average per night which is where I am at now.  Very intermittent sleep though, hypnotic jerks, etc.  

 

In summary, went CT from Wellbutrin (75mg per day) and Cymbalta (4 beads) on July 5. Was in the ER July 15th.  Reintroduced Wellbutrin Aug 23 at 20mg with very little effect.  Reintroduced Cymbalta at 2 beads Sept 21 with Better Sleep, diminished GI Issues (two of my biggest complaints at the time) and I have been getting out of the house more but anxiety and agitation flared up some (could be more related to pushing myself some to try to keep myself distracted).  I definitely agree that WB is not helping my sleep situation.  Not sure if it is making me more anxious, maybe.  I do recall a time or two where I was feeling worse at WB peak times so maybe.  

 

Sorry I'm such a mess and so confusing for you to follow.  I am trying my best to make my response as clear and concise as possible.  I know you deal with a lot of folks on here.  You are a true blessing to many.

 

Son

 

 

[Altostrata]

9 hours ago, SonSetFree said:

7:00 AM 10mg Wellbutrin and 1 Bead (~0.1mg) Cymbalta

12:30 PM 6mg Wellbutrin

5:00 PM 6mg Wellbutrin

6:15 PM 1 Bead (~0.1mg) Cymbalta

10:50 PM  7.5mg Remeron and 50mg Trazodone

 

Are you taking immediate-release Wellbutin (IR) or extended-release (XR)? How are you taking a dose of 6mg?

 

You went off Cymbalta and Wellbutrin at about the same time. Your withdrawal could be mainly from Cymbalta. Wellbutrin is a drug that often causes anxiety and sleeplessness.

 

You are also taking not insubstantial dosages of 3 antidepressants: Wellbutrin, trazodone, and Remeron. It's very possible these drugs are interacting in such a way to produce your symptoms. 

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php

and copy and paste the results or a link to them in this topic.

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[SonSetFree]

Hi @Altostrata

 

I am taking Wellbutrin IR and using a Gemini scale to cut and weigh 6mg based on calculated pill weight and Active Ingredient Concentration.  
 

Here is the drug interaction list based on my 4 meds:  https://www.drugs.com/interactions-check.php?drug_list=440-0,949-0,1640-0,2228-0

Seems I need to get rid of at least one of these meds.  Which would you suggest first? Wellbutrin?
 

I will keep a dose/symptom journal and post here each day as you suggested.  Thanks 🙏 

 

Son

[ChessieCat]

Here is the drug interaction from a different interaction checker which gives some additional information:

 

https://reference.medscape.com/drug-interactionchecker

 

8 Interactions Found

Patient Regimen

•   bupropion  - Wellbutrin
•   duloxetine - Cymbalta
•   mirtazapine - Remeron
•   trazodone

Serious - Use Alternative

• duloxetine + trazodone

  duloxetine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• duloxetine + bupropion

  duloxetine increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.

• trazodone + bupropion

  trazodone increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.

Monitor Closely

• bupropion + mirtazapine

  bupropion will increase the level or effect of mirtazapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• duloxetine + mirtazapine

  duloxetine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.

• trazodone + mirtazapine

  trazodone and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.

• bupropion + duloxetine

  bupropion will increase the level or effect of duloxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• trazodone + mirtazapine

  trazodone and mirtazapine both increase sedation. Use Caution/Monitor.

[ChessieCat]

(Edited to add:  See Alto's comment about this in the following post)

Something to be aware of.  Cymbalta / duloxetine has a very short half life and might need to be dosed twice daily to reduce interdose withdrawal.  At this time, because you are taking a lot of drugs with a large amount of interactions you might not be noticing interdose withdrawal.  However, as your doses of the other drugs reduces it will be something to keep in mind with regards to any symptoms you experience.  See: dose-splitting-for-interdose-withdrawal-from-short-half-life-drugs

 

And remember to only make one change at a time.

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

And it can be helpful to keep notes of your symptoms so you can be more objective (factual) instead of subjective (emotive).  See:

 

recording-drug-schedule-and-symptoms-to-track-patterns-and-progress

 

Edited October 23, 2021 by ChessieCat
added note

[Altostrata]

Thanks, @ChessieCat Always useful to have more information about drug interactions.

 

FYI Duloxetine is unusual in that while the chemical has a half-life of only about 12 hours, the drug behaves more like a drug with a 24-hour half-life. "Duloxetine has a mean plasma half-life of 12 hours, but it can be dosed once daily as the central nervous system half-life may be very different from the plasma half-life."

 

That's an impressive list of major interactions. 

 

@SonSetFree, why are you taking both trazodone and mirtazipine?

 

Yes, if I were you, I'd go off buproprion first. See Tips for tapering off buproprion (Wellbutrin, SR, XR, XL)

 

[Go2zero]

On 8/23/2021 at 12:25 AM, Go2zero said:

 

It becomes an extra problem when Wellbutrin is tapered when taking other meds that are metabolized slower because of taking Wellbutrin. Because Wellbutrin slowers down the metabolism of all drugs that are metabolized by the CYP2D6 enzym.

 

Also Trazodone (and Cymbalta and Remeron) are metabolized by this enzym. This means effectively that when one tapers Wellbutrin the metabolism of the other drugs increases. And this gives the same effect as tapering all taken med at the same time!

 

Since you tapered Cymbalta to zero before fast tapering the Wellbutrin, I guess there was no effect. But with the Trazodone there will have been interaction nearly for sure. 

 

So this may have worsened the withdrawal effect as a whole. I know from experience how heavy Wellbutrin withdrawal can be (in combination with Lexapro (escitalopram) and Prozac (fluoxetine).

 

This should be taken into my account @ChessieCat and @Altostrata  Tapering Wellbutrin will increase the metabolism of Trazodone, Cymbalta (duloxetine) and the Mirtazapine as well!  

 

So that may give the effect of tapering 3 meds at the same time.... Not sure if Wellbutrin should be tapered as the first med.... Just to take into account.

[Altostrata]

From the drug interaction reports, we can assume all the drugs are conflicting via liver enzymes or other avenues.

 

Two beads of Cymbalta is probably not enough to make a big difference. However, taking the 3 drugs trazodone, mirtazapine, and bupropion at the same time is clearly excessive -- something has to go.

 

Bupropion is a prime culprit. It's no more difficult to taper than the other drugs. Where insomnia or anxiety are a problem, it may very well be the cause. It is not a calming drug.

[SonSetFree]

Thanks Alto and Chess and Go2Z for chiming in!

 

Quote

@SonSetFree, why are you taking both trazodone and mirtazipine?

At the beginning of my WD, Trazodone wasn’t touching the WD Insomnia.  The psych doc wanted to manage that and depression at the same time and prescribed Remeron.  If I could go back in time and not fill the prescription I would.  The only thing that really helped insomnia has s Cymbalta reinstatement of 2 beads. 

[Altostrata]

14 minutes ago, SonSetFree said:

The only thing that really helped insomnia has s Cymbalta reinstatement of 2 beads. 

 

At the time you added 2 beads of Cymbalta, you had also made other drug changes. It may not be the 2 beads that made the difference.

 

What is it you want to do regarding tapering?

[SonSetFree]

Hi @AltostrataI agree with eliminating one of the drugs and leaning towards Wellbutrin taper first only because doing so COULD provide more near term relief in anxiety and insomnia.  I am not sure it will though because I don’t see a strong dosing/symptom pattern. 
 

However, I am also holding out hope that my Cymbalta reinstatement, at the right dose, COULD have a dramatic effect reducing WD symptoms and I would always wonder if I didn’t try. If I tried adding 1 bead of Cymbalta I would know fairly quickly and I could go back down if it got worse.  First reinstatement of 2 beads there was definitive improvement.  
 

What do y’all think, give reinstatement updose a try first, before WB taper?

[SonSetFree]

@Altostrata Curious if you had a chance to see my response.  Also, was wanting to let you know I had been on Wellbutrin for 35 years and in times past, when trying to come off of it, I experienced irritability, anxiety and restlessness.  This makes me hesitant to start tapering Wellbutrin, and is one of the reasons why I asked about updosing my Wellbutrin reinstatement of 22mg.  So question is, have you seen Wellbutrin in people with withdrawal consistently causing problems with anxiety with relief upon tapering?

 

All my best,

Son

 

[Altostrata]

On 10/24/2021 at 1:49 PM, SonSetFree said:

I am not sure it will though because I don’t see a strong dosing/symptom pattern. 

 

You are taking 3 drugs plus a dash of Cymbalta. After taking a total of 22mg of Wellbutrin all day, how would you be able to tell if reducing that has any effect on your sleep problem? You're taking the other 2 drugs at night. Maybe they're keeping you awake.

 

Point is, taking 4 antidepressants at once is an absurd drug combination under any circumstances. How can you simplify your drug cocktail?

 

On 10/24/2021 at 1:49 PM, SonSetFree said:

First reinstatement of 2 beads there was definitive improvement.  

 

As explained before, there were too many moving parts, the 2 beads may not have made the difference. However, if you want to increase your 4th drug, it's your choice.

 

Please let us know when you want to taper.

[Colonial]

The 2 reinstatements may have worked if the other 2 had not been added in the mix in order to "treat" the withdrawal. When that does not work, and ppl go to try reinstatement, if can be problematic now on 4 meds.

Perhaps a drop in the other 2 newer meds may help. It's too many meds now all at once most likely.

On 10/27/2021 at 1:08 PM, SonSetFree said:

So question is, have you seen Wellbutrin in people with withdrawal consistently causing problems with anxiety with relief upon tapering?

 

My Wellbutrin wd was mostly neurological symptoms but, it is a brain stimulant, which is difficult since anxiety is a wd symptom.  But you did reinstate at a high dose of wellbutrin, so, you may benefit from that being lowered as well.

 

[Colonial]

Hope your doing better.

 

 

[Knosretep]

Hey @SonSetFree

 

Was just looking at your signature and we're both on a drug cocktail including Trazodone and Remeron, but you did lots of tapers and reinstatements during the last year.

 

How are you doing now?

[SonSetFree]

Withdrawal symptoms worse after prescription refill - shelf life issue?

 

Hi All,

 

Anyone experience feeling different after a prescription refill?  I am on 22 mg of Bupropion (Wellbutrin) and have been holding steady for a while and doing better until I refilled my prescription.  Feels like I updosed, anxiety is 10X worse and feeling restless. 

 

My previous prescription fill was about 10 months old by the time I ran out.  I called the pharmacist to confirm that the manufacturer had not changed and he said that the potency can be impacted by 10% or so after sitting on a shelf for a year.  I suppose that is enough for me to feel.  So my theory I have had an effective updose of 10% or so, but maybe there is something else going on with the formulation.

 

Anyone else experience this?

 

-Son

 

Edited January 27, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Sometimes we can be blinkered and put things down to the drug/withdrawal and forget to look at what other things might be the cause.

 

And you might have had a wave anyway, even if you hadn't got new tablets.

 

Q:  What other things changed at the same time or just prior?  Examples: drinking alcohol, not sleeping as well, argument, extra stress, sick, vaccination.

 

However, sometimes manufacturers might change something in their formulation, eg new supplier of a filler.  In this example, the filler might cause the drug to release at a different rate that the other filler.

 

I think that the best thing to do is to continue taking the same dose you are and holding until things stabilise before making a reduction.

 

If you think it was the new prescription tablets which caused the issues, when you get your next prescription filled, I suggest you make sure that you have some of the old tablets left so that you can do a cross over to the new prescription.

 

cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug

[SonSetFree]

Thanks @ChessieCat  Hope you are well!

 

A:  To answer your question, I did get Omicron COVID back on 12/23, which triggered a wave that started Dec 27.  It lasted about a week to a week and a half where my insomnia and other symptoms were back.  Then it lifted and I was feeling well...or at least WD Normal by Jan 6.  

 

Then I started on the new refill tablets Jan 19 and almost immediately felt horrific extreme anxiety and restlessness and unable to sleep.  It was unlike the Covid induced wave.  I also thought, maybe I have a secondary infection or something going on, but I started a journal and noticed my episodes correspond with my dosing (about 2 hrs after taking the Wellbutrin dose, which I take 3 times a day).

 

It felt so apparent the Wellbutrin change was affecting me that I started a 5% taper from 22mg to 21mg on Jan 24 to see if it brought relief.  No relief yet so was thinking about another 5% taper before I saw your response.  I also contacted the Wellbutrin manufacturer and they started a case so hoping to hear back.  It's the generic Indian manufacturer...not sure if I'll hear back.

 

Q:  Have you and the other moderators seen Covid cases in the SA community?  I've tried to search and only hearing about Vaccines.  

 

Not sure what to do...I'll hold off on dropping another 5% before hearing from you.  PS, Alto already wanted me to start a Wellbutrin taper anyway.  I just don't know if now is a good time to start if something else is at play.

 

-SOn

[ChessieCat]

1 hour ago, SonSetFree said:

It felt so apparent the Wellbutrin change was affecting me that I started a 5% taper from 22mg to 21mg on Jan 24 to see if it brought relief. 

 

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  So it hasn't been 1 week yet.

 

My suggestion would be not change anything and reassess after 1 week.

 

Please continue to let us know how you are going.

 

My thoughts:  There is a possibility that the start of the new tablets was just a coincidence.  Even though you felt you had recovered from Covid, you4 body went through a period of extra stress fighting the virus.  So even if you no longer had the virus you body was/is probably still recovering from the stress that it was under.  The holiday period can be stressful, even without Covid.  I might be that you experienced some more stress just before or at the same time as getting the new tablets.

[SonSetFree]

Hi @ChessieCat hope you are well.

 

I have been hanging in there.  Almost 3 months since COVID and still struggling.  I just went up a bead of Cymbalta in the AM dose.  I was taking 1 bead in the AM and 2 beads in the PM.  I just wanted to level out my doses at 2 beads to keep a more steady serum level each day.  I felt I might also be experiencing interdosal WD in the mornings.   I am on day 6 of that change and have felt my physical symptoms improve (dizziness and ringing in the ear).  However, I still have same crippling anxiety and depression and only sleeping 4-5 hours a night, same as before.  Not where I thought I'd be at 8 months in.  I thought I would see the waves become less intense and more spaced apart.  I thought I would see more frequent windows than once or twice a week, and that they would last more than an hour or two.

 

Now I am thinking about what my next move is.    The question I am having is should I give up on reinstatement, or updose slowly until the withdrawal levels out, then start a slow taper?  Or should I give up on reinstatement, and start tapering now?  In my current state, I don't think I can handle more than i am already dealing with and I know things will get worse if I start tapering. 

 

Or should I hold steady?  Will my CNS stabilize eventually if I just hold where I am at?  See bottom of my signature for current cocktail.  The Remeron and Trazadone is helping me get the 4-5 hrs (sometimes more) so wouldn't want to touch that at this point.  I am only on 4 out of 208 beads of Cymbalta so 0.38mg which it seems my body is holding onto for dear life.  The Wellbutrin is at 21mg a day...I CT'd at 75mg.

 

Any advice much appreciated.

[ChessieCat]

13 minutes ago, SonSetFree said:

I am on day 6 of that change and have felt my physical symptoms improve (dizziness and ringing in the ear). 

 

As stated before:

 

On 1/29/2022 at 9:25 AM, ChessieCat said:

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  So it hasn't been 1 week yet.

 

The fact that you have noticed improvement is a very good sign.  If it was me I would not be making any changes for at least 1 month and then reassess then.

 

Non-drug techniques

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

 

 

[SonSetFree]

Thanks @ChessieCat I should have mentioned I wasn't looking to make a move now but in a couple of weeks or so.  Assuming I am feeling roughly the same a month after the change, would you suggest starting a taper or continue reinstatement updose at this point?  I know reinstatement is less likely to work this far out, but maybe is worth trying.

[ChessieCat]

Be patient and try not to worry about what you will be doing in 'x' number of weeks' time.  You have no idea how you will feel then.  It causes stress because you end up continually ruminating; you start making multiple plans, plan A if this, plan B if that, plan C if something else.

 

26 minutes ago, SonSetFree said:

I know reinstatement is less likely to work this far out, but maybe is worth trying.

 

You have already reinstated and it is working because you have noticed improvement.

 

The idea of reinstatement/updosing is not to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

28 minutes ago, SonSetFree said:

Assuming I am feeling roughly the same a month after the change, would you suggest starting a taper or continue reinstatement updose at this point? 

 

It might take several months for you to stabilise.  It is better to hold for longer than to risk reducing too soon.  If it was me I would not be thinking about reducing for at least 3 months.  Even if you feel a lot of improvement, after having withdrawal symptoms it is nice to take a break.  And it can also give your brain extra time to make any adaptations that it needs to make that you don't know about.

[Knosretep]

Hey @SonSetFree

 

Sorry to read about your troubles with the new prescription.   I'm right there with you thinking that I would see more positive improvements at this point, but I guess it's going to take as long as it takes.

 

Hope you see some stabilization soon and a lifting of symptoms! ❤️

[SonSetFree]

Hey @Knosretep

 

Thanks for your kind words.  I am wishing you many windows ahead.

 

-Son

[SonSetFree]

Hi @ChessieCat

 

Hope you are well.  Checking in after about 4 months attempting to stabilize per your advice.  So far my sleep has stabilized (thank god) and I have been doing a little better with some windows.  I am currently in a wave that has lasted about a month without windows.  Any thoughts on why I am continuing to suffer this far out?

 

Also, one of my main issues is still fear and dread in the mornings that start with vivid dreams like clockwork every morning around 5:00 AM. 

 

Any thoughts on whether my dosing schedule or drug interaction with Remeron could be to blame for the harsh 5:00 AM?  Interdosal withdrawal of WB or Cymbalta maybe?  would make sense given I'm 12 hrs since last Wellbutrin.  Or is it cortisol spike...  I thought about spacing the wellbutrin equally apart at 8 hrs to level out my daily serum.  It seemed to help when I did the same with Cymbalta.

 

Thanks so much for your advice as always

 

Currently on Trazodone 50mg and Remeron 7.5mg for sleep at night.  Cymbalta 2 Beads (0.1mg) 2X Day 7AM and 6PM.  Wellbutrin 9mg @ 7:00 AM / 6mg @ 12:30 PM / 6mg @ 4:30 PM.

[Altostrata]

Hello, @SonSetFree What are the most prominent symptoms of your current wave?

 

Since your sleep has improved and you say you've been doing a little better overall, we might say your glass is half-full.

 

People often have rough mornings because of the early-morning cortisol spike. See 

 

What is the sleep cycle?

 

Waking with panic or anxiety -- managing the morning cortisol spike

[SonSetFree]

Hi @Altostrata

 

Most prominent symptom is horrific beyond anxiety and depression.  Like shear terror like seeing something tragic.  
 

Only peace is at night before bedtime.  
 

Given I am 11 months since reinstatement looking for any advice on what to do.  Is it normal to not see major improvement by now?  Is my current medicine and dose schedule keeping me from improving?  

 

-Son

[Altostrata]

Quote

Currently on Trazodone 50mg and Remeron 7.5mg.  Cymbalta 2 Beads (0.1mg) 2X Day 7AM and 6PM.  Wellbutrin 9mg AM / 6mg Mid day / 6mg Early Evening

 

Are you currently taking these drugs? What times o'clock do you take them, with their dosage? You're taking immediate-release Wellbutrin?

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

 

[SonSetFree]

Hi @Altostrata

 

Yes immediate release Wellbutrin.  Here is the schedule.  

 

7:15 AM Wellbutrin Immediate Release 9mg

7:15 AM Cymbalta (2 beads) 0.1mg

12:30 PM Wellbutrin Immediate Release 6mg

4:30 PM Wellbutrin Immediate Release 6mg

6:30 Cymbalta (2 beads) 0.1mg

10:50 PM Trazodone 50mg

10:50 PM Remeron 7.5mg

 

I have been taking Wellbutrin, Cymbalta and Trazodone at higher doses than I am now for many years.  I only started on the Remeron since starting withdrawal.  Psyc doc convinced me I needed it for sleep and appetite issues during acute withdrawal.

 

Here is the interaction link :  https://www.drugs.com/interactions-check.php?drug_list=440-0,949-0,1640-0,2228-0

 

Thanks Alto

 

[ChessieCat]

Q:  Did you scroll down to the bottom of the page of the interaction report and see the duplications?

 

[Altostrata]

On 7/30/2022 at 10:30 AM, SonSetFree said:

Most prominent symptom is horrific beyond anxiety and depression.  Like shear terror like seeing something tragic.  

 

How has your symptom pattern changed in the last week? Do you feel better or worse at certain times of day? What is your sleep pattern?

[SonSetFree]

Hi @Altostrata,

 

My wave ended and life has been better up until about a week ago.  I started cross tapering a new refill of my Wellbutrin.  I think even though I am doing a cross taper at 25%, I am still that sensitive to change.  It had been about 8-9 months since last refill.  

 

What have you found to be the best frequency of refill for medications?  30 days?  90 days?  If 30 days, the higher frequency of change puts you at higher risk.  If waiting too long on the otherhand, the potency can drop too much.  

 

Any thoughts appreciated,

-Son

[Altostrata]

What do you mean by cross-tapering? From what to what?