Anastasia Posted September 29, 2021 Share Posted September 29, 2021 Hello all, I am new to this forum and have been on 150 mg. of Bupropion SR for over 10 years (among many other meds). My new Psychiatrist (who I sought out because he seemed sensitive to the necessity for slow tapering for Benzodiazapines and Effexor). I was very disappointed that in our first meeting he recommended a jump from 150 to 100 mg Bupropion. Much of this was based on my report to him that on a couple of days when I forgot to take the Bupropion, I was much less anxious (I know it tends to be stimulating). I tried to challenge him but was too anxious at the time and just agreed with the plan. I plan on broaching this with him in an email. I want to tell him how I would like to taper and ask him if he would work with me on this. The problem is, I don't know myself. I've been looking through this site and trying to make sense of the tapering schedules for this medication and it feels overwhelming to me. I don't know if I'm experiencing brain fog or what. There were a few people who recommended splitting the SR tablets. All of this is so confusing to me. If I were to do a 10 or 25% taper, what would be the easiest way? Thank you in advance for any guidance around this. Warmly, Anastasia 1993: Buspar and Restoril (don't recall dosages)- both for about 4 months. 1998: Paxil, Antidepresants and Lithium (don't recall doses just that they were all moderate), Clonazepam (low dose) 2000: Was tapered off all meds by the Psychiatrist- don't recall the schedule. Was fine for the two years off all the meds. 2002: Clonazepam (initially .5 mg quickly increased to 1 and then to 1.5 or 2 mg). Lithium (don't recall dose- though moderate), various and sundry SSRI's (don't recall the doses) including Celexa and Effexor. 2004: Effexor discontinued. I developed a tolerance. Another SSRI was tried (don't recall which one). 2010: Depakote added (increased up to 450mg over a period of months). Lithium was discontinued. 2011: Effexor reinstated (moderate dose). Bupropion started- eventually increased to 300 mg. Clonazepam increased to 3mg. 2014: Effexor taper continued to 50 mg (what it is at present). It was excruciatingly difficult to taper and I had to stop. 2015-2018 Clonazepam taper from 3mg to 1.5mg (current dose). I tapered at the directed of Psychiatrist by .5 mg per year. Link to comment
Moderator arbor Posted October 1, 2021 Moderator Share Posted October 1, 2021 Hello @Anastasia Welcome to SA. To get you started and to give you pertinent information, could you summarize your medication history in a signature – only drugs, doses, dates, and discontinuations & reinstatements in a vertical list format. Account Settings – Create or Edit a signature. I sympathize with the difficulty in communicating with doctors sometimes. I encourage you to share links from this site with your doctor. The first one explains our philosophy for slow tapering. The second is recently published by our SA founder, Alto: How to talk to a doctor about tapering and withdrawal? What I have learnt from helping thousands of ... - PubMed These links can be helpful for planning your taper: why taper by 10% Tips for tapering off Wellbutrin, SR, XR, XL (buproprion) Based on Chessie Cat's experience tapering Wellbutrin, and quoting her words, I recommend reducing 150 by 10% and see how you go. If after 3 weeks you find that you are feeling ok, you could reduce again by another 10%. The idea is to stay tuned to your reactions so as not to move too quickly. Remember to calculate the next reduction on the previous dose your took. Once you've finished your signature, please ask further questions as you begin. Remember also to avoid skipping doses as this can unsettle the nervous system which will be extra sensitive during the taper. This is your Introduction site where you can ask questions, report your progress, and connect with other members. I'm glad you've found us. Arbor 1 Zoloft: 1995 - 2015 Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on December 15, 2018 Gabapentin: 2016 to 2019 (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019 Enalapril: 2010 - 2019 Lipitor: 2017 -2017 Metformin: 2000 - 2020 Liothyronine: 2007 - 2019 Levothyroxine: 2000 - Link to comment
Anastasia Posted October 3, 2021 Author Share Posted October 3, 2021 Thanks Arbor. I appreciate these resources. They were helpful to me. I communicated by email very diplomatically with my Psychiatrist and while he agreed to a tapering schedule of 10% per month for the Bupropion, he completely invalidated my past experience of tapering too fast and other things he said make me see that he wouldn't be open to reading any of these papers. 1993: Buspar and Restoril (don't recall dosages)- both for about 4 months. 1998: Paxil, Antidepresants and Lithium (don't recall doses just that they were all moderate), Clonazepam (low dose) 2000: Was tapered off all meds by the Psychiatrist- don't recall the schedule. Was fine for the two years off all the meds. 2002: Clonazepam (initially .5 mg quickly increased to 1 and then to 1.5 or 2 mg). Lithium (don't recall dose- though moderate), various and sundry SSRI's (don't recall the doses) including Celexa and Effexor. 2004: Effexor discontinued. I developed a tolerance. Another SSRI was tried (don't recall which one). 2010: Depakote added (increased up to 450mg over a period of months). Lithium was discontinued. 2011: Effexor reinstated (moderate dose). Bupropion started- eventually increased to 300 mg. Clonazepam increased to 3mg. 2014: Effexor taper continued to 50 mg (what it is at present). It was excruciatingly difficult to taper and I had to stop. 2015-2018 Clonazepam taper from 3mg to 1.5mg (current dose). I tapered at the directed of Psychiatrist by .5 mg per year. Link to comment
Moderator arbor Posted October 3, 2021 Moderator Share Posted October 3, 2021 Dear @Anastasia Good for you--talking to your doctor and agreeing to a 10% taper! But it's amazing, isn't it? how staunchly disinterested these doctors are in learning anything from their patients. Their priority in their own superiority rather than the patient themselves, is causing so much suffering--as we can see all over this site. I so support you in taking good care of yourself, especially as you begin to taper. Arbor PS--Don't forget to fill out your signature. Then you'll be able to share with others. 1 Zoloft: 1995 - 2015 Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on December 15, 2018 Gabapentin: 2016 to 2019 (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019 Enalapril: 2010 - 2019 Lipitor: 2017 -2017 Metformin: 2000 - 2020 Liothyronine: 2007 - 2019 Levothyroxine: 2000 - Link to comment
Administrator Altostrata Posted October 4, 2021 Administrator Share Posted October 4, 2021 Hello, @Anastasia We really don't expect new information to be welcomed by any psychiatrist. Occasionally, one surprises us, though. If you have the opportunity, please do send your doctor Framer, A. (2021). What I have learnt from helping thousands of people to taper off antidepressants and other psychotropic medications. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125321991274 Hengartner, M. P., Schulthess, L., Sorensen, A., & Framer, A. (2020). Protracted withdrawal syndrome after stopping antidepressants: A descriptive quantitative analysis of consumer narratives from a large internet forum. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125320980573 1 This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
HikingAlong Posted October 5, 2021 Share Posted October 5, 2021 Hi @Anastasia, I have experience tapering from Bupoprion (Welbutrin). Slow was the way to go for me. It took me 3 years to get off it, but I'm good now. I started by switching to the immediate release form. Then I went down 5% at a time, and waited til I felt really stable before attempting another taper. Sometimes I could taper within a couple weeks, but in the winter it was more like 2 months or more. I think I even did a 6 month hold once. Anyway, slow is the way for any of these meds. It's complicated, difficult, and worth it. Hiking Along 1 1984 Elavil, Zoloft, wellbutrin, other ADs. 1995 wellbutrin. Light therapy in winter. 2000-2002 Tapered wellbutrin very very slowly. 2003-2008 No ADs, no therapy. Felt good, vital, motivated. Then some losses and pain. 2008-July 2014 citalopram, escitalipram, zoloft, 300 mg wellbutrin XL August 2014 300 mg wellbutrin, immediate 1200 mg neurontin 200 mg tramadol April 15, 2015 175 mg 1050 200 June 15, 2015 150 mg 900 200 Nov 14, 2017 OFF Welbutrin ! 300 150 Feb 1, 2018 OFF Neurontin! 150 March 1, 2018 Starting to taper Tramadol. Scared. May 1, 2018 142.5 March 1, 2019 88 mg tramadol March 1, 2020 OFF Everything! Treating depression with HumanCharger Ear lights, fish oil, psilocybin Link to comment
Anastasia Posted October 5, 2021 Author Share Posted October 5, 2021 Thanks for all of your very supportive responses and helpful information. It means a lot. Congratulations to you HikingAlong in being able to taper off all meds! You truly are a survivor! I started to taper from Bupropion 150 mg SR by 10% yesterday. I took 100mg SR in the morning along with 18.75 of the Bupropion IR (I quartered the 75 mg IR tablet that my doctor called in) and then 18.75 mg IR in the afternoon (around 1 or 2 pm). I am wondering if it is wise to taper this way. Also, the pill cutter I have isn't doing a stellar job of cutting the pills. Can anyone recommend a really good one? Thanks again! Anastasia 1993: Buspar and Restoril (don't recall dosages)- both for about 4 months. 1998: Paxil, Antidepresants and Lithium (don't recall doses just that they were all moderate), Clonazepam (low dose) 2000: Was tapered off all meds by the Psychiatrist- don't recall the schedule. Was fine for the two years off all the meds. 2002: Clonazepam (initially .5 mg quickly increased to 1 and then to 1.5 or 2 mg). Lithium (don't recall dose- though moderate), various and sundry SSRI's (don't recall the doses) including Celexa and Effexor. 2004: Effexor discontinued. I developed a tolerance. Another SSRI was tried (don't recall which one). 2010: Depakote added (increased up to 450mg over a period of months). Lithium was discontinued. 2011: Effexor reinstated (moderate dose). Bupropion started- eventually increased to 300 mg. Clonazepam increased to 3mg. 2014: Effexor taper continued to 50 mg (what it is at present). It was excruciatingly difficult to taper and I had to stop. 2015-2018 Clonazepam taper from 3mg to 1.5mg (current dose). I tapered at the directed of Psychiatrist by .5 mg per year. Link to comment
Ariel Posted April 18 Share Posted April 18 Hi @Anastasia How are you doing? Well wishes, A. 1 1996-2018 - misc. polypharmacy, incl. SSRIs, SNRIs, neuroleptics, lithium, benzos, stimulants, antihistamines, etc. (approx. 30+ drugs) 2012-2018 - 10mg lexapro/escitalopram (20mg?) Jan. 2018 - 10mg -> 5mg, then from 5mg -> 2.5mg, then 0mg --> July 2018 - 0mg 2017(?)-2020 - vyvanse/lisdexamfetamine 60-70mg 2020-2021 - 70mg down to 0mg --> July 2021 - 0mg March-April 2021 - vortioxetine 5-10mg (approx. 7 weeks total; CT) --> April 28th, 2021 - 0mg supplements: magnesium powder (dissolved in water) as needed throughout the day; 1 tsp fish oil w/ morning meal; 2mg melatonin August 1, 2022 - 1 mg melatonin Courage is fear that has said its prayers. - Karle Wilson Baker love and justice are not two. without inner change, there can be no outer change; without collective change, no change matters. - Rev. angel Kyodo williams Holding multiple truths. Knowing that everyone has their own accurate view of the way things are. - text on homemade banner at Afiya house I am not a medical professional; this is not medical advice. Link to comment
Anastasia Posted April 18 Author Share Posted April 18 Hi @Ariel Thanks so much for checking in! I've had ups and downs. I started a taper from 150mg of Bupropion which I had been on for several years or more. The first week in October of 2021 I went down from the 150 to 137.5 mg. Initially I was okay but I started to become much more depressed in November or December. I wasn't having any changes in sleep, appetite or energy level. I was just feeling very depressed about my life- how it's turned out so far (being single during a Pandemic and social isolation doesn't help) and the holidays have been hard for me in the last few years. I found myself with decreased motivation (i.e., "Why does it matter?) with fleeting passive suicidal ideation and a lack of enjoyment in many things. I told my psychiatrist and he agreed with me to stay steady and not decrease the Bupropion any more until the spring. I actually have been feeling a lot better and able to enjoy life in the past couple of months. However, I was concerned about continuing to decrease Bupropion (particularly while on a Benzo and wondered if we should have started tapering that first) I asked him if he would consider a slow taper of my Clonazepam instead. I have been on 1.5 mg of Clonazepam for four years (was on 3 mg for several years and slowly tapered down over a year to 1.5mg). So, we started the taper on April 1st and I went down from 1.5 to 1.375 mg. I've been taking it at bedtime all these years. Oh..and I am doing the taper with 2 .5 mg tablets, splitting the third .5 tablet in half and then adding a .125 ODT everyday. I haven't noticed a change yet though I do feel a little "off balance" at times when getting up from a seated position. I want to taper by 10% at a time but am not sure of the time frame. I was actually going to go on this site or Benzo Buddies for advice on that. Any thoughts you would have on that would be very helpful. Also, today, I am feeling unusually tired and a little weak (hope I haven't caught the Covid!). Sorry to dump all of this. Thanks for reading. I hope you are doing well. Kind regards, Anastasia 1993: Buspar and Restoril (don't recall dosages)- both for about 4 months. 1998: Paxil, Antidepresants and Lithium (don't recall doses just that they were all moderate), Clonazepam (low dose) 2000: Was tapered off all meds by the Psychiatrist- don't recall the schedule. Was fine for the two years off all the meds. 2002: Clonazepam (initially .5 mg quickly increased to 1 and then to 1.5 or 2 mg). Lithium (don't recall dose- though moderate), various and sundry SSRI's (don't recall the doses) including Celexa and Effexor. 2004: Effexor discontinued. I developed a tolerance. Another SSRI was tried (don't recall which one). 2010: Depakote added (increased up to 450mg over a period of months). Lithium was discontinued. 2011: Effexor reinstated (moderate dose). Bupropion started- eventually increased to 300 mg. Clonazepam increased to 3mg. 2014: Effexor taper continued to 50 mg (what it is at present). It was excruciatingly difficult to taper and I had to stop. 2015-2018 Clonazepam taper from 3mg to 1.5mg (current dose). I tapered at the directed of Psychiatrist by .5 mg per year. Link to comment
Ariel Posted April 19 Share Posted April 19 Hi @Anastasia Thank you for your update. There are so many unpredictable twists and turns, aren't there? 10 hours ago, Anastasia said: I want to taper by 10% at a time but am not sure of the time frame. I was actually going to go on this site or Benzo Buddies for advice on that. Any thoughts you would have on that would be very helpful. I'm not a mod, just a fellow member here on the long, bumpy road to recovery. I can only imagine the moderators would be happy to help with specific tapering advice. Good luck to you on your journey, A. 1996-2018 - misc. polypharmacy, incl. SSRIs, SNRIs, neuroleptics, lithium, benzos, stimulants, antihistamines, etc. (approx. 30+ drugs) 2012-2018 - 10mg lexapro/escitalopram (20mg?) Jan. 2018 - 10mg -> 5mg, then from 5mg -> 2.5mg, then 0mg --> July 2018 - 0mg 2017(?)-2020 - vyvanse/lisdexamfetamine 60-70mg 2020-2021 - 70mg down to 0mg --> July 2021 - 0mg March-April 2021 - vortioxetine 5-10mg (approx. 7 weeks total; CT) --> April 28th, 2021 - 0mg supplements: magnesium powder (dissolved in water) as needed throughout the day; 1 tsp fish oil w/ morning meal; 2mg melatonin August 1, 2022 - 1 mg melatonin Courage is fear that has said its prayers. - Karle Wilson Baker love and justice are not two. without inner change, there can be no outer change; without collective change, no change matters. - Rev. angel Kyodo williams Holding multiple truths. Knowing that everyone has their own accurate view of the way things are. - text on homemade banner at Afiya house I am not a medical professional; this is not medical advice. Link to comment
Anastasia Posted April 19 Author Share Posted April 19 Hi Ariel, Thank you for your kind response. Yes. The road to recovery is long and bumpy. That's for sure! I was looking at your signature and realized that you have been drug-free since August of 2021. Many congratulations! Warm regards, Anastasia 1 1993: Buspar and Restoril (don't recall dosages)- both for about 4 months. 1998: Paxil, Antidepresants and Lithium (don't recall doses just that they were all moderate), Clonazepam (low dose) 2000: Was tapered off all meds by the Psychiatrist- don't recall the schedule. Was fine for the two years off all the meds. 2002: Clonazepam (initially .5 mg quickly increased to 1 and then to 1.5 or 2 mg). Lithium (don't recall dose- though moderate), various and sundry SSRI's (don't recall the doses) including Celexa and Effexor. 2004: Effexor discontinued. I developed a tolerance. Another SSRI was tried (don't recall which one). 2010: Depakote added (increased up to 450mg over a period of months). Lithium was discontinued. 2011: Effexor reinstated (moderate dose). Bupropion started- eventually increased to 300 mg. Clonazepam increased to 3mg. 2014: Effexor taper continued to 50 mg (what it is at present). It was excruciatingly difficult to taper and I had to stop. 2015-2018 Clonazepam taper from 3mg to 1.5mg (current dose). I tapered at the directed of Psychiatrist by .5 mg per year. Link to comment
Anastasia Posted April 20 Author Share Posted April 20 (edited) On Clonazepam for 20 years and wondering how to best taper off from 1.5 mg Hi all, I started on a low dose of Clonazepam in 2002 but by 2011 ended up on 3mg. Tapered down to 1.5 mg over a period of three years (2015-2018), .5 mg a year which I realize was probably not wise (to make such big decreases in dose and wonder if some of my anxiety may be a result of this). Now, with a new psychiatrist am starting another taper from 1.5mg. As of April 1st, I've been on 1.37 mg (less than a 10% reduction). Normally, I would take the 1.5 mg dose all at bedtime (three .5 mg pills). Now, I take two of the .5mg pills, split the third in half (.25 mg) and add on a .125 mg ODT at bedtime. I had the idea of reducing by 10% but didn't want to have to weigh pills. So the 1.37 is less than 10% of a reduction. Is this okay? So far, I feel fine but it's only been a 3 weeks or so. And what would the timetable be for the next reduction? I'm thinking that I want to do this extremely slowly given the length of time I've been on this drug. Thanks so much in advance for any thoughts about this! Warmly, Anastasia Edited April 20 by ChessieCat added Intro topic title before merging with intro topic 1993: Buspar and Restoril (don't recall dosages)- both for about 4 months. 1998: Paxil, Antidepresants and Lithium (don't recall doses just that they were all moderate), Clonazepam (low dose) 2000: Was tapered off all meds by the Psychiatrist- don't recall the schedule. Was fine for the two years off all the meds. 2002: Clonazepam (initially .5 mg quickly increased to 1 and then to 1.5 or 2 mg). Lithium (don't recall dose- though moderate), various and sundry SSRI's (don't recall the doses) including Celexa and Effexor. 2004: Effexor discontinued. I developed a tolerance. Another SSRI was tried (don't recall which one). 2010: Depakote added (increased up to 450mg over a period of months). Lithium was discontinued. 2011: Effexor reinstated (moderate dose). Bupropion started- eventually increased to 300 mg. Clonazepam increased to 3mg. 2014: Effexor taper continued to 50 mg (what it is at present). It was excruciatingly difficult to taper and I had to stop. 2015-2018 Clonazepam taper from 3mg to 1.5mg (current dose). I tapered at the directed of Psychiatrist by .5 mg per year. Link to comment
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