ReinaAMS: What happens once you taper below the "minimal effective dose" of Wellbutrin / bupropion?

[ReinaAMS]

Hi all, I am over halfway through a buproprion taper and am so glad to have this forum to ask questions and learn from others! My history:
-on Bupropion XL 300mg for 11 years for major depressive disorder
-began a gradual taper in March 2021 because I no longer needed the medicine (I had changed my life around, a complete 180)
-I switched to bupropion SR first, and have been taking small compounded doses to allow me to taper at around 5% every two weeks
-my taper has been uneventful since I've gone so slowly. I feel so fortunate that I haven't experienced any issues aside from a bit of dizziness (but that was only at one taper dose)
-I'm currently at 115mg and plan to hold here for a bit, given that I've just contracted covid or else a raging flu, and my body has enough to deal with without adding a taper into the mix

I was reading online that the minimum therapeutic dose for bupropion to have any impact is between 100-150mg (different sites say different things). I've been trying to find info about how the minimum therapeutic threshold could affect tapering, and couldn't find any info online. I'd love to know the following:

For people who have tapered off bupropion completely: did you find it was easier or harder to taper off when you went below 150mg/120mg/100mg?

For everyone (please feel free to chime in with any theories you have, or your experience even if with another drug!): in your best guess, do you think withdrawal symptoms would be worse or better once someone goes below the minimum therapeutic threshold?

I'm asking these questions bc I'm wondering if I could potentially speed up the taper a little bit now that I'm below the minimal effective dose? I just don't know if my body would likely still react poorly even though I'm taking a dose that isn't supposed to have any effectiveness for treating depression.

Thank you in advance!
 

[ChessieCat]

Hi ReinaAMS and welcome to SA,

 

I am really glad that you have found SA when you did. 

 

Yes it is possible to get off your drug.  This is the link to the results of a search for Wellbutrin in the Success stories forum of SA:

 

https://www.survivingantidepressants.org/search/?q=wellbutrin

 

SA isn't concerned about therapeutic doses so I won't bother trying to answer your question but give you information about SA's recommendations.  SA strongly encourages members to listen to their body/symptoms and not taper again until they have resolved or reached what is termed withdrawal normal / WD normal (link to information below).

 

SA's recommended taper rate is to reduce the current dose by no more than 10% followed by a hold of at least 4 weeks to allow the brain to adapt to not getting the drug.  This is not a rule, but a guide.  Some members find that they need to reduce by less.  The goal of tapering is to be able to get off your drug with minimal withdrawal symptoms and be able to live your life as normally as possible.  It is not a race.  We have members here who have tried to go faster and it has ended up taking them longer to get off their drug than if they had followed the 10%/4 weekly method.  And some of them have ended up switching drugs (which doesn't always work)or have added another drug which then needs to be tapered.

 

It is better to go slow enough so that you do not experience more than mild withdrawal symptoms.

 

I will give you links to some of the relevant information:

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Post #1 of this topic explains how to get non standard doses of the drug:

 

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

 

Also, we have seen here at SA that many members need to go slower the lower their dose gets, reducing less and/or holding longer.  This topic helps to explain why this might happen:

 

Why taper paper: dose-occupancy curves

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

 

SA strongly encourages members to learn and use non drug coping skills:

 

Non-drug techniques to cope

Please create your drug signature following these instructions:

 

Instructions:  Withdrawal History Signature

 

Post #1 of this topic has links to many of the helpful SA topics:

 

Important topics in the Tapering forum and FAQ

 

This is your own Introduction topic.  Each member has only ONE.  Your Introduction topic is the best place to ask questions about your own situation and journal your progress.  This keeps your history in one place and means that you do not have to repeat your story.

[Go2zero]

On 2/3/2022 at 8:14 AM, ReinaAMS said:

For people who have tapered off bupropion completely: did you find it was easier or harder to taper off when you went below 150mg/120mg/100mg?

 

As far as my experience and knowledge goes, lots of people can come off Wellbutrin without too many problems. But...., others (like me) can have severe problems with it. So there is not one average answer to your question.

 

In my personal case I could taper without much symptoms from 150 mg to approximately 55 mg. Then suddenly extreme symptoms started which lasted sometimes 8 months after a small taper. I made once a hold of 1 year at 35,5mg and then went down in 2 small steps to 33,3. Then 8 months heavy symptoms. After that I made a hold of almost 2 years. I went down 2 weeks ago from 33,3 to 32,3 mg (so 3%). Hope this will work out fine this time. 

 

Problem with tapering Wellbutrin can be that symptoms start very late (sometimes 3-4 months) after a taper. So it is very advisable to monitor (write it down for example) what is happening after each step down. As soon as symptoms become too heavy, make a hold until symptoms go away.

 

Another thing that can make tapering Wellbutrin more difficult, is when one is taking other meds that interact with Wellbutrin. Lots (if not most) of SSRI's interact with it for example. And this can cause problems with tapering Wellbutrin, like I experience. In such cases it might help to taper the SSRI before Wellbutrin.

 

Are you taking other meds or supplements then Wellbutrin? If so, please let us know which ones and what dosages.

Edited February 5, 2022 by Go2zero

[ReinaAMS]

@ChessieCat thank you so much for your detailed post! I read through what you shared and was familiar with most of it as I had read a lot of these posts on survivingantidepressants.org before I started my taper. I have added my history to my signature as well.

@Go2zero thank you very much for sharing your taper history with me. I greatly appreciate it. I am glad to know your story. I had anticipated that my last 100mg would be an opportunity to taper faster. I just assumed that below the minimal effective dose I wouldn't notice as much of an impact. But reading your experience, I see this is not necessarily the case and so I'm going to continue being just as careful as I was up until now. I have a very strong desire to just be off of this drug, but the last thing I want is to get destabilized!

In answer to your question, I'm not taking any other medications. I work with a functional medicine doctor (a medical doctor who has done advanced training in nutraceuticals, hormone health, etc, etc) and am taking quite a few supplements for my health.  Even though I eat 7 servings of vegetables daily, it's not enough and so I started to take the following supplements well before starting the taper (to make sure my body was in optimal shape for the taper):

Omega3: 1,000mg (710mg EPA / 290 mg DHA)
Vitamin A: 5,000 IU
Vitamin B complex
Vitamin C : 500mg 2x/day
Vitamin D : 8,000 IU
Vitamin E (tocotrienols): 150mg
Vitamin K2: 200mcg
Magnesium bisglycinate: 200mg 3x/day
N-acetyl-cysteine: 600mg 2x/day
Zinc bisglycinate chelate: 30mg
Iron: 150mg
Evening primrose oil: 1000mg (115mg GLA)

[ChessieCat]

9 minutes ago, ReinaAMS said:

Vitamin D : 8,000 IU

 

That seems to be an extremely high dose of Vitamin D.  My doctor had me on 4,000iu because I was low (blood test) but it was never re-checked.  Many years later I discovered that it was very high so I reduced it to 1,000iu.  A recent blood test showed it was at an okay level.

 

I cannot comment on the other doses of the supplements because I am not familiar with them.  You might do some research of your own to see whether you might be taking too high a dose of some of them.

 

Q:  Have you had your levels checked to see if you can reduce any of them?  If not, I think it would be a good idea to do that.  I think I have read that there are some vitamins that it is not good to take too high a dose of for an extended period of time.

 

Here is SA's magnesium topic:

 

Magnesium

 

15 minutes ago, ReinaAMS said:

Omega3: 1,000mg (710mg EPA / 290 mg DHA)

 

You might consider taking more of this one:

 

Omega-3 Fish Oil

 

From Post #1 of the above topic:

 

  

On 3/14/2011 at 1:29 PM, Altostrata said:

ADMIN NOTE Fish oil contains EPA and DHA, 2 omega-3 fatty acids. For nervous system support, 2,000-3,000 mg EPA + DHA a day is best. You may need to look at the ingredients label on your fish oil to find the amounts of EPA + DHA in a capsule. Usually, you will want to take 4-6 capsules of fish oil per day (2 capsules at each meal). To help fish oil to work, take it with 400IU vitamin E (preferably mixed tocopherols) per day.