Marlow: Venlafaxine, Mirtazapine, Lamotrigine, Bupropion

[Marlow]

Hi everyone. I'm very glad to be here. Thank you to all the moderators and members who make this site such a rich resource. Please see my main, time-sensitive question near the end of this post.

 

My current psychiatric medications

• Bupropion XL tablets (24 hour) 150 mg 1x/day
  • 2022: April 18 - Started it.
• Lamotrigine tablets 200 mg 1x/day
  • 2015: December - Started it.
• Mirtazapine tablets 15 mg 1x/day
  • 2015: December - Started it.
  • Have attempted tapering 3 times and failed each time
    • Attempt #1: May 1, 2020 to May 5, 2020. Reduced dose by 50% because of doctor's instructions. That was way too fast.
    • Attempt #2: May 15, 2020 to June 29, 2020 (45 days total) - Reduced by 12.5% of original dose every 3 weeks. 11.25 mg is where I failed & went back up to 15 mg.
    • Attempt #3: January 20, 2022 to March 5, 2022 (44 days total) - Reduced by 12.5% of original dose every 3 weeks. 11.25 mg is where I failed & went back up to 15 mg.
• Venlafaxine ER capsules 112.5 mg 1x/day (one 75 mg capsule & one 37.5 mg capsule)
  • 2012: Started it. Over a few months, the psychiatrist increased it all the way to maximum dose. I was on no other psychiatric medications. This likely contributed to my development of hypomania
  • 2014-2015: was off it for several months after a short taper
  • 2015: October - started again after major mental health crash (extreme depression, suicidality, etc)
  • 2021: March 16 to March 31 (15 days) I was taking immediate-release 37.5 mg 2x/day rather than extended-release 75 mg 1x/day because my doctor filled the wrong kind. That was an AWFUL experience & it took 6-8 weeks after I restarted extended-release for my anxiety-related chest pain to go away.
  • 2022: March 14 I increased from 75 mg to 112.5 mg

 

Past psychiatric medications

• 2015: Tried Gabapentin, Fluoxetine, Lorazepam, Zolpidem. Tapers were either short or non-existent & I was off all these meds by October 2015. That year I was cycling between hypomanic & severely depressed & thus medication details are a blur.
• 2018 April to 2020 October: Trazodone 100 mg nightly for insomnia (I've since learned that this high of a dose can actually *increase* insomnia). 7-8 months taper. Trazodone free as of October 23, 2020!
• 2021 January 31 to February 4 (5 days): Methylphenidate ER Tablets 10 mg 1x/day. Quit cold turkey - doctor recommended this! - due to hypomania & insomnia.

 

MAIN QUESTION

Is it okay to quit Bupropion extended-release (24 hour) tablets cold turkey given that I have only been taking them for 12 days? I have read the Bupropion thread on this site & it doesn't indicate whether quitting cold turkey is okay or recommended if someone's been on the medication for less than 2 weeks.

 

Why I think I want to quit Bupropion

I have noticed negative side effects, some of which are hard to describe. Definitely seems to have increased my nose stuffiness and dry mouth. Psychological side effects - I think I have become more irritable. I think it has worsened my executive dysfunction because *I think* it has made transitioning between activities even more difficult than it was for me before? I notice I get "stuck" (hyperfixating?) online & find it even harder to tear myself away than it was before I took Bupropion, even when part of my brain is saying "I want to get offline now! I'm hungry and need to eat!" but I can't seem to bring myself to actually change activities, sometimes for hours at a time.

 

I hope I've followed the site posting rules correctly. Thank you all in advance for any help you can offer.

[manymoretodays]

Hey there Marlow,

 

Yes, you are still in a time frame where you might be able to do a quicker taper with the Buproprion.

Here's that link again: Tips for tapering off Wellbutrin, SR, SR, XL/Zyban(buproprion)

As an alternative to "cold turkey" you could reduce by half,  but presently you are on  XL or extended release form so it gets trickier.......as once you split the pill it becomes immediate release.

 

Given that you are on a pretty potent, supposedly activating "cocktail" now, you might do okay with the CT.  Never ideal, but given all your other medications right now, you might get off fairly unscathed.  I don't know, you'll have to be the judge of your symptoms.

 

And work with your doctor too........you're on a pretty good cocktail as it is, who would prescribe more.......and more???

 

Do let us know how it goes, or what you decide.

And then also if you have an interest in further tapering too.

Yes, you posted fine, and thanks for doing your signature.

 

More about your "activating cocktail"

About going off mirtazapine plus venlafaxine aka "california rocket fuel"

 

And then there is the Lamictal too.

 

Know your drugs, check for interactions too.......consider using Drugs.com to do that.

Are you familiar with MadinAmerica, or any of Robert Whitaker's work?

 

And best, sorry for the delay.

Love, Peace, Healing, and Growth,

manymoretodays(mmt)