JoJo1812: Tapering off Trintellix is very difficult

[JoJo1812]

3/3/2023
6a   woke up, slept 6 hours
       Gabapentin 300mg
8a   Prozac 20mg
10a Wellbutrin XL 300mg
12p   Gabapentin 300mg
6p   Gabapentin 300mg
8p   Multi-Vitamin, B-Complex, Magnesium
10p Gabapentin 300mg

 

3/4/2023 Saturday
8a   woke up
       Gabapentin 300mg
10a   Prozac 20mg
120a Wellbutrin XL 300mg
2p   Gabapentin 300mg
6p   Gabapentin 300mg
10p Gabapentin 300mg

 

3/5/2023 Sunday
7a   woke up
       Gabapentin 300mg
9a   Prozac 20mg
11a Wellbutrin XL 300mg
1p   Gabapentin 300mg
6p   Gabapentin 300mg
8p   Multi-Vitamin, B-Complex, Magnesium
10p Gabapentin 300mg

 

3/6/2023 Monday
6a   woke up
       Gabapentin 300mg
8a   Prozac 20mg
10a Wellbutrin XL 300mg
10a Anxiety elevated - possibly due to seeing new psychiatrist
12p Gabapentin 300mg
6p   Gabapentin 300mg
8p   Multi-Vitamin, B-Complex, Magnesium
10p Gabapentin 300mg
*anxiety remained elevated all day and night

 

3/7/2023 Tuesday
6a   woke up, slept 6 hours
       Gabapentin 600mg 
          * switching back to 600mg/2x/day so I can better observe the effect Wellbutrin has on me - possibly causing additional stress, anxiety.
8a   Prozac 20mg
10a Wellbutrin XL 300mg
11a Highly agitated - rested in car for an hour
8p   Multi-Vitamin, B-Complex, Magnesium
       Gabapentin 600mg
*was even more agitated all day than the previous day. Evening of stress and crying.

 

3/8/2023 Wednesday
6a   woke up, slept 8 hours.  Had a very agitated sleep - kept waking up, scared, shaking.  Very difficult to control emotions and keep myself from spiraling emotionally.
       Gabapentin 600mg 
8a   Prozac 20mg
*really struggling so I went home from work @ 10am
11a Wellbutrin XL 300mg
4p   Multi-Vitamin, B-Complex, Magnesium
5p   Still shaking and anxious, fearful racing thoughts.
6p   Gabapentin 600mg
 

[JoJo1812]

GOALS: My ultimate goal is to be from these drugs.  I have given them 20 years of my life, and they have not given me the results I am looking for.

 

PSILOCYBIN: last used 2/23/2023. Not going to use again.  It was not prescribed, it was a street drug.

 

TMS: going to read through the articles that were linked in the previous post.  I will consider it.

 

WELLBUTRIN XL: My p-doc mentioned that the XL version of Wellbutrin can cause anxiety.  Should I switch to a different version?

 

Non-drug techniques to cope with emotional symptoms: I have started a journal of different methods that might work for me and my attempts to use them.  For a few weeks I have done meditation and mindfulness techniques. So far, none of the techniques have helped, but I will keep trying. I struggle the most with my episodes of elevated anxiety lasting for hours.  

[Altostrata]

1 hour ago, JoJo1812 said:

WELLBUTRIN XL: My p-doc mentioned that the XL version of Wellbutrin can cause anxiety.  Should I switch to a different version?

 

Any version of Wellbutrin can cause anxiety. Did the same doctor prescribe all these drugs? You are taking an excessive amount of every drug.

 

22 hours ago, Altostrata said:

In fact, your symptom pattern in your daily notes shows a bout of "anxiety" regularly after you take Wellbutrin and Prozac together.

 

I see you're taking your drugs on an inconsistent schedule, off by an hour or 2 each day, and gabapentin way off in schedule and dosing. This can cause odd symptoms.

 

Organizing your schedule might be complicated. Your dosing is packed, you're taking some drug every 2 hours. First, I suggest choosing a consistent daily dosing schedule for all your drugs. Stop playing with your drugs.

 

It would be best if you took Wellbutrin earlier in the day, such as 8 a.m., and Prozac later, such as 4 p.m. 

 

If I were you, I'd keep Wellbutrin at 10 a.m. for now and move Prozac later in the day by 2 hours each day until you're taking it at 4 p.m. Then move Wellbutrin to 8 a.m. I guess you'll have to distribute your 4 300mg gabapentin doses among these.

 

These changes may be bumpy for a little while but you may have less of a reaction to the Prozac-Wellbutrin combination.

[JanCarol]

Hey JoJo - 

 

So wait - this psychiatrist cold-switched you from Pristiq to Prozac?  Just quit one and started the other?  OH GOSH we don't recommend that, see: The Prozac Bridge 

 

On 3/9/2023 at 12:14 PM, JoJo1812 said:

PSILOCYBIN: last used 2/23/2023. Not going to use again.  It was not prescribed, it was a street drug.

 
Good call, it was a confounding factor.  Psychedelic therapy needs to be right time & place - if you are in distress, it could emphasize your distress.  Set & setting, set & setting, set & setting (& why I am disgusted at "psychedelic therapy" being held in institutional settings - shock treatment rooms & hospital beds with no music, not even a pretty picture.)

 

On 3/9/2023 at 12:14 PM, JoJo1812 said:

TMS: going to read through the articles that were linked in the previous post.  I will consider it.

 

I've dropped into a TMS rabbit hole with James Hall's articles, and found some more:

https://www.madinamerica.com/2021/01/tms-hurt/

 

and in one of the articles above, he references some case studies (they are in medical-ese - so you may or may not be able to engage them.  Sometimes I can read research, sometimes not - depends on the cognition of the day!)

https://pubmed.ncbi.nlm.nih.gov/19371866/

https://www.tandfonline.com/doi/abs/10.1080/15622970600671002

https://pubmed.ncbi.nlm.nih.gov/21930451/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639843/

 

On 3/9/2023 at 12:14 PM, JoJo1812 said:

WELLBUTRIN XL: My p-doc mentioned that the XL version of Wellbutrin can cause anxiety.  Should I switch to a different version?

 

This makes no sense at all!   (harsher words were on my tongue!)

 

See Alto's post above - I almost didn't address this because she agrees that ANY version of Wellbutrin can cause anxiety.

I reckon the XL would be *less* anxiety inducing than regular Wellbutrin because it's time released, a little bit at a time.  Geez Louise! 

 

I did a study on this - another drug for pain management - that it was a stronger dose for me to take 1/4 an XL - making it IR (Immediate release) -  than to take the whole tablet for a 12 hour dose.  XL/XR formulations tend to dribble dosage into your system over time.  So IMO and in my experience, IR hits your system faster.  With Wellbutrin, this could equal an anxiety spike.

Wellbutrin is a jazzy, sexy, amp-you-up drug.  They sold it as being one which does not interfere with sexuality.  They rebranded it for smoking cessation.  They rebranded again & recommend it for PMS (extending their patent life).  It is one of the most stimulating "antidepressants" out there.  So yeah, anxiety.  But it has nothing to do with whether it is XL or IR - it's the drug, Joyce!  (sorry, that's an Aussie joke, and I couldn't find an American equivalent)

 

At some point you will need to switch to IR when you are tapering it - cutting or dissolving XL/XR makes it IR, which means multiple dosings a day.

 

I agree with Alto (I always do!) that it will help you to take the Wellbutrin first, Prozac later (though some people feel stimulated by Prozac, too).  Nice work on getting 2 hours in between your doses - I know it's hard, it feels like your whole day is managing doses right now.   Keep these 2 apart, and I think that Alto's schedule of early am Wellbutrin, and taking the Prozac later, will be helpful.

Also good work on posting your dosing schedule and symptoms.  Those help us a lot!!!!  They will continue to help us, as you move your doses around, to figure out what works for you.

 

On 3/9/2023 at 12:14 PM, JoJo1812 said:

Non-drug techniques to cope with emotional symptoms: I have started a journal of different methods that might work for me and my attempts to use them.  For a few weeks I have done meditation and mindfulness techniques. So far, none of the techniques have helped, but I will keep trying. I struggle the most with my episodes of elevated anxiety lasting for hours.  

 

Yar, that's the hard part, I'm sorry.  These are skills that are best learned when you are stable - it's a lot harder to learn when your nervous system is screaming at you.  Journaling is awesome, and always benefits, even if it just keeps a record of where you are, where you've been, and where you want to go.

 

Maybe these quiet activities are harder than it would be to put on some music and dance your soul away.  I fell into tai chi, because the precision of the movements forces mindfulness - if I wool-gather or daydream, then it becomes "not tai chi" - and it's about my body and movement, not just sitting still.  Yoga does a similar thing for me (though, it's more confronting, as it's about challenging the emotions that come up in pose).  Or maybe your thing is crocheting and knitting, painting, or playing a musical instrument.  All of these require mindfulness (as long as you don't let perfectionism get in the way!).

 

There are myriads of ways to be mindful, not just sitting Zen.  Chop wood, carry water is a spiritual practice.  Doing the dishes, they say, like "washing the Baby Buddha" (or whatever infant you care about) is a mindfulness practice.

Here's a simple practice, just 4 minutes, that helps release excess (anxiety): Kim Eng - Shaking Practice

 

I was also just reading about spinning as a similar practice to shaking.  Don't like your mood?  Spin counter clockwise to banish it, and clockwise to build something new.  I did this early in my training, and had built up to 30 spins each way.  I'm thinking of taking it up again as a daily practice.

 

Other things you can do to Change the Channel include challenging your senses.  Shower as hot as you can stand, then cold as you can stand.  Smell something tangy, then something floral.  Taste something spicy, something sweet.  Walk in the sun and the shade.  Listen to Mozart, then Rachmaninoff...

 

Something which is dramatic and may appeal to you is the Wim Hof method.  It's a breathing technique (based on yoga, but a little more extreme) followed by cold showers.  I never got to the cold shower part, but even the just breathing is excellent for making a shift in your mood.

 

Members have discussed Wim Hof (videos included) here:  

 

So - your plan for now is to space out your dosing?  And see if you settle some?  

 

Then - first taper - Wellbutrin?  

 

I hope you see the Sun today!

 

[JoJo1812]

Thank you for all of the great advice!  I have been raving about this website to my other friends on AD's.

 

Taking into account the advice about when to take my dosages and how they relate to other drug interactions, I came up with a schedule that will hopefully create a baseline of my current symptoms so that I can start tapering down.  I know that I have been a bit inconsistent with the specific times I have been taking my meds, but I'm willing to commit to these times.  Please let me know if I should be doing something different.

 

6a Wellbutrin XL 150mg
     Multi-Vitamin, B-Complex
8a Gabapentin 600mg
2p Prozac

6p Wellbutrin SR 150mg
8p Gabapentin 600mg
10p Magnesium
 

I'm hoping to begin tapering the Wellbutrin by 10% after two weeks on this schedule using the SR version.  Should I wait to taper the Gabapentin until after I am off Wellbutrin?  Or should I alternate 10% decreases, ex. reduce WellB by 10%, 2 weeks later reduce GabaP by 10%, repeat.

 

For now, I am going to hold off the TMS until I understand it better.  My psych said I would need to be down to zero Wellbutrin by the time I started anyways.

 

Thank you!

JoJo

[Shep]

5 hours ago, JoJo1812 said:

I'm hoping to begin tapering the Wellbutrin by 10% after two weeks on this schedule using the SR version.  Should I wait to taper the Gabapentin until after I am off Wellbutrin?  Or should I alternate 10% decreases, ex. reduce WellB by 10%, 2 weeks later reduce GabaP by 10%, repeat.

 

Do you feel overly sedated by the Gabapentin? If not, you may want to concentrate on getting off Wellbutrin completely. This is a great thread on the "which drug to taper first" conversation:

 

Taking multiple psych drugs? Which drug to taper first?

 

[JanCarol]

21 hours ago, JoJo1812 said:

I'm hoping to begin tapering the Wellbutrin by 10% after two weeks on this schedule using the SR version.  Should I wait to taper the Gabapentin until after I am off Wellbutrin?  Or should I alternate 10% decreases, ex. reduce WellB by 10%, 2 weeks later reduce GabaP by 10%, repeat.

 

Hey JoJo - while your gabapentin is indeed a high dose - start with the Wellbutrin, and get it down to a reasonable dose.  For example, if your current dose involves 4 pills, as you taper it down to 3,  see how you feel.  You may want to take a break from tapering Wellbutrin, and get the Gabapentin down.

 

But I wouldn't alternate every taper.  You could go obsessively crazy trying to keep track of 2 tapering doses at once!  Focus on one at a time, make sure you're nice and slow and easy.  When you get the Wellbutrin down to a manageable dose (that you don't have to cut & weigh), then maybe you'll look at the gabapentin.

 

There is a ton of synergy between these drugs - so you may feel more sedated as you come off the Wellbutrin.  That's a sign that the gabapentin is too much.

 

You will probably be on some gabapentin throughout the process, it will likely be the last to go (It may actually alleviate some symptoms) - but you may want to decrease it along the way.

 

This is how I did it with lithium.  The lithium was killing me, but the antidepressant was activating (much like yourself).  So I tapered  the antidepressant down (at a 10% rate!)  from 2 pills to 1, and then switched to lithium taper.  Got the lithium taper down from 4 pills to 2 (also at a 10% rate), and went back to tapering the antidepressant.  This was about a 2 year process.

I'm a little concerned with the 6 pm Wellbutrin dose - the half life is 21 hours - and I wonder how well you are sleeping.  As we break out your Wellbutrin into SR doses, we'll better figure out when is the best time to take your doses.

 

Are you feeling better now that your conflicting doses are separated?

Keep us posted, and keep those symptom journals coming!

 

I hope you see the Sun today.

Edited March 14, 2023 by JanCarol
clarity & compassion

[JoJo1812]

Question: can I take the two Wellbutrin doses in the morning/ noon time and leave Prozac for the evening so they can be spaced out for interactions but also not take the most activating drug in the evening when I am supposed to wind down for sleep? Last night I forgot to take Wellbutrin SR at 6 pm and I decided to skip the dose when I remembered rather thank take it at 8 pm.

 

Thanks, I am nearly there

[JoJo1812]

3/9/2023 Thursday
6a   woke up, slept 11 hours.
       Gabapentin 600mg 
8a   Prozac 20mg
11a Wellbutrin XL 300mg
4p   Multi-Vitamin, B-Complex, Magnesium
6p   Gabapentin 600mg

 

3/10/2023 Friday
*shifting Prozac to the afternoon
6a Gabapentin 600mg
10a WellbutrinXL 300mg
2p Prozac 20mg
6p Anxious, shaky, heart beating fast
8p Gabapentin 600mg

 

3/11/2023 Saturday
6a Gabapentin 600mg
10a WellbutrinXL 300mg
2p Prozac 20mg
6p Anxious, shaky, heart beating fast
8p Gabapentin 600mg

 

3/12/2023 Sunday
6a Gabapentin 600mg
8a WellbutrinXL 300mg
3p Prozac 20mg
8p Gabapentin 600mg

 

3/13/2023 Monday
6a Wellbutrin XL 150mg
8a Gabapentin 600mg
12p Tense shoulders, anxiety, shaking hands
4p Prozac
6p Wellbutrin SR 150mg forgot until late, was afraid I wouldn’t be able to sleep.
8p Gabapentin 600mg

 

3/14/2023 Tuesday
6a Wellbutrin XL 150mg
     Very anxious, stressed, wanted to cry
8a Gabapentin 600mg
9a Was able to have an orgasm - first in weeks.
4p Prozac 20mg
8p Gabapentin 600mg

 

3/15/2023
6a Wellbutrin XL 150mg
8a Gabapentin 600mg
10a Clonazepam 0.5mg - mother had accident, TBI. Visited in hospital.
4p Prozac 20mg
5p Anxouos, racing thoughts, agitated
8p Gabapentin 600mg

 

3/16/2023
Difficult to fall asleep, but slept well.
6a Wellbutrin XL 150mg
8a Gabapentin 600mg
10a anxiety has been very low
12p feel sedated 
4p Prozac 20mg
5p Anxious, agitated
7p Got very upset at a party, crying
8p Gabapentin 600mg
9p Began to feel better, more social
11p Went to bed, awake until 2am

 

3/17/2023 Friday
Difficulty sleeping - I believe it is the Prozac so I moved it up 2 hours in my schedule
6a Wellbutrin XL 150mg
8a Gabapentin 600mg
10a Feeling anxious yet sedated, lots of tension in shoulders.
2p Prozac 20mg
4p Gabapentin 600mg
 

[Shep]

9 hours ago, JoJo1812 said:

4p   Multi-Vitamin, B-Complex, Magnesium

 

JoJo, I noticed you had this in your notes for 3/9/2023 but not in the remaining days. Did you stop taking these supplements? If not, please include your supplements in all of your notes. 

 

Because you're making changes in the timing of your drugs, it's really important that all the other drugs and supplements stay consistent. Otherwise, you won't know if the drug timing change is helpful or not or if how you're feeling is the result of the supplement change. Only one change at a time. Please see:

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

[Addax]

Hi @JoJo1812,

I saw you were taking and tapering Prozac and Wellbutrin, two drugs I’m familiar with, and thought I’d swing by. I saw your last entry withe your schedule written out. I noticed you went from 300mg/day of Wellbutrin to 150mg 1x/day on 3/13. Is this a typo? Or did you reduce by 50%? 
 

Edited March 19, 2023 by Addax

[JoJo1812]

14 hours ago, Addax said:

Hi @JoJo1812,

I saw you were taking and tapering Prozac and Wellbutrin, two drugs I’m familiar with, and thought I’d swing by. I saw your last entry withe your schedule written out. I noticed you went from 300mg/day of Wellbutrin to 150mg 1x/day on 3/13. Is this a typo? Or did you reduce by 50%? 
 

@Addax

I have been looking for someone with experience with my combo of ADs.  You correctly noticed that I cut my Wellbutrin dose in half from 300mg XL to 150mg XL.  I was trying to split the 300mg XL dose into a 150mg XL and a 150mg SR so that I can start slowly tapering.  I forgot to take the SR the first night, and the second night I realized that taking Wellbutrin and Prozac in the afternnoon was going to be too stimulating and cause issues sleeping. In addition to this, I had to take an emergency trip from CA to WI because my mother had a bad accident and is in the ICU.  This also distracted me aand messed up my plans for this new medication schedule.

 

So I decided to try a few days of half dose to see what happens. I'm back home in CA now and taking stock of my symptoms: more agitated, more shaky, tense, weepy, very foggy brain.  In fact, it was the same symptoms you described in your withdrawal story.

 

I'm going back to 300mg of Wellbutrin in the morning: 150mg XL and 150mg SR, and keep everything else the same.  My intention is to give this two weeks and then reassess.  It's clear that splitting Wellbutrin and spacing it out with Prozac and Gabapentin is not going to work for me.

 

Questions: What are your thought sof taking Wellbutrin XL and SR together in one dose? Is this a good setup for me to start tapering later?  Also, my doctor has been recomending me to increase my Prozac so that I can get to a stable baseline.  Would this increase help with the Wellbutrin taper or make it harder?  With the end goal of tapering all of meds eventually.

 

Thanks for your thoughts and advice!

JoJo

 

 

[JoJo1812]

@Shep I have been a bit inconsistent with noting my supplements in my daily journal.  I will make sure to do that going forward.  I understand that these are also important to assessing my situation.

 

Thank you!

[Addax]

1 hour ago, JoJo1812 said:

So I decided to try a few days of half dose to see what happens. I'm back home in CA now and taking stock of my symptoms: more agitated, more shaky, tense, weepy, very foggy brain.  In fact, it was the same symptoms you described in your withdrawal story.

I am sorry that has been your experience! It is a horrific experience. My experience this time has been very, very different. My cuts have been small with lots of holds. It’s made all the difference.
 

The increase in intensity of your symptoms is very much likely due to your 50% cut.  This site recommends no more than 10%, and smaller or holding if you’re already struggling in order to minimize withdrawal symptoms. Like I said, smaller cuts and holding has been a game changer for me.  Because of the interaction between Prozac and Wellbutrin, be as conservative as you can be. Had I paid better attention last time, the experience you read about in my story  would probably not have happened the way it did.

 

1 hour ago, JoJo1812 said:

Questions: What are your thought sof taking Wellbutrin XL and SR together in one dose? Is this a good setup for me to start tapering later?  Also, my doctor has been recomending me to increase my Prozac so that I can get to a stable baseline.  Would this increase help with the Wellbutrin taper or make it harder?  With the end goal of tapering all of meds eventually.

I don’t know whether there are adverse effects of taking SR and XL at the same time, but people tend to divide doses because Wellbutrin can be stimulating.  Other than that, I’m not able to advise you regarding the the XL and SR, or increasing the Prozac. I will say that, often, the best way to set up to begin to taper is to make as few changes to your meds and med schedule as possible and hold there for a bit so you can stabilize. This will give you a solid place to start stepping down from.  That’s where Shep and the rest come in. And absolutely follow the guidance provided by Shep and the other Admins and moderators closely.  They will help you get you where you need to be to start your taper. 
 

 

 

[JanCarol]

Hey JoJo - 

 

Be kind to yourself - I understand wanting to split the Wellbutrin, but the 150 XL should hold your for 24 hours.

 

Taking the XL with the SR to start is fine - but the SR will drop away, and you will need to split that dose to last you until the following morning.

 

For now, take them together.   At some point, when you start tapering, you will want some SR later in the day - but it will likely be a smaller dose - just to "hold" you till morning.  Does this makes sense to you?

 

As far as missing doses - we've all made mistakes.  Don't beat yourself up, keep moving forward!

 

Good work getting the Wellbutrin separated from the Prozac and Gabapentin!  Nice logs, too - easy to see what is happening.

 

I hope you see the Sun today!

Edited March 20, 2023 by JanCarol

[Shep]

10 hours ago, JoJo1812 said:

Also, my doctor has been recomending me to increase my Prozac so that I can get to a stable baseline.  Would this increase help with the Wellbutrin taper or make it harder?  With the end goal of tapering all of meds eventually.

 

I doubt this will lead to a stable baseline. The reason you're unstable isn't because you are taking too little Prozac. Is this the same doctor who placed you on this cocktail, which contains multiple drug interactions? As you can see in this link, the Wellbutrin is already increasing the level of Prozac in your system. 

 

Drug Interaction Report - Prozac, Wellbutrin, Gabapentin

 

Your recent experiment with a 50% Wellbutrin decrease is also affecting your Prozac levels, so it's best to approach your reductions carefully, without any abrupt large changes. 

 

Addax's post here is spot on: 

 

8 hours ago, Addax said:

The increase in intensity of your symptoms is very much likely due to your 50% cut.  This site recommends no more than 10%, and smaller or holding if you’re already struggling in order to minimize withdrawal symptoms.

 

I'm going to "ditto" what JanCarol wrote here:

 

3 hours ago, JanCarol said:

As far as missing doses - we've all made mistakes.  Don't beat yourself up, keep moving forward!

 

Give yourself a break. Having a loved one in the hospital in another part of the country is no small stressor. Please be gentle with yourself and do as much self care as possible. 

Edited March 20, 2023 by Shep
added information

[JoJo1812]

3/17/2023
Difficulty sleeping - I believe it is the Prozac so I moved it up 2 hours in my schedule
6a Wellbutrin XL 150mg
8a Gabapentin 600mg
     Multi-Vitamin, B-Complex
10a Feeling anxious yet sedated, lots of tension in shoulders.
2p Prozac 20mg
4p Gabapentin 600mg
Couldn’t sleep all night

 

3/18/2023 Saturday
Lots of fear, tension, feet to head
6a Wellbutrin XL 150mg
8a Gabapentin 600mg
     Multi-Vitamin, B-Complex
9a Family meeting about Mom’s TBI.
     Clonazepam 0.5mg
11a Wellbutrin SR 150mg
2p Prozac 20mg
6p Gabapentin 600mg

 

3/19/2023 Sunday
7a Wellbutrin XL 150mg
Had an episode of panic and fear. 8 out of 10. Racing, spiraling thoughts of hopeless doom.
8a Gabapentin 600mg
     Walked, used weight machines in the park and sat in the grass. Anxiety brought under control.
11a Wellbutrin SR 150mg
2p Prozac 20mg
6p Gabapentin 600mg

 

3/20/2023 Monday
     Slept poorly
6a Wellbutrin XL 150mg AND Wellbutrin SR 150mg
     Multi-Vitamin, B-Complex
     Nervous, anxious - partly due to first day back at work after a week
7a Yoga & meditation
8a Gabapentin 600mg
9a VERY shaky, barely able to write
     Having issues with motor skills - using mouse, typing
1p very anxious, heart racing, balance is off
2p Prozac 20mg
6p Gabapentin 600mg
9p From shoulders to back to feet feel anger, rage. 
     Magnesium
Awake most of the night - HIGHLY agitated, racing thoughts, burning energy throughout body

 

3/21/2023 Tuesday
Awoke VERY distressed, curling in a ball, burning skin on my back
6a Wellbutrin XL 150mg AND Wellbutrin SR 150mg
     Multi-Vitamin, B-Complex
8a Gabapentin 600mg
9a Began to feel some relief from the distress. Balance is off.
12p Anxious, but calmer than earlier. Heart pounding in chest.
 

Link to daily dose log

[JoJo1812]

3/21/2023 Tuesday
Awoke very distressed, curling in a ball, burning skin on my back
6a Wellbutrin XL 150mg AND Wellbutrin SR 150mg
     Multi-Vitamin, B-Complex
8a Gabapentin 600mg
9a Began to feel some relief from the distress. Balance is off.
12p Anxious, but calmer than earlier. Heart pounding in chest.
2p Prozac 20mg
4p Crawling out of my skin, scratching
6p Gabapentin 600mg

      Miserable. Uncontrollable crying and hitting the walls.
7p Clonazepam 0.5mg
 

 

Today has been a horrible day of constant torment.  Shaking and fear, body tensed and burning.  I woke up and my girlfriend comforted me as best she could, and I took my medicine as planned.  I had a bit of relief during the middle of the day, but later starting suffering and tensing so badly my head was going to pop.  Meditated, walked.  No relief.  Went home from work and cried uncontrollably for two hours. Yoga 45 minutes. A little relief, but still miserable.

 

But also, I am making those loved ones around me suffer. Especially my dear girlfriend who has been nothing but the most supportive person for over a year through this battle against the meds.  How can I care for her and protect her from ME?  How do I keep her healthy while I suffer?

 

Please! I need advice on how to relieve this torment and how I can protect and love those closest to me.

[JanCarol]

Thanks JoJo - 

 

From your notes, it's easy to see how these drugs are messing with you.  

 

There is going to be time involved, see Are We There Yet? How Long is Withdrawal Going to Take?

 

The best thing you can do is - be kind to yourself.

 

You can't drive away the withdrawals & drug effects, they are going to do what they do.  Meditation and non-drug practices help distract you and maybe help your mood some - let them be the anchors that help you (like you've been doing - but - with a gentler, kinder attitude).  If you are fiercely walking to "fix this" you may only drive it in deeper.  I'm not sure if I'm explaining this well - 

 

But you cannot use the sympathetic nervous system (fight and flight) to activate your para-sympathetic nervous system (relax & rest).  There's an element of surrender.  So this is what it is?  Okay, how can I best cope with this?  And cultivate curiosity - what is this experience (5 senses)?  Where in my body does this come from?  Are there emotions & feelings attached to it?    In curiosity, you seek to deepen the experience.  The only way out of the woods is through.

 

Upon looking at your notes, you may (no guarantees) be helped by stopping your Vit B and multivitamin.  Small things, I know - but until you start tapering, all we can look at is the small things.  See:  Hypersensitive to B Vitamin or B-Complex

 

I'm sorry to hear this is affecting your relationships.  If you express to your friends & family the struggles you are dealing with, perhaps it would help?  I know - a lot of people have trouble believe just how insidious these drugs are (many of my friends & family take them in spite of my protests!).  But try, speak from the heart, let them know how much you really care about them, but that your brain & world are upside down right now, making it difficult for you.

I hope you see the Sun today.

 

JC

[JoJo1812]

DAILY JOURNAL

 

3/17/2023
Difficulty sleeping - I believe it is the Prozac so I moved it up 2 hours in my schedule
6a Wellbutrin XL 150mg
8a Gabapentin 600mg
     Multi-Vitamin, B-Complex
10a Feeling anxious yet sedated, lots of tension in shoulders.
2p Prozac 20mg
4p Gabapentin 600mg
Couldn’t sleep all night

 

3/18/2023 Saturday
Lots of fear, tension, feet to head
6a Wellbutrin XL 150mg
8a Gabapentin 600mg
     Multi-Vitamin, B-Complex
9a Family meeting about Mom’s TBI.
     Clonazepam 0.5mg
11a Wellbutrin SR 150mg
2p Prozac 20mg
6p Gabapentin 600mg

 

3/19/2023 Sunday
7a Wellbutrin XL 150mg
Had an episode of panic and fear. 8 out of 10. Racing, spiraling thoughts of hopeless doom.
8a Gabapentin 600mg
     Walked, used weight machines in the park and sat in the grass. Anxiety brought under control.
11a Wellbutrin SR 150mg
2p Prozac 20mg
6p Gabapentin 600mg

 

3/20/2023 Monday
     Slept poorly
6a Wellbutrin XL 150mg AND Wellbutrin SR 150mg
     Multi-Vitamin, B-Complex
     Nervous, anxious - partly due to first day back at work after a week
7a Yoga & meditation
8a Gabapentin 600mg
9a VERY shaky, barely able to write
     Having issues with motor skills - using mouse, typing
1p very anxious, heart racing, balance is off
2p Prozac 20mg
6p Gabapentin 600mg
9p From shoulders to back to feet feel anger, rage. 
     Magnesium
Awake most of the night - HIGHLY agitated, racing thoughts, burning energy throughout body.

 

3/21/2023 Tuesday
Awoke very distressed, curling in a ball, burning skin on my back
6a Wellbutrin XL 150mg AND Wellbutrin SR 150mg
     Multi-Vitamin, B-Complex
8a Gabapentin 600mg
9a Began to feel some relief from the distress. Balance is off.
12p Anxious, but calmer than earlier. Heart pounding in chest.
2p Prozac 20mg
4p Crawling out of my skin, scratching
6p Gabapentin 600mg
     Miserable. Uncontrollable crying and hitting the walls. 10 out of 10 anxiety level.
7p Clonazepam 0.5mg
     Did yoga and lifted weights for an hour.
8p calmed down and was able to get myself down to a 2 out of 10 anxiety level.

 

3/22/2023
*researched the last few weeks and and found that I was the healthiest when I was spreading out my Gabapentin over 4 of 300mg doses rather than 2 of 600mg.
6a  Gabapentin 300mg
8a  Wellbutrin XL 300mg
12p Gabapentin 300mg
2p  Prozac 30mg
2:30p Tense, agitated
6p Gabapentin 300mg
10p Gabapentin 300mg

 

3/23/2023
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
11am high agitation
1p No relief from agitation, anxiety at 8 of 10

 

3/24/ 2023
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
Slept horrible, but feel good
Mom passed away after 3 weeks in ICU from falling down the stairs
Felt outside of head - like on a swing ride, free fall

 

3/25/2023 Saturday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p

 

3/26/2023 Sunday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
2p jittery

 

3/27/2023 Monday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
No sleep, flight to Wisconsin today for funeral

 

3/28 Tuesday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
1pm jittery

 

3/29/2023
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
Headache all day - probably dehydrated

 

3/30/2023
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
1p anxious

 

3/31/2023 Friday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
Mom’s funeral

 

4/1/2023 Saturday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p

 

4/2/2023 Sunday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
Flew from Wisconsin to California
Normal anxiety on the plane.
6p Very high anxiety when discussing the coming week.

 

4/3/2023 Monday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
Slept ok.
Very anxious, world is ending - probably because I am returning to work.
Spoke with p-doc: recommended I begin slow taper of Wellbutrin XL 300mg using Wellbutrin SR.
 

[JoJo1812]

Over the past ten days I have not done any changes to my meds or the schedule, and it has made a difference with my anxiety levels.  The swings have been a little less frequent and less in strength.  However, it may also be due to the fact I was very distracted with my mother's death.  When I am distracted and thinking of others, I don't have time to think about myself and let the anxiety build up.

 

I am ready to start a slow taper off of Wellbutrin XL 300mg.  My p-doc said I should go to 150mg SR once a day - I said no.  Too fast.  She wrote me a script for 200mg SR.  I think I will reduce the amount by 10% (30mg) for two weeks and see how it goes.  What is the best way to do this?  Take all 270mg in the morning (shaving off 30mg from the SR)? Or split them into two equal doses?

[JanCarol]

With Wellbutrin, it is recommended that you dose SR 2x daily.

[JanCarol]

Hey JoJo - 

 

I was doing a little research today on Gabapentin, and have posted to the Gabapentin thread, here:  

  

You may wish to read the whole thread.

 

I hope you see the Sun today!

[Shep]

@JoJo1812 How many hours of sleep are you getting each night? Please add that to your daily journal. 

[JoJo1812]

Hi all - this afternoon I had a seizure. I fell in the warehouse and woke up shaking. I am in the hospital getting a full workup. CAT scan was clear. They are doing more bloodwork now.

 

i read about wellbutrin possibly causing seizures and I think switching to SR lowered my seizure threshold.

what do I do? Stop wellbutrin cold turkey or some fast taper? 
 

thank you

[Go2zero]

6 hours ago, JoJo1812 said:

i read about wellbutrin possibly causing seizures and I think switching to SR lowered my seizure threshold.

what do I do? Stop wellbutrin cold turkey or some fast taper? 

What was the brand of the 300 XL Wellbutrin? And which brand is the SR Wellbutrin you are taking now?

 

Changing form (IR, SR or XL) or brand may give symptoms.... Such a change (if really needed!) should best be done with a gradual crossover of several weeks.

 

I see you have been using Wellbutrin already a long time. So it is not logic to think that Wellbutrin is suddenly causing a seizure.

 

Suddenly stopping or a fast taper would most probably cause (heavy) symptoms. 

 

I cannot tell if changing XL to SR caused your seizure. It may have.

 

Do you take alcohol (now and then or frequently)? If so, this may cause seizures when taking Wellbutrin.

 

But stopping or a fast taper may make things worse. Since you are also taking Prozac, you should be extra careful when tapering Wellbutrin!. Every step down in Wellbutrin will have an effect on the metabolism on Prozac. This means that the Prozac will be metabolised faster after each step down in Wellbutrin. Which will give the same effect and symptoms as tapering the Prozac (but without even dropping the dosage of Prozac).

 

Therefor you should be extra careful (and slow) when tapering Wellbutrin!

 

Changing back to the brand and form you were taking before, may help.There are other ways to taper the 300 XL pills you took before. If needed we can help you to learn how. 

 

But please tell first which brand(s) the XL and SR are.

 

 

 

Edited April 12, 2023 by Go2zero

[Shep]

7 hours ago, JoJo1812 said:

Hi all - this afternoon I had a seizure. I fell in the warehouse and woke up shaking.

 

I'm sorry to read this, JoJo. This is the last thing you need on top of withdrawal. 

 

How hot was the warehouse? Were you dehydrated? Heat and dehydration can cause seizures, especially with the drugs you're taking. But it may be more about the heat and dehydration than the drugs, so please don't make any abrupt changes, especially while you're still waiting on your test results. As @Go2zero mentions, "Suddenly stopping or a fast taper would most probably cause (heavy) symptoms." That could make you susceptible to more problems. 

 

Please look into getting some time off from your job. Do you get any type of sick leave pay or disability pay? 

 

[JoJo1812]

@Go2zero  I’m not sure how you tell the brand, but the original med was Bupropion Hydrochloride Extended Release XL, and I switched to Bupropion Extended Release SR.

 

@Shep The area I was in was not too warm and I was well hydrated. And I was not stressed at all when it happened.
 

I’m going to stick to my slow taper schedule while I wait for my nuero doctor appointments next week.  Thank for responding!!!

[Go2zero]

2 hours ago, JoJo1812 said:

I’m not sure how you tell the brand, but the original med was Bupropion Hydrochloride Extended Release XL, and I switched to Bupropion Extended Release SR.

Are the pills these 2 links show, exactly the pills you were/are taking?

 

If so, they are from different manufacturers. With different inactive ingredients. Both generics. One is made in India, the other one in China.

 

And one is XL and the other SR. So a lot of differences between those pills. Changing brand and/or form (certainly when generics) may cause different effects and/or symptoms.

 

There are more members here who experienced (sometimes heavy) problems when changing form and/or brand/manufacturer of bupropion (and also other meds). I also experienced this once with (generic) bupropion, which made me change back to the pills I was using before.

 

Another problem with generics is that dosages sometimes are not equal when comparing different makes (even if they should the same amount of mg's)

 

There would be several ways you could deal with this. One of them is to change back to the former make, but then in 150mg pills. If the link above you placed about your pills is correct, than this could be the one https://www.lupin.com/US/product/bupropion-hydrochloride-extended-release-tablet-usp-xl/

 

You could take one 150mg XL pill and cut 30 mg from the 2nd XL pill, so that you would take 270 per day. The cut pil should best be cut in 3 more or less equal pieces and taken over the day, to give an effect of extended release. 

 

In this way you would taper the same product you have been taking before and not a drug which is very different in form, make and ingredients.

 

 

 

[JoJo1812]

@Go2zero After a few days on the SR, I noticed a major reduction in anxiety so I decided to stick it out.  I am increasing the rate I am decreasing it though.  Not in a big rush, but not able to wait the full 2-4 weeks between each 10% reduction.  SO GRATEFUL I have enjoyed a few days with manageable anxiety!

[JoJo1812]

4/3/2023 Monday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
Slept ok.
Very anxious, world is ending - probably because I am returning to work.
Spoke with p-doc: recommended I begin slow taper of Wellbutrin XL 300mg using Wellbutrin SR.
Consitant shaking in upper body non-stop, all day

 

4/4/2023 Tuesday
Gabapentin 300mg @ 6a, 12p, 6p, 10p; Wellbutrin XL 300mg @ 8a; Prozac 30mg @ 2p
Very anxious - unable to determine cause of shaking and anxiety. all day.

 

4/5/2023 Wednesday
6a  Gabapentin 300mg
      Vitamin C (people sick at office)
8a  Wellbutrin SR 135mg (90% of 1/2 dose)
10a hot flashes

11a consistent agitation one hour prior to GabaP12p Gabapentin 300mg
       Prozac 30mg
       SCRATCHING head until bleeding
4p   Wellbutrin SR 135mg (90% of 1/2 dose)
5p Gabapentin 300mg
10p Gabapentin 300mg
Constant shaking in upper body non-stop, all day

 

4/6/2023 Thursday
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 135mg @ 8a & 4p; Prozac 30mg @ 12p
Relatively calm at work while busy.
Constant shaking in upper body non-stop, all day.  Had a little relief from shaking during workout.

 

4/7/2023 Friday
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 135mg @ 8a & 4p; Prozac 30mg @ 12p
11a Anxiety spiked, hot flashes
Constant shaking in upper body non-stop, all day.  

 

4/8 Saturday
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 135mg @ 8a & 4p; Prozac 30mg @ 12p
11a strong shakes and body tension

 

4/9 Sunday
8 hours of sleep
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 135mg @ 8a & 4p; Prozac 30mg @ 12p

 

4/10/2023 Monday
7 hours of sleep
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 135mg @ 8a & 4p; Prozac 30mg @ 12p
11a body shakes started
5p shakes

 

4/11/2023
5 hours of sleep
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 135mg @ 8a & 4p; Prozac 30mg @ 12p
12:30 Seizure - lost control, went dark, head, arms, and legs twitched.

 

4/12/2023
8 hours of sleep
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 135mg @ 8a & 4p; Prozac 30mg @ 12p

 

4/13/2023
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 120mg (80% of full dose) @ 8a & 4p; Prozac 30mg @ 12p

 

4/14/2023
Slept 4 hours 
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 120mg @ 8a & 4p; Prozac 30mg @ 12p
Shaking began to reduce in intensity, anxiety levels reducing

 

4/15/2023
Slept 7 hours
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 120mg @ 8a & 4p; Prozac 30mg @ 12p

 

4/16/2023
Gabapentin 300mg @ 6a, 12p, 5p, 10p; Wellbutrin SR 120mg @ 8a & 4p; Prozac 30mg @ 12p
Woke up very shaky and uncertain, but meditation brought me back to lower anxiety levels.
Shaking continued to reduce in intensity, anxiety levels reducing.
Ended day with the best feeling day in a long time.
 

[Go2zero]

4 minutes ago, JoJo1812 said:

After a few days on the SR, I noticed a major reduction in anxiety so I decided to stick it out.  I am increasing the rate I am decreasing it though.  Not in a big rush, but not able to wait the full 2-4 weeks between each 10% reduction.  SO GRATEFUL I have enjoyed a few days with manageable anxiety!

Great to hear that you are doing better. Please understand that you made a serious change in brand, form and dosage. So if I were you I would be careful and not too fast with the next taper. If things work out fine and you keep stable, you can still speed up the tapering. Often WD symptoms kick in after 2 weeks or later. Better start tapering in a safe and controlled way.

[JoJo1812]

My anxiety has decreased about 50% since I started reducing my Wellbutrin dosages.  I was originally taking XL 300, switched to SR to taper, and now I am at 70% of 300mg after 5 weeks.  I plan to stay on this level for a few more weeks.

 

The issue I have now is that I am SOOOOOOO tired that I sleep all the time and can barely stay awake all day.  Other than waking up at 2am every night, I sleep well at night.  Should I start tapering down on my Gbapentin 1,200mg/day?

 

Link to daily dose log

[JanCarol]

Hey JoJo - hypersomnia is a common, common effect of withdrawing (especially from Wellbutrin, in my experience!)

It's an indicator for you to go slow.  I had severe hypersomnia (18 hours a day) when I tapered too fast.  I suspect that Wellbutrin, being a "jazzy" antidepressant - might stimulate you to the point of straining your adrenals - so that when you go off it, you find out the true state of your fatigue.  But that's a theory, can't prove it.

 

It's great that your anxiety has dropped.  So the Wellbutrin may be jazzing your anxiety, and we picked a good drug for your first taper.

Maybe wait another week before considering a drop - see if you can balance a bit before tapering again.  Nobody ever complained about tapering too slow (though we have lots of complaints about too fast!).

 

Good work, I hope you see the sun today!  (I got a sun bath and a moon bath today)

[JoJo1812]

I could use some advice on my tapering plan.  I was doing well on my plan to taper off of Wellbutrin SR 300mg/day (now at 210mg/day since 4/27/23), and I was feeling really exhausted, so I reduced my Gabapentin 1,200mg/day by 10% on 5/4/23.  I had a setback to my confidence at work on 5/9, and since then I have been spiraling and unable to pull myself up.  The anxiety is quite severe.

 

More details here in my Daily Log

 

I could really use any advice or encouragement because this is really affecting my girlfriend too, and I'm afraid to lose her.

[Addax]

On 5/17/2023 at 8:05 PM, JoJo1812 said:

I had a setback to my confidence at work on 5/9, and since then I have been spiraling and unable to pull myself up.  The anxiety is quite severe.

It was almost strange to read this because I was going to write something similar in my thread. I was having some uncharacteristic self doubt for awhile then got some feedback at work towards the end of April that I interpreted negatively (because of how I was already feeling). My confidence tanked hard and it did not seem like I was going to bounce back, then morning anxiety amped up. Yesterday and again today I could tell I was coming out of it. so my encouraging message is a reminder that these waves of symptoms are temporary, they just never feel temporary until they pass. That’s why they are called waves.  Unfortunately, how soon they pass is never predictable, as is what can trigger them. 
 

Anything you can do to distract yourself from negative thoughts and from focus on your symptoms can often provide some relief. Whether it’s a movie, a mundane activity, a game on your phone, a walk… something to divert your attention.

 

The wave will pass. You’ll see.