new joiner, tapering Wellbutrin and Citalopram. screen name "Gerberas"

[Gerberas]

Hello All!

 

I have read quite a bit of content here. Very good resource. Thanks for high quality contributions by Altostrata with the Lynx face, and many others. Quality seems very high. I have started my tapering from Anti-depressants. Looking forward to ridding myself of the side effects, and the hassle of having tablets with me everywhere.

 

Me, male mid 40's, some depression/mood disorder and Adult ADD-like symptoms (attention, distractibility, concentration) but without hyperactivity. Probably all connected.

 

Citalopram - started in 2002/3 - hasn't had much effect for years. Was initially good as buffer for work related anxiety/stress/burnout. I seem to have high sensitivity to withdrawal (I notice it when I am 2 or 3 hours late for a dose). So withdrawal issues the only reason I was still on it.

 

In February 2015 I started on Wellbutrin, for SAD (seasonal affective disorder) and ADD-like symptoms. Brilliant first few weeks, then the honeymoon was over and effectiveness dropped off. It no longer provides much positive or energizing effect, and upping the dose to 300mg brought on even stronger negative side effects (I seem to get most of the side effects I find listed "out there"). So my treating doctor has suggested I come off both - initially suggesting a steep drop off of by 1/4 a month, but agreeing with me for slower taper due to my sensitivity.

 

So, my baseline dosage before tapering was Citalopram 20mg and Wellbutrin XR 150mg.

 

I have been tapering both simultaneously for a month. Ok so far - some recognizable Citalopram withdrawal effects in weeks 2-3 but ok again now. Having just read, I thought I would heed the advice to taper only one at a time from now on in, due to potential synergistic nature of the combination. A positive already is that Orgasm is much sweater, more pleasurable and less delayed, even after this short period. 

 

Today I am on:

1. 1/2 a cut 150mg Wellbutrin XR (I went from 1 to 3/4 to 1/2 in 4 weeks and going off fast seems to be going just fine despite the sustained release feature being bypassed by cutting it). 
2. 3/4 a cut 20 mg Citalopram. Have taken it gently by using the larger "quarters" initially and now using the smaller "quarters" (a cut tablet never provides neat 1/4' s)

 

Incidentally, or not: Advice from my psychiatrist was to switch from Citalopram to a longer acting (longer half life) SSRI drug like Prozac and then taper from that for a less bouncy ride. However I am going for a straight reduction, 10% or so at a time, gradually, for the sake of simplicity. I have read all the posts about the merits of the 10% taper.

 

A question though. One person says that serum SSRI concentration goes up when on Wellbutrin (they apparently compete for metabolism), so going off Wellbutrin can shake up the SSRI effects (and risky if tapering off both simultaneously, if the absence of Wellbutrin can allow sharp drop-off in serum SSRI concentrations!). Any other corroborations of that out there (either research based or based on your own experience)? 

 

thanks,

"Gerberas"

[Altostrata]

Welcome, Gerberas.
 
Thank you for doing all that research!
 
Yes, a direct taper from citalopram is less risky than switching drugs. You may wish to use a liquid for more precise reductions. See Tips for tapering off Celexa (citalopram)

 

Many psychiatric drugs are metabolized by the same liver enzymes. This can cause a traffic jam in the liver causing a backup of some drugs. Citalopram and buproprion share some pathways, but you'll be tapering slowly enough so this probably won't be a problem.