https://www.alternativetomeds.com/blog/wellbutrin-tapering/Challenges of Wellbutrin Tapering and Titration
Below, we will discuss some of the main challenges and how to stay healthy during tapering from Wellbutrin (or any other of Wellbutrin’s namesakes).
An important challenge is estimating how quickly or slowly to administer a Wellbutrin tapering program. Alternative to Meds Center structures its Wellbutrin tapering programs with built-in monitoring, involving real-time discussions, and coordinated teamwork between the client and the various staff on your team.
Wellbutrin Discontinuation Syndrome
When weaning off an NDRI (Wellbutrin is an NDRI type of medication, targeting both norepinephrine and dopamine), a cluster of symptoms can commonly emerge, sometimes referred to as Wellbutrin discontinuation syndrome. These can occur regardless of whether bupropion was prescribed for depression, smoking cessation, or any other reasons.
Wellbutrin discontinuation symptoms may include:
brain zaps
flu-like symptoms, lethargy, headache, achiness, sweating
insomnia, vivid nightmares, and dreams
hyperarousal, mania, rage, aggression, agitation, anxiety, restlessness
jerky muscle motions
abdominal symptoms, nausea, vomiting, change in appetite
More information is given below on these and other adverse effects involved. Many clients come to us referred by their prescribers because they felt ill-equipped to navigate their patients through Wellbutrin discontinuation syndrome.
Often, more support is needed than can realistically be provided in an outpatient setting, and inpatient care is preferred.
Commonly, these adverse effects can occur while weaning off Wellbutrin including brain zaps, emotional upheavals, unusual sensory perceptions, disrupted sleep, and many more.
Abruptly stopping is NOT recommended, as it can intensify and even prolong these reactions.
Wellbutrin Tapering Guidelines and Schedule
wellbutrin tapering guidelines
Stopping Wellbutrin safely is not necessarily as simple as cutting the dosage over time. While mathematics does play a role, there is much more that can be done to make the process surprisingly comfortable, as well as efficient time-wise. Our goal at Alternative to Meds Center is to make it possible to actually improve the client’s health in the process. A gradual Wellbutrin cessation is important but is one part only of a multi-faceted process. This is best done within an individualized step-by-step process aimed towards regaining natural mental health, without drugs.
Your prescribing physician may be able to guide you on how to cut the dosage which may involve actually cutting the pills. In the case of Wellbutrin, the lowest dosage is 75mg yellow round tablets.
The tablets can be cut in half when needed providing a 37.5mg option, but it will lose the extended-release attribute, which reduces the half-life elimination of the drug. Be sure to ask your doctor about these matters.
Wellbutrin has a half-life of 21 (±9) hours,4 which is about average for antidepressants. The longer the half-life, the slower the medication will leave your body, which, generally speaking, makes the tapering easier. As is common with stimulants, fatigue, and depression are common features of this withdrawal.
Please note: The below information is intended to be shared with your prescriber and health care team and is not intended as medical advice or direction.
Examples of Wellbutrin Tapering Guidelines include:
Gradual tapering is recommended — exceptions include a medical emergency such as seizure or serotonin syndrome, etc. requiring immediate transport to a hospital for emergency intervention.
Get the smallest dose possible to work with, which in this case, is 75mg Wellbutrin yellow round tablets
You can cut the 75mg pills in half for smaller dosing but if you are using WellbutrinXL, it will lose its time-released attribute.
This means that the withdrawal onset may occur faster than 21 hours. A half pill would be 37.5mg.
Generally, 10-25% reduction is a good starting point — be alert to reactions that may require less of a reduction and adjust as needed, in discussion with your prescribing physician.
Withdrawals generally emerge around the drug’s half-life range. In this case, the elimination half-life is 21 (±9) hours depending on individual variability.3 Onset and duration of symptoms of withdrawal will be different for each person.
After a reduction, allow time to settle out at that level, for instance, 2 to 4 weeks, before attempting further adjustments.
If the final cuts are problematic, you may need to slow down at the end.
Please note that all the above estimated times can vary according to an individual’s general health, dosage, and other factors. Should a protracted withdrawal develop, be sure to enlist a professional to help you who is familiar with Wellbutrin alternatives and withdrawal management.