User87222: Tapering of off Wellbutrin XL in fear of drug interactions

[User87222]

Long story short, my primary doctor had some sort of medication plan for me, then due to a family emergency moved upstate and left her practice. Now I'm stuck dealing with several doctors who have either given me medication that had harmful side effects (100mg of Trazodone on top of my other medication spiked my blood pressure so high it nearly killed me), or doctors who want to completely take me off of the medication I'm currently on (no tapering) and switch me directly over onto something in a completely different drug class. It seems the best course of action would be to just taper off of my medication and see where I stand psychologically after that.

Due to my line of work I know enough about medication to know that what they want me to do at this point is dangerous, but I'm positive this forum knows more than me, and at this point I'm not sure where else to turn. My insurance isn't leaving me with many options unless I want to pay a ton of money out of pocket just for a doctor to give me advice.

Here's where I'm at right now:

I'm currently on 450 mg of Wellbutrin XL once daily and 1 mg of Xanax three times daily due to some psychological problems apparently due to PTSD. I've been on this medication for four years. The Xanax I won't discuss here, I just thought that would be important from a drug interaction standpoint.

I figure tapering off of the Wellbutrin FIRST would be the best option, however I can't get any doctor to change any of my current medication. They're "afraid to mess around with it." To be more specific: I take a 300 mg tablet AND a 150 mg tablet every morning. I'm figuring, not being able to get a script for a different release type of Wellbutrin, two differing dosages of pills could at least help, I've just been on it for so long I'm not sure about the time frame in which to drop the dosage.

Any help would be greatly appreciated, this has been going on for months now.

(Also, apologies for posting this in the wrong sub-forum. Was in a rush and didn't notice support right above this)

[scallywag]

Hi User87222! -- Welcome to Surviving Antidepressants (SA)
 
I hope you'll find the information in the SA forums enlightening and helpful for your taper.  I'm sorry that you are in the position that you need the information, but am glad that you found us -- especially before you start reducing your Wellbutrin dose.
 
As you plan reducing dosage, please read these topics:

Why taper by 10% of my dosage?

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

Using a digital scale to measure doses

Making a liquid from a tablet or capsules
 
A request: Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-18 months particularly? Any drugs prior to that can just be listed with start and stop years. Please put your withdrawal history in signature
 
A tip: You may way want to follow this topic so that you get notifications when someone posts in your thread.  Click the gray "Follow this topic" button. A dialog box appears:  select one of the notify options, then click follow this topic in the dialog box.

 

Setting this web page as a bookmark or favorite in your browser will help you navigate back to it.

 

This is YOUR introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.

 

Have a read of the topics I've posted as links above. Come back to your intro topic (here) and post your questions.

[Shep]

Hi, User87222. Welcome to the forum from me, too. 

 

It sounds like your use of Trazodone was brief, but please list the of time you took Trazodone and when you came off. Combining multiple antidepressants can indeed raise blood pressure, but I'm hoping that is resolved for you now.

 

You are wise to come off the Wellbutrin first before tackling the Xanax. Coming off the "activating" medication before the "sedating" meds will help with symptoms such as anxiety and sleep. With PTSD to deal with, this is especially important. Please see this link for more information:

 

Taking multiple psych drugs? Which drug to taper first?

 

I placed Wellbutrin and Xanax in the Drug Interactions Checker. There is a moderate interaction, due to Wellbutrin's side effects including the possibility of seizures.

 

 

Interactions between your selected drugs

alprazolam   buproprion

Applies to: Xanax (alprazolam), Wellbutrin (bupropion)

Moderate

 

Excessive use of alprazolam, or abrupt discontinuation following long-term use, may occasionally trigger seizures in patients taking bupropion. Talk to your doctor before using these medications together if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

So this is even more of a reason to come off the Wellbutrin first. I came off Wellbutrin back in 2006 briefly and again in 2011, and this was also a concern I had. By coming off the Wellbutrin first and keeping your Xanax dose steady, you will lower this risk. 

 

We have a members-only Benzo forum which contains a great wealth of information:

 

Members only benzo forum

 

The Ashton Manual will give you more information on what to expect with benzo withdrawal:

 

The 2002 Ashton Manual is at http://www.benzo.org...anual/index.htm

 

The April, 7 2011 Ashton Manual Supplement is at http://www.benzo.org.uk/ashsupp11.htm

 

The majority of Dr. Ashton's work was done prior to much being known and circulated about antidepressant discontinuation, so you may run across comments about her recommending antidepressants to help with benzo withdrawal. This, of course, is something we do NOT recommend. But most of her research on benzo withdrawal is relevant and provides a lot of insight into these drugs. 

 

You may find some ways of handling not only your withdrawal symptoms, but very good ways of dealing with PTSD. I also have a PTSD diagnosis along with a few other labels, but I found that mindfulness and improved nutrition have resolved a lot of those problems. Simply getting off these drugs really helped stop the repetitive thoughts that fed into the PTSD. This link will get you started on some non-drug coping methods:

 

Non-drug techniques to cope with emotional symptoms

 

Again, welcome to the forum. You'll find a lot of information and support here.

 

[JanCarol]

Doctors are funny creatures.  They like to be in charge.  They like to know more than you.  They like to be revered and respected.  They do not like Dr. Google.

 

It is weird to me, that doctors (consistently) will not prescribe reduced doses of these psych drugs, and sometimes people have been "fired" from their doctor for asking to taper.

 

We have a number of strategies to get what we want from doctors.  Start here:

How do you talk to a doctor about tapering and withdrawal?

 

You can always try another doctor until you find one who will cooperate with you (even if they don't agree with you).

 

You are also in a very special time and place - you are doing your homework before you start your taper!  Good for you!  It is such a relief to people like me to hear this, instead of hearing how bad it has gone "listening to doctors advice" which often includes skipped doses, cold turkeys, cold switches, and too-fast tapers.  So - you are in a key position to plan for your taper and get some support in place before you start.

 

Here are three of my "before you taper" discussions:

Icarus Harm Reduction Guide to Coming off Psych Drugs

Psych Central 6 Ways to Prepare for Antidepressant Withdrawal

and

Preparing to Taper