vetdoc going off valium and Wellbutrin

[vetdoc]

Hi

 

I am new to this forum, coming from benzobuddies forum. I was on an AD wellbutrin for 7 years and then a P Doc took me off cold turkey and I wound up in a psych hospital for 10 days December 2012,  I was reinstated on Wellbutrin in the hospital and upon leaving I found a new P Doc immediately. 

 

He diagnosed me with Bipolar ll. He kept me on the Wellbutrin and added Lamictal and 40 mg Valium for insomnia.  I became tolerant after 3-4 months to the Valim and  I started a micro taper off the 40 mg valium 1/2013. 

 

I am currently at 1.5 mg as of 10/01/2014.  Withdrawl symptoms were not to severe with the micro taper until 3mg valium.  Now down at 1.5 mg withdrawl symptoms are pretty intense ,insomnia, anxiety, feeling poorly.  My P doc didn't want me to come off of the valium because he thought it helped with keeping my bipolar stable.  He agreed to help me with the taper if I wanted to get off.   I just wanted to get off because I was tolerant and didn't want to stay on a benzo any longer. 

 

I also recently decided I would like to decrease my AD dose after I am off the benzo, but I'm not certain I can completely taper off because of my bipolar.  I discussed this with my P Doc and he said he would consider this after I'm stable on  my valium taper.  I was reading thru some posts here and noticed that tapering the AD first might have been better then tapering the benzo according to many here.  I started my benzo taper first because I wasn't  going to  taper down my AD at the advice of my P doc..   I have decided that I would like to taper down my Wellbutrin at least to a lower dose but I assume I should wait till I am off the benzo at this point?   

 

If I do taper down my Wellbutrin will it be harder now that I am tapering off the benzo first   Also I need some advice  about getting off the 6mg of Doxepin (Silenor), I have been taking for insomna the past year, it is no longer helping with my insomnia.  Since  it is such a low dose do I need to taper off this slowly or can I just jump off. 

 

Thanks

[bubble]

Hello Vetdoc and welcome to SA,

 

thank you for providing your drug history. We have a separate section here on tapering benzos because the main forum, as its name suggests, deals with tapering antidepressants. It would be good if you start a thread there to look in more detail at your situation with Valium taper. You didn't write what you mean by micro taper, that is how much you have been cutting and how frequently and if you had any holding periods in between. However, judging by increase in symptoms, I would say whatever speed you were taking, it has become too fast for your nervous system to catch up and adjust. That's why more details on the benzo section would be very helpful. http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-tapering-discussion/

 

I don't know much about benzo buddies but it seems that the main difference with the approach here is that we believe in holds which help our CNS to rewire after the drug has been removed which is particularly important at low doses. 

 

The second thing is that we don't believe in psychiatric labelling and bipolar II in particular. It happens very often that people get labelled with it just like you after abrupt discontinuation of a drug when they are in fact suffering from withdrawal. I like how our member mlrp explained the tendency of psychiatrists to label what is actually a pattern of recovery through windows and waves as "mental illness".

• I can totally see how a person who has been put on these drugs, or is attempting to taper off of them, and who experiences windows and waves could easily be misdiagnosed by some shrink as bipolar.  During windows, I am almost always overtaken by immense joy at simply being alive and feeling symptom-free. Add to that the accompanying desire to "make up for lost time" by reconnecting with people, picking up dropped interests, and taking big bites out of life once again, and I can just see the raised eyebrow on a pdoc's face. I'm pretty much done sharing any details with pdocs, myself, but just sayin'

 

Since you are taking 4 drugs at the moment, it would be good to check them for possible interactions: 

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

 

You are right that we recommend tapering ADs first since they are more activating. You probably read about the rationale behind it here: http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/

 

What I would advise in your situation now is HOLD until the symptoms subside. Don't introduce any new changes. Hold even with the Valium taper. While you are allowing your CNS to recover from what seems to be a too fast taper, learn about the best approaches to coming off these drugs. There is a lot of valuable information here which will enable you to safely come off the drugs without causing even harsher symptoms than you had before being put on drugs which psychiatrists then blame on "illness" while it is just a too fast or mostly no taper. Check this section for non-drug way of managing symptoms that you are currently experiencing: http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

 

You don't have to taper the benzo off completely before you start tackling the antidepressant but you have to hold for as long as it takes for the symptoms to subside between the two tapers. I'm for instance tapering benzo to a certain dose. Then I will hold with the benzo at that dose and start tapering AD and end with tapering benzo till the end. WITH LONG HOLDS IN BETWEEN.

 

Here is very important information on Doxepin that you might want to check: http://survivingantidepressants.org/index.php?/topic/3914-tips-for-tapering-doxepin-sinequan-zonalon/

 

When the time comes you can read about our approach to tapering in more detail. Now I will just copy a post which explains the importance of holds and what is happening with our brain while holding.

 

Welcome once again. If you have any questions, just post them and sorry for throwing so much info at you

 

best,

bubble

 

Rhi on how drugs change our brains/regowing a new brain through tapering

 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

When the drug is removed, the remodeling process has to take place in reverse.

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

It's a matter of, as I describe it, having to grow a new brain. 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected. 

 

[vetdoc]

Hi bubble

 

Thank you for your response to my post. I will start by taking you recommendations and post on the benzo section for my valium taper.  I do agree with you about the B polar label put on me by the P Doc.  I told my wife I never had any issues with mental problems until I cold turkey my AD and went thru sever withdrawls putting me in the hospital.  Then I was labeled Bi polar because of my severe symptoms with the withdrawl.  Thats when everything went down hil,l because besides being reinstated with the AD wellbutrin which was probably a good thing at the time, they added in 3 more drugs, Lamictal, Klonopin, and Doxepin.  I lost 3 years of my life thus far becasue since 2011 I have become a shell of the man I was before all this happened.  I no longer have the energy to do much besides dragging myself to work and back home.  I have very little social interaction any more and I am not a very happy joyous person anymore.  I used to be a strong,vibrant, sharp minded individual with confidence and the ability to take care of myself, but I no longer feel that way about myself.  I need to get my life back if it's possible not only for me, but for my wife and son.  I am glad I found this forum and look forwar to interacing and getting advice from members like yourself.

 

Thank You

[mammaP]

Hi vetdoc, there is nothing to add to the info that Bubble has given you but just wanted to say hi.

I am another one who gained the bi-polar label after being put on the drugs merry go round!

That was 20 years ago and I started to taper off  about 2 and a half years ago.  

 

You will get your life back, and if you taper slowly and carefully it will be without too  much trouble

along the way.  

[vetdoc]

Thanks Mamma P

 

I appreciate your comments and encouragement.  I will stay positve and work toward gtting my "life" back

[vetdoc]

Please note that some posts in this Intro have been merged from a post in the Tapering section,  Hence, the two introductory posts. -Jemima

 

 

I was on Wellbutrin for 7 years prior to the start of this hellish journey.  It all started with the pain killer oxycodone which I took for several months for a picnhed nerve in my neck back in January 2011. 

 

Once my neck pain improved in several months my Doc told me to just stop taking the oxycodone cold turkey.  I went into severe withdrawls  almost psychotic and not knwing what was happening to me I sought out a P Doc.  The P Doc said I had severe anxiety from the oxycodone withdrawls and he told me to immediately stop the 300mgxl wellbutrin I had been on for 7 years cold turkey and he put me on Seroquel.

 

So I stopped the Wellbutrin and had already stopped the oxycodone 10 days earlier.  I felt miserable and told my P Doc , but he said I would be alright.  I continued to get worse with increased anxiety and suicidal thoughts over the net week and I was put in a psyciatric ward in the hospital. Febuary 2011.   I was reinstated on Wellbutrin in the hospital and also Lamictal and they diagnosed me with Bipolar ll even though I told them I never had a history of mental Illness for 50 years. 

 

I was discharged form the hospital and sought out a new P Doc who added Klonopin 2mg and Doxepin 6mg for insomnia.    I became tolerant after 4-5 months to the Klonopin and was put on Doxepin for sleep along with the Klonopin.    I started my own  micro taper January 2012 off the Klonopin reducing by 10% every 3-4weeks. I crossed over to 20 Valium  when I tapered to 1mg Klonopin.  I continued my taper and I am now at 1.5 mgs of Valium. 

 

I didn't have major withdrawl symptoms during the slow taper until I got down to about 3 mgs valium.   Now down at 1.5 mg withdrawl symptoms are pretty intense ,insomnia, anxiety, feeling poorly.  My P doc didn't want me to come off of the valium because he thought it helped with keeping my "bipolar stable".  He agreed reluctantly allowed me to taper and continued to wrie scrits for valium to help me to taper.  I just wanted to get off because I was tolerant and didn't want to stay on a benzo any longer. 

 

I am now at a point were I realize all these medications have been wreaking havoc on my life.  I fell terrible I really am a shell of the person I used to be both mentally and physically.  I never had any mental Illness before except ADD, and I was taking the Wellbutrin with no problem until the cold turkey on the Oxycodone which started this whole nightmare. 

 

I would like to decrease my AD dose after I am off the benzo, but I'm not certain I can completely taper off if I truely have Bipolar ll which I am quite skeptical about being diagnosed at the age of 54.  I discussed this with my P Doc and he said he might consider this after I complete  my valium taper. 

 

I was reading thru some posts here and noticed that tapering the AD first might have been better then tapering the benzo according to many here.  I started my benzo taper first because I wasn't  going to  taper down my AD at the advice of my P doc..   I have decided that I would like to taper down my Wellbutrin first at least to a lower dose because I think it is adding to my severe insomnia from the valium withdrawls.  I assume I should wait till I am off the benzo at this point before I start tapering my Wellbutrin.

 

If I do taper down my Wellbutrin will it be harder now that I am tapering off the benzo first   Also I need some advice  about getting off the 6mg of Doxepin (Silenor), I have been taking for insomna the past year, it is no longer helping with my insomnia.  Since  it is such a low dose do I need to taper off this slowly or can I just jump off.  Sorry for the long post .but I just wanted to give a complete history of my situation.

 

Thanks

Edited June 17, 2015 by Altostrata
added paragraph breaks

[Jemima]

Welcome to the forum vetdoc.  I moved your topic from 'Tapering' to 'Introductions and updates' where it will likely get more attention.  The Tapering and Symptoms sections are mainly sections for reference material where people go for information.

 

What you can do is hold on the Valium taper, get stabilized, and then, after several months, start tapering the Wellbutrin. I am tempted to say that you might want to updose the Valium while getting off the antidepressants, but I'm no expert on benzos, so I suggest you post about this in our benzo section: Members-only Benzo Tapering Discussion .  Rhi, one of our moderators, has extensive experience with benzos and will no doubt have some very good advice.

 

Doxepin is an older type of antidepressant, a tricyclic, and those should be tapered slowly just like the newer SSRI drugs. But taper just one drug at a time. A few members have tapered several drugs at a time, but Rhi is the only one I know of who's done it successfully and she has a strong background in science.

 

Are you still taking Lamictal?

 

Welcome to the forum, vetdoc.  You'll find lots of solid information and friendly support here.

[vetdoc]

Jemima

Thanks for your input and I will hold on my Valium taper for awhile.  I will check on the benzo board what they suggest.  Yes I am still on Lamictal and will taper that at some time in the future.

[vetdoc]

Hi

 

I was on a valium taper down to 1.7 mgs and holding to get more stable.  The past several weeks I developed some new symptoms related to Wellbutrin.  The 300 xl Im taking has started to cause me severe agitation, pressure headaches and marked insomnia which is starting to be unbearable.  It starts about one hour after my wellbutrin dose and lasts all day.  I did change my country of origin for getting my Brand Wellbutrin from   Canada to brand name in the USA about a month ago.  I don't know if there is some connection here to my symptoms by  changing the country of origin for the meds.  Unfortunately I don't have any Canada made pills left to switch back to in order to check this out.  I have decided to just start tapering using the US brand using 100mg SR tabs and IR tabs. I want to reduce by 50 mg to start the taper.   My Pdoc said to take 200 mg of the SR in the morning and 50 mg of IR in the late afternoon to help getting better sleep at night.  I am concerned about taking 200mg SR all at once in the morning due to the activating effect it may have on me being sensitive to the drug at this point.  I would like some input form you guys on what you think about my situation and best way to taper the wellbutrin.  I will be holding the valium taper 1.7mg at this point and may updose to 2 mg   during the wellbutrin taper.

 

Thanks

[Altostrata]

vetdoc, I moved your post from the Tapering section, which is mainly for reference.

 

See Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

[vetdoc]

vetdoc, I moved your post from the Tapering section, which is mainly for reference.

 

See Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

I have a question on starting my  taper of my Wellbutrin dose.  I will be starting with a 10% reduction from 300g xl.  When I need to cut a tablet in half or quarters there is no way to get an exact cut, to have the same amount of Wellbutin in each section.  I know with my benzo taper I never cut a tablet, I always used a whole tablet for my daily dry dose and calculated the additional dally amount of benzo needed from a liquid suspension.  This was to get a more exacting dose on each taper cut.

 

So my question is do I need to be that exacting with the Wellbutrin taper, as the benzo taper especially at the beginning higher doses. 

 

I read in the Wellbutin taper thread it is ok to cut up pills  to make up part of the total daily dose amount.   It would certainly be easier to cut the pills rather then to make up a nightly suspension.  I assume that since it was stated that cutting pills in sections is ok then the AD daily taper dosing  does not have to be as exacting as the benzo taper.  Please advise if I my assumptions are correct.

 

Thanks

[mammaP]

Hi Vetdoc, you should be fine cutting up the tablets at the higher doses, it is the lower doses that

seem to cause the problems. Let us know how it goes for you.

[ang]

 

Hello Vetdoc and welcome to SA,

 

thank you for providing your drug history. We have a separate section here on tapering benzos because the main forum, as its name suggests, deals with tapering antidepressants. It would be good if you start a thread there to look in more detail at your situation with Valium taper. You didn't write what you mean by micro taper, that is how much you have been cutting and how frequently and if you had any holding periods in between. However, judging by increase in symptoms, I would say whatever speed you were taking, it has become too fast for your nervous system to catch up and adjust. That's why more details on the benzo section would be very helpful. http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-tapering-discussion/

 

I don't know much about benzo buddies but it seems that the main difference with the approach here is that we believe in holds which help our CNS to rewire after the drug has been removed which is particularly important at low doses. 

 

The second thing is that we don't believe in psychiatric labelling and bipolar II in particular. It happens very often that people get labelled with it just like you after abrupt discontinuation of a drug when they are in fact suffering from withdrawal. I like how our member mlrp explained the tendency of psychiatrists to label what is actually a pattern of recovery through windows and waves as "mental illness".

• I can totally see how a person who has been put on these drugs, or is attempting to taper off of them, and who experiences windows and waves could easily be misdiagnosed by some shrink as bipolar.  During windows, I am almost always overtaken by immense joy at simply being alive and feeling symptom-free. Add to that the accompanying desire to "make up for lost time" by reconnecting with people, picking up dropped interests, and taking big bites out of life once again, and I can just see the raised eyebrow on a pdoc's face. I'm pretty much done sharing any details with pdocs, myself, but just sayin'

 

Since you are taking 4 drugs at the moment, it would be good to check them for possible interactions: 

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

 

You are right that we recommend tapering ADs first since they are more activating. You probably read about the rationale behind it here: http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/

 

What I would advise in your situation now is HOLD until the symptoms subside. Don't introduce any new changes. Hold even with the Valium taper. While you are allowing your CNS to recover from what seems to be a too fast taper, learn about the best approaches to coming off these drugs. There is a lot of valuable information here which will enable you to safely come off the drugs without causing even harsher symptoms than you had before being put on drugs which psychiatrists then blame on "illness" while it is just a too fast or mostly no taper. Check this section for non-drug way of managing symptoms that you are currently experiencing: http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

 

You don't have to taper the benzo off completely before you start tackling the antidepressant but you have to hold for as long as it takes for the symptoms to subside between the two tapers. I'm for instance tapering benzo to a certain dose. Then I will hold with the benzo at that dose and start tapering AD and end with tapering benzo till the end. WITH LONG HOLDS IN BETWEEN.

 

Here is very important information on Doxepin that you might want to check: http://survivingantidepressants.org/index.php?/topic/3914-tips-for-tapering-doxepin-sinequan-zonalon/

 

When the time comes you can read about our approach to tapering in more detail. Now I will just copy a post which explains the importance of holds and what is happening with our brain while holding.

 

Welcome once again. If you have any questions, just post them and sorry for throwing so much info at you

 

best,

bubble

 

Rhi on how drugs change our brains/regowing a new brain through tapering

 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

That's not what happens with medications that alter neurotransmitter function, we are learning.

 

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

 

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

 

When the drug is removed, the remodeling process has to take place in reverse.

 

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

 

It's a matter of, as I describe it, having to grow a new brain. 

 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected. 

 

 

Thankyou so much.  I never was labelled anything till I went hyper on Dothiepin, told everyone in the world how wonderful I felt, and how wonderful psychiatrists are,  and had a siezure, then I was told, no I had an "Underlying mania, that was exposed by the dothiepin", and now I read that  such and such reactions occur in "susceptible individuals"... makes it sound like the individual is to blame, not the damn drug.... what a load of rubbish, but believed it then.  I never had any problems, no labels, until I was 35, and went to a bad doc who believed in prescribing big doses  "as we are all different",, but now I don't trust any of them.  And now I got a whole heap of labels on my medical file.  If I got hit by a bus now, first thing they would do in hospital probably would be put me on an antispychotic. Hope its not a valium, because I know that would kill me, been there, done that.  I dont want to move cities, but I wonder if I might have to. I might have to go and see a doc... because my drivers licence says "to take medication as prescribed by the doctor"..... so I better make sure SOMEONE in authority, knows I am only on 50mg Seroquol at present.

[vetdoc]

Hi Vetdoc, you should be fine cutting up the tablets at the higher doses, it is the lower doses that

seem to cause the problems. Let us know how it goes for you.

 

OK thanks  I've had to make a liquid suspension in my benzo taper at low doses.  It sounds like a similar scenario for the AD.

[vetdoc]

Hi

 

Any body have an opinion when tapering Wellbutrin would there be a big difference using only  Wellbutrin SR tablets twice daily to taper vs mixing  SR and IR tablets for a combined  daily dose.  I know they can both be used, but since I am just starting the taper I would like some input from  those that have experience with Welbutrin.  I will be reducing down from 300mgxL, using a 25 mg reduction for my first taper.  I was planning on taking a large  200mg SR dose in the morning and a  75 mg IR tab.for the afternoon dose.    The other option would be to just use all SR tablets take the 200mg SR morning dose and  cutting up 100mg SR tab for the 75mg  afternoon dose.  I;m thinking that taking the 75mg IR tablet   in the afternoon might give me less insomnia compared to using the cut up SR tablet for the 75mg afternoon dose. I do have insomnia issues since tapering my valium the past few years, still on 2mg valium.    I'd appreciate some input from you guys since I am just starting the taper much earlier the I want due to adverse effects from the Wellbutrin.

Thanks

[Meimeiquest]

You might just have to experiment. The SR AM, IR PM plan might be just right. I don't think changing it up if necessary would be too much for most people. If worse came to worse you could do 50 SR immediately on awakening, 150mg XL a couple of hours later, and 75mg SR about 2PM. But you probably don't need it that smooth. By the time I got down to just IR as a liquid, I was dosing four times a day, last dose 4PM. But I had a difficult relationship with Wellbutrin, many aren't that sensitive.

[vetdoc]

You might just have to experiment. The SR AM, IR PM plan might be just right. I don't think changing it up if necessary would be too much for most people. If worse came to worse you could do 50 SR immediately on awakening, 150mg XL a couple of hours later, and 75mg SR about 2PM. But you probably don't need it that smooth. By the time I got down to just IR as a liquid, I was dosing four times a day, last dose 4PM. But I had a difficult relationship with Wellbutrin, many aren't that sensitive.

 

Thanks Meim  My biggest concern is having been on the 300xl which basically is a 24 hr tablet, now that Im experimenting with shorter acting wellbutrin will I have a period later in the night were I won't have blood levels of the drug.  I don't know much about the pharmacology of wellbutrin,but I don't want to destabilize myself

by not taking the drug properly and having it maintain proper blood levels.

[Wildflower0214]

I tried to answer you question in Benzo section... Just so u know.

 

Peace

[Meimeiquest]

http://psychopharmacologyinstitute.com/antidepressants/bupropion-psychopharmacology/

 

I know I am posting in the wrong thread but couldn't find the right one.

 

The link above has a graph in it comparing the pharmacology of the hree forms of bupropion. I found it very helpful to learn all I could about those types of things during the taper. Apparently steady state is achieved in eight days and the half-life is 21 hours plus/minus 9 hours, lots of variability.

 

I doubt that you are reacting to the inactive ingredients...most of the people who become that sensitive have been through CT's. But the extended release mechanism may not be the same between the Canadian and American versions, leading to different patterns in blood levels. Your symptoms don't sound like typical "I raised my benzo too much" symptoms, but of course anything is possible. I think it is something with the timing or amount of Wellbutrin. Tracking your symptoms throughout the day might help you figure that out. Also, I really think the pharmacodynamics change as you lower doses, as the liver or kidney can process a drug faster. Definitely a moving target. Not so much in the first 10%, but later.

 

In all openness, I have to say I did not do well off Wellbutrin. I ended up working with mensahmedical.com, which has helped me immensely. They work out of their clinic or in mini-consults by phone which is cheaper but less comprehensive. Actually, doing a lot of things which I have tried to keep up with on my thread.

 

Between Christmas and all the threads coming up right now, if you would like my rank amateur opinion about anything, it would be easier if you sent me a pm. It will be worth exactly the cost

 

So pulling for you!

[vetdoc]

Hi

 

I have gotten into a major crisis the past week and I'm am becoming more unstable then I have ever been in years.   I am a regular poster on the benzo section and they have been great helping me with my valium taper and giving me support thruout  when I need it.  I presently am on a valium taper and have been holding at 1.7mg mg for about 2 months now to  stabilize some symptoms from my valium withdrawal.   All thru the 2 year valium taper I was functional enough to work and exercise with manageable symptoms until now.

 

 

 I'm starting a new thread and  posting this on the AD section at the suggestion of Skylar, because I desperately need advice and opinions  on whether my new symptoms are related to my Wellbutrin AD and not my valium taper.  I know there are extremely knowledgeable people on this board who have a lot of experience with AD.

 

The symptoms I am having now which started last week are  destabilizing me to the point that  I'm getting in  crisis mode, because I can't get a handle on what is truly happening.   Those guys over on the benzo section have supported me and continue to support me with  this, but I just want to see if some  AD experts can chime in here and give some opinions on the best course of action. 

 

The increased symptoms I am experiencing are anxiety,brain fog,mental pain and dullness,difficult concentrating ,some depression, insomnia  and tinnitus which I have never encountered before now.  The combination of these  symptoms all at once are leaving me dysfunctional to the point I was forced to take off  work this week. 

 

The only changes I have made to my meds recently were to updose my valium  .2 mgs two months ago.  Also  5 weeks ago I changed  my supplier of the  300mg Wellbutrin XL forn Canada to the US.  I was getting my  Wellbutrin brand name from a canadian pharmacy for the past 2years.  I ran out before I had time to order so I switched to Wellbutrin brand name in the US.  The US brand and the canadian brand are both owned by the same company Valeant so I would think they have the exact same chemical makeup . However it is possible some of the binders or expediants might be different?  The fact that I just started taking this US brand Wellbutrin 5 weeks ago and now have become unstable makes me question if this switch might have caused the problem.  I ordered more Canadian brand wellbutrin but for now I need to take the US brand.

 

I spoke to my Pdoc 5 days ago and he wanted me to drop down to 200mg SR once day from 300mg XL once day.  He also wanted me to up my lamictal to 300mg from 200 and increase my valium to 15-20 mg.  There is no way I can increase my Valium to those doses after tapering for 2 years down to 1.7mg valium.  I would like to decrease the wellbutrin but dropping  100mg might cause some additional problems?  I don't know what to do about the lamictal.

 

Here is what I have done thus far starting 4 days ago.  The first day I only took 100 mg wellbutrin on the advise of my Pdoc to see how I felt.  I did feel somewhat less anxious, less brain pain and fogginess. The second day  I started taking wellbutrin 200mg sr in the am and 75mg IR around 5 pm.  I updosed the valium from 1.7mg to 2 mg.  I did not change the lamictal dose.   I have been on this medication change for 4 days now.  I seemed to feel somwhat better the day I only took 100 Wellbutrin SR and the second day on the 200mg SR and 75mg IR.  The past 2 days I don't feel right, head very unclear, foggy and some anxiety.  Maybe not as  as bad as when I was on 300mg XL but not normal at all.  The tinnitus is bad becasue it is constant and just reminds you that your not well. The tinnitus started around second day of reducing the Wellbutrin and updosing valium to 2 mg.  I hope I didn't cause this by updosing valium .3mgs.

 

Please guys give me some opinions and possible advice on what you think here.  I'm really confused and starting to get a bit scared.

 

Thanks

 

 

 

 

 

 

 

 

 

[Altostrata]

vetdoc, I merged your two Intro topics. Only one topic to a person in the Intro forum.

 

It sounds to me that perhaps the change in brand of Wellbutrin is significant. It could be the new brand is somewhat stronger than the older one. Some people are sensitive to differences in brands.

 

You may wish to reduce your dosage somewhat. Going from 300mg XL to 200mg SR once a day seems like quite a big drop to me. You may wish to continue to take one 200mg SR plus the 75mg IR tablet later in the day for a total of 275mg.

 

Be sure to be very regular in the times you take your drugs. I would not add any other drugs or increase any other dosages. It may take some time for your system to settle down because of the change in Wellbutrin.

 

(IMHO, your pdoc is over-reacting and, as they so often do, throwing prescriptions at the problem.)

 

Read this carefully: Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

 

(Thanks, meimei. I've added some of that info to Tips for tapering off Wellbutrin, SR, XR, XL (buproprion) )

[vetdoc]

vetdoc, I merged your two Intro topics. Only one topic to a person in the Intro forum.

 

It sounds to me that perhaps the change in brand of Wellbutrin is significant. It could be the new brand is somewhat stronger than the older one. Some people are sensitive to differences in brands.

 

You may wish to reduce your dosage somewhat. Going from 300mg XL to 200mg SR once a day seems like quite a big drop to me. You may wish to continue to take one 200mg SR plus the 75mg IR tablet later in the day for a total of 275mg.

 

Be sure to be very regular in the times you take your drugs. I would not add any other drugs or increase any other dosages. It may take some time for your system to settle down because of the change in Wellbutrin.

 

(IMHO, your pdoc is over-reacting and, as they so often do, throwing prescriptions at the problem.)

 

Read this carefully: Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

 

(Thanks, meimei. I've added some of that info to Tips for tapering off Wellbutrin, SR, XR, XL (buproprion) )

Thanks Alto

 

I'll try and hold tight and just take the 200mg SR morning and the 75mg IR in the afternoon.  I will hope that I get some symptom relief over the next week, I need it.  Do you have any idea why I suddenly developed tinnitus as these symptoms escalated?  I"m starting to wonder  if maybe I have brain damage from these poison meds.

[Altostrata]

Tinnitus can be a side effect of the drugs, also a common withdrawal symptom.

[vetdoc]

 

Tinnitus can be a side effect of the drugs, also a common withdrawal symptom.

 

Alto

  The acute symptoms  that just started after I switched Wellbutrin  brands from one country to another I have done a lot of thinking.   I just remembere I actually left a possible important event out about my history with Wellbutrin in my original introduction post, which I will allude to now.   I had been on 300 mg xl Wellbutrin US Brand and generic for about 9 years for "ADHD" up to November 2010 with no issues.  December 2010 I developed acute  withdrawls from a C/T off  oxycontin which  I was taking as a painkiller.  I went to a PDoc (big mistake),  because  I was so distressed from the severe  mental withdrawal symptoms.   He proceeded to discontinue all meds including Wellbutrin C/T and put me on seroquel, which made me worse.  He tried to reinstate the Wellbutrin about a month later but  I got so activated and so agitated form it I felt like I was going crazy, so he discontinued the reinstatement.  I wound up in the hospital  about 2 weeks later  (Jan,2011), when I had   severe anxiety,psychosis and near suicidal thought..   That is were I was diagnosed with "Bi Polar" and put on Lamictal and Klonopin.  Then 2 months later (March 2011) I was  put on Wellbutrin again by a new Pdoc and have been on the 300mg xl up to now with not serious side effects.

 

So my question is since  I was previuously CT off Wellbutrin, had a failed reinstatement and then later put back on it may have sensitized my brain to Wellbutrin in any way.  . Could this possibly  make my present taper off Wellbutrin more bumpy.  If so would you advise a slower taper then 10 % a month.?  I also wonder if  the  the C/t off wellbutrin many years back could have been a factor in bringing on the acute  symptoms I am experiencing  with the recent switch from one country Wellbutrin brand to a different country brand.

 

I do know that the C/T off both Wellbutrin and Oxycontin led to severe insomnia which has continued ever since and definitely has  worsened thruout my slow Valium taper.

 

Thanks Alto

[Altostrata]

vetdoc, your nervous system may be sensitized by all your drug adventures, it's probably not the Wellbutrin specifically.

[vetdoc]

vetdoc, your nervous system may be sensitized by all your drug adventures, it's probably not the Wellbutrin specifically.

Alto

I have no doubt that is.  In light of this would a more cautious approach to tapering any of my meds be warranted.  Instead of the usual 10% a month would a slower taper possibly be less of a shock to my system or  taper at the "norma"l recommended rate and let what my body tells me be my guide.

 

Thanks

[Altostrata]

Yes, you may be sensitized to changes in any of your drugs.

 

You may wish to start with a 5% taper to see how it works for you and gain confidence in the process.

[Rhiannon]

 

vetdoc, your nervous system may be sensitized by all your drug adventures, it's probably not the Wellbutrin specifically.

Alto

I have no doubt that is.  In light of this would a more cautious approach to tapering any of my meds be warranted.  Instead of the usual 10% a month would a slower taper possibly be less of a shock to my system or  taper at the "norma"l recommended rate and let what my body tells me be my guide.

 

Thanks

 

 

Your body is really the only expert here. I say always let your body be the guide. 10% is just a place to start and is a very general rule of thumb. 

 

It's always better to start out more cautious and then only ramp up if you are doing fine, rather than start too aggressively and crash and burn.

 

You've had some pretty big changes recently with the Wellbutrin, including an overall decrease in dose, plus some recent changes in Valium dose. I wouldn't change anything else at all for now. You're sensitive due to your past history, and it's just going to be a bumpy ride for a while, but the changes you've made are not excessively drastic and if you can hang in there you will eventually adapt and stabilize.

 

I wish there was some way around the bumpiness of the ride, but there's not, other than following the standard lifestyle suggestions to at least make it as smooth as it can be.

[vetdoc]

Yes, you may be sensitized to changes in any of your drugs.

 

You may wish to start with a 5% taper to see how it works for you and gain confidence in the process.

Thanks Alto

[vetdoc]

 

 

vetdoc, your nervous system may be sensitized by all your drug adventures, it's probably not the Wellbutrin specifically.

Alto

I have no doubt that is.  In light of this would a more cautious approach to tapering any of my meds be warranted.  Instead of the usual 10% a month would a slower taper possibly be less of a shock to my system or  taper at the "norma"l recommended rate and let what my body tells me be my guide.

 

Thanks

 

 

Your body is really the only expert here. I say always let your body be the guide. 10% is just a place to start and is a very general rule of thumb. 

 

It's always better to start out more cautious and then only ramp up if you are doing fine, rather than start too aggressively and crash and burn.

 

You've had some pretty big changes recently with the Wellbutrin, including an overall decrease in dose, plus some recent changes in Valium dose. I wouldn't change anything else at all for now. You're sensitive due to your past history, and it's just going to be a bumpy ride for a while, but the changes you've made are not excessively drastic and if you can hang in there you will eventually adapt and stabilize.

 

I wish there was some way around the bumpiness of the ride, but there's not, other than following the standard lifestyle suggestions to at least make it as smooth as it can be.

 

Rhi

Overall the tapering has  been pretty good considering my past history although it gets a bit scary when I hit a wall for awhile.  I definitely need to stay very much in tune to how I feel day to day, in order to guide my tapering process.  Slow and steady wins the race when it comes to tapering.

 

Thanks

[vetdoc]

Hi everyone

 

I just wanted to update my progress tapering   off 300mg Wellbutrin XL .  I started the taper about 25 days ago, down to 275 mg Wellbutrin.  I am  using 200 mg SR  AM and 75 mg IR in the PM (around 5:00 PM)   .  It was somewhat bumpy for the first 2 weeks or so, poor sleep, and flu like symptoms in the PM with some anxiety.

It has smoothed out the past week or so, less anxiety, sleeping better and the flu like symptoms have eased off.  I still feel a bit activated when I take the Wellburtin, but it is tolerable at this point.  I assume at the lower doses I will feel less activated from the drug. 

The tinnitus that started about 1 month ago when I made the switch from Canadian brand 300 XL to US brand 300 XL is still present and very annoying.  I never had tinnitus before even while tapering 40mg of valium down to my present 2mg valium.  I don't know what triggered it, but the only change I made was the switch to US brand Wellbutrin, which was much more activating then the Canadian brand.  I'm hoping the tinnitus will resolve at some point and not be permanent.

 

I have a few questions related to the taper.  I was thinking of dropping another 25 mg of Wellbutrin in another week down to 250mg, which would be a month since the last taper.  I don't know if it would be better to taper at a slower rate or make  smaller cuts due to my history of being C/T off Wellbutrin several years ago. 

Also does taking of my dosage at 200mg SR morning and 75mg IR evening seem ok.    Wen  I drop down to 250mg I might try taking 150mg SR AM and 100mg IR PM to smooth out the blood levels some.   I just don't want to mess up my sleep with increasing the evening dose of Wellbutrin to much..

 

Thanks

[Meimeiquest]

What times are you taking it? I might try splitting the SR in half and gradually move the second half out a bit. Like 7 a.m. and 8 a.m., then 7 a.m. and 9 a.m. till you get to something like 7 a.m. and noon. In hopes lowering the peak and bringing the over-activation down might bring down the tinnitus. But just an idea, nothing to back it up.

[vetdoc]

What times are you taking it? I might try splitting the SR in half and gradually move the second half out a bit. Like 7 a.m. and 8 a.m., then 7 a.m. and 9 a.m. till you get to something like 7 a.m. and noon. In hopes lowering the peak and bringing the over-activation down might bring down the tinnitus. But just an idea, nothing to back it up.

 

Miem The worst activation seems to be from the evening 75mg IR, about 2 hours after I take it.  I know the IR peaks much sooner,so that may explain it.  It's interesting that the 75mg IR activates me more then the 200 mg SR.  I would like to get to the point where I take just the SR only, split maybe 3 hours apart, with no evening IR tablet.  I know they recommend 8 hours between SR doses, but I don't know how important it is, except to provide a smoother ride.

 

Thanks

[Meimeiquest]

Maybe if it is bothering you, take the next reduction there and leave the a.m. the same?

[vetdoc]

Meime

 

I'm on the same page as you here.  I'm going to cut the evening dose by 25mg next week, so 200mg SR morning and 50mg IR around 5:00 PM.

 

Thanks

[Meimeiquest]

Good luck! It would be great if you could get rid of that tinnitus.