From the FDA Drug Label
When discontinuing treatment in patients treated with bupropion hydrochloride extended-release tablets (XL) 300 mg once daily, decrease the dose to 150 mg once daily prior to discontinuation. To taper a 23-year-old male off bupropion XL 300mg, decrease the dose to 150 mg once daily before discontinuing the medication, as stated in the drug label 1 and 1.
- Tapering schedule: Decrease the dose from 300 mg to 150 mg once daily.
- Monitoring: The patient should be monitored for any potential withdrawal symptoms or relapse of depressive symptoms.
From the Research
To taper off bupropion XL 300mg, I recommend a gradual reduction over 2-4 weeks under medical supervision, as the most recent and highest quality study does not provide specific guidance on tapering, but emphasizes the importance of medical supervision and gradual reduction to minimize withdrawal symptoms and relapse risk 2.
Tapering Schedule
- First, decrease to 150mg daily for 1-2 weeks,
- then to 150mg every other day for another 1-2 weeks before stopping completely. Do not abruptly discontinue as this may cause withdrawal symptoms including irritability, anxiety, insomnia, headaches, and mood changes.
Medical Supervision and Monitoring
Schedule an appointment with your prescribing physician before starting this taper, as they may recommend a different schedule based on your specific situation. During the taper, monitor for any return of depression or anxiety symptoms, as discontinuation may lead to relapse even if you currently feel in remission. Continue regular follow-up appointments for at least 6 months after stopping the medication. The gradual reduction allows your brain chemistry to adjust slowly to decreasing levels of the medication, which affects norepinephrine and dopamine levels in the brain. If symptoms return during or after the taper, contact your healthcare provider immediately to reassess your treatment plan. Although the provided studies do not directly address the tapering of bupropion, they highlight the importance of medical supervision and gradual reduction in minimizing risks associated with discontinuation 3, 4, 5, 6.