How do I taper Wellbutrin (bupropion) before stopping?

How to Taper Wellbutrin (Bupropion) Before Discontinuing

When discontinuing Wellbutrin (bupropion), implement a gradual tapering schedule by reducing to 150mg once daily for 1-2 weeks before complete discontinuation to minimize withdrawal symptoms. 1

Recommended Tapering Schedule

For patients on Wellbutrin XL (extended-release):

• If taking 300mg daily: Decrease to 150mg once daily for 1-2 weeks before stopping completely 2
• If taking 150mg daily: Consider taking the medication every other day for 1-2 weeks before stopping

For patients on Wellbutrin SR (sustained-release):

• If taking 150mg twice daily: Reduce to 150mg once daily for 1-2 weeks before stopping
• If taking 100mg twice daily: Reduce to 100mg once daily for 1-2 weeks before stopping

Rationale for Gradual Tapering

Abrupt discontinuation of bupropion can lead to withdrawal symptoms including:

• Neuropsychiatric symptoms (depression, anxiety, irritability)
• Insomnia
• Headache
• Mood changes 1

The FDA specifically recommends tapering bupropion to minimize withdrawal symptoms rather than stopping abruptly 2. A slow taper helps the brain adjust to decreasing levels of the medication, reducing the risk of adverse effects.

Factors Affecting Tapering Speed

The tapering schedule should be adjusted based on:

• Duration of treatment (longer treatment may require slower tapering)
• Current dose
• Individual response to dose reduction

Managing Withdrawal Symptoms

If withdrawal symptoms occur during tapering:

• Slow down the tapering process
• Return to the previous dose temporarily before attempting a more gradual reduction
• Use supportive measures for specific symptoms (e.g., sleep hygiene for insomnia)

Special Considerations

1. Different Formulations: Bupropion comes in immediate-release (IR), sustained-release (SR), and extended-release (XL) formulations, which have different pharmacokinetic profiles 3. The XL formulation has a longer absorption time (approximately 5 hours) compared to IR (1.5 hours) and SR (3 hours).

2. Medical Supervision: While tapering, maintain contact with your healthcare provider to monitor for any concerning symptoms.

3. Timing: Morning dosing is typically recommended for Wellbutrin XL to minimize sleep disturbances 2.

Common Pitfalls to Avoid

• Stopping too quickly: This increases risk of withdrawal symptoms
• Cutting or crushing tablets: Extended-release and sustained-release formulations should never be cut, crushed, or chewed 2
• Self-adjusting without medical guidance: Always consult with your prescriber before changing your medication regimen

Remember that while these guidelines provide a general approach to tapering Wellbutrin, individual responses may vary. If you experience significant withdrawal symptoms or worsening of your original condition during the tapering process, contact your healthcare provider promptly.