From the Guidelines
Bupropion (Wellbutrin) withdrawal symptoms can be severe and include anxiety, agitation, low mood, and somatic symptoms, which is why a gradual tapering schedule under medical supervision is crucial to minimize these effects. According to a 2019 study published in The Lancet Psychiatry 1, stopping long-term antidepressants like bupropoin can lead to a range of severe withdrawal symptoms with sudden onset and protracted duration. These symptoms can be disabling and may include severe anxiety, agitation, low mood, and somatic symptoms.
Key Symptoms
- Severe anxiety
- Agitation
- Low mood
- Somatic symptoms It's essential to note that patients often feel that their experiences of withdrawal symptoms are either discounted by clinicians or attributed only as an indication of relapse to depression, as reported in the study 1. Determining optimal tapering procedures to minimize withdrawal symptoms is a current topic of debate among clinicians 1.
Tapering Schedule
A typical tapering schedule might involve reducing the dose by 50-100mg every 3-7 days, depending on the current dose and how long the medication has been taken. However, the exact tapering schedule may vary, and it's crucial to work with a healthcare provider to determine the best approach.
Managing Withdrawal
During withdrawal, maintaining healthy habits like regular exercise, adequate sleep, proper hydration, and stress management techniques can help minimize symptoms. If withdrawal symptoms become severe or unmanageable, it's essential to contact a healthcare provider immediately, as the tapering schedule may need adjustment or additional supportive treatments may be necessary.
From the Research
Symptoms of Bupropion (Wellbutrin) Withdrawal
The provided studies do not specifically focus on Bupropion (Wellbutrin) withdrawal symptoms. However, they do discuss withdrawal symptoms associated with antidepressants in general.
- Symptoms of antidepressant discontinuation may be somatic (e.g., dizziness and light-headedness; nausea and vomiting; fatigue, lethargy, myalgia, chills, and other flu-like symptoms; sensory and sleep disturbances) or psychological (anxiety and/or agitation, crying spells, irritability) 2.
- Withdrawal symptomatology does not necessarily subside within a few weeks and may be associated with other manifestations of behavioral toxicity (loss of treatment efficacy, refractoriness, switch into mania/hypomania, or paradoxical reactions) 3.
- Severe withdrawal symptoms are possible when antidepressants are discontinued, and some patients may struggle with stopping, whereas others have few or no problems 4.
- Interruption or abrupt discontinuation of the use of antidepressants may lead to withdrawal symptoms, which are most common with selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) 5.
- Note that Bupropion is not an SSRI or SNRI, but rather a norepinephrine-dopamine reuptake inhibitor, so the withdrawal symptoms may differ from those experienced with SSRIs and SNRIs.
Risk Factors for Withdrawal Symptoms
The following factors are consistently named as risk factors for the occurrence of withdrawal symptoms:
- The patient experiences withdrawal symptoms in case of non-compliance or skipped doses;
- A previous attempt to stop was unsuccessful;
- The patient is being treated with higher doses than the smallest effective dose of SSRIs or SNRIs 5.
Tapering Strategies
A "one-size-fits-all" taper approach is recommended, balancing the need for withdrawal prevention with the need to avoid unnecessary complexity for the majority of patients 4.
- In patients with one or more risk factors, a tapering schedule with non-linear dose-reduction steps should be considered, and the speed at which these steps are taken should be adjusted depending on the occurrence of withdrawal symptoms 5. However, these tapering strategies are not specific to Bupropion and may not be directly applicable.