How do I safely wean off Wellbutrin (bupropion)?

How to Safely Wean Off Wellbutrin (Bupropion)

Bupropion can typically be discontinued abruptly without a formal taper in most patients, as it does not cause a classic withdrawal syndrome like SSRIs or benzodiazepines. However, gradual discontinuation over 1-2 weeks may reduce the risk of depression relapse and minimize any discontinuation symptoms.

Key Clinical Principle

Unlike opioids, benzodiazepines, or SSRIs, bupropion does not produce physical dependence requiring a structured weaning protocol 1. The primary concern with stopping bupropion is return of depressive symptoms, not withdrawal syndrome 2, 3.

Recommended Discontinuation Approach

For Most Patients:

• Abrupt discontinuation is generally safe for patients who have been on bupropion for any duration 2, 4
• If concerned about symptom recurrence, taper over 1-2 weeks by reducing the dose by 50% for one week, then stopping 5

Formulation-Specific Tapering (if gradual discontinuation preferred):

For Bupropion SR (150 mg twice daily):

• Week 1: Reduce to 150 mg once daily
• Week 2: Discontinue 5

For Bupropion XL (300 mg once daily):

• Week 1: Reduce to 150 mg once daily
• Week 2: Discontinue 5

For lower doses:

• May discontinue immediately or reduce by half for 3-7 days before stopping 5

Monitoring During Discontinuation

Watch for these symptoms (depression relapse, not withdrawal):

• Return of depressed mood, anhedonia, or hopelessness 3
• Changes in sleep, appetite, or energy levels 2
• Increased anxiety or irritability 4
• Difficulty concentrating 4

Timeline for monitoring:

• Assess symptoms weekly for 4 weeks after discontinuation 1
• Most depression relapse occurs within the first 2-4 weeks 3

Important Clinical Caveats

Bupropion does NOT require the prolonged tapering protocols used for:

• Opioids (which require 10-20% dose reductions every 24-48 hours over weeks) 1
• Benzodiazepines (which require tapering over 2+ weeks to prevent seizures) 1
• SSRIs (which commonly cause discontinuation syndrome) 2

Special considerations:

• Patients on bupropion for smoking cessation can stop after the 7-12 week treatment course without tapering 1, 5
• Patients with history of severe depression may benefit from closer monitoring during discontinuation 3
• If depression symptoms return, resume previous dose and consider alternative strategies rather than continuing the taper 3

When to Seek Additional Support

• If depressive symptoms worsen significantly within 1-2 weeks of discontinuation, resume bupropion and consult with the prescribing provider 3
• Consider transitioning to another antidepressant rather than simply discontinuing if ongoing treatment is needed 2, 3