Can a patient experience withdrawal effects when discontinuing Wellbutrin (bupropion) 150 mg after extended use?

Bupropion Discontinuation and Withdrawal Effects

Yes, you can experience withdrawal effects from Wellbutrin (bupropion) 150 mg, though these effects are generally milder and less frequent compared to SSRIs, SNRIs, benzodiazepines, or opioids. 1

Withdrawal Symptom Profile

Bupropion discontinuation can produce withdrawal symptoms including:

• Irritable mood 2
• Anxiety 2
• Sleeplessness 2
• Headache 2
• Generalized aches and pains 2

These symptoms typically emerge after abrupt discontinuation, particularly following extended use. 2

Severity and Clinical Context

Bupropion withdrawal is notably less severe than withdrawal from other psychiatric medications. 1 The World Health Organization classifies bupropion withdrawal as considerably less serious than benzodiazepine or opioid withdrawal, which can be life-threatening and include seizures or delirium. 1

The American Psychiatric Association recognizes that bupropion has a distinctly different discontinuation profile compared to SSRIs and SNRIs, which are associated with more severe and frequent withdrawal syndromes. 1

Recommended Discontinuation Strategy

The American Medical Association recommends gradual tapering for bupropion discontinuation to minimize withdrawal symptoms. 1 The FDA label specifically instructs that when discontinuing bupropion 300 mg once daily, the dose should be decreased to 150 mg once daily prior to complete discontinuation. 3

For patients on 150 mg daily, a reasonable approach would be:

• Taper to 150 mg every other day for 1-2 weeks before complete cessation
• Monitor for withdrawal symptoms during the taper period 1
• Extend the taper if symptoms emerge 2

The National Institute of Mental Health supports tapering gradually over several weeks rather than stopping suddenly to reduce withdrawal risk. 1

Clinical Pitfalls to Avoid

Never abruptly discontinue bupropion after extended use. 2 The case literature demonstrates that sudden cessation can trigger withdrawal symptoms that are uncomfortable and may lead to treatment non-compliance or unnecessary medication resumption. 2

Do not confuse withdrawal symptoms with relapse of depression. 4 Withdrawal symptoms typically have quick onset, limited duration depending on the drug's half-life, and remit after restarting therapy—distinct from true disease relapse. 4

Patient Education

Patients should be educated about:

• The benefits of compliance and gradual discontinuation 2
• Expected withdrawal symptoms so they can recognize them if they occur 2
• The transient nature of these symptoms, which generally resolve within days to weeks 4