Tapering Off 300mg Wellbutrin (Bupropion)
For patients taking 300mg of Wellbutrin XL daily, reduce the dose to 150mg once daily before discontinuing the medication entirely. 1
FDA-Recommended Tapering Protocol
The FDA label provides explicit guidance for discontinuing bupropion extended-release formulations:
- Patients on 300mg daily should decrease to 150mg once daily prior to complete discontinuation 1
- This represents a 50% dose reduction as the tapering step 1
- The FDA does not specify an exact duration for the 150mg phase, but clinical practice typically maintains this reduced dose for 1-2 weeks before stopping 2
Formulation-Specific Considerations
For Wellbutrin XL (Extended-Release):
- Taper from 300mg once daily to 150mg once daily 1
- Continue the 150mg dose for at least 1-2 weeks before complete discontinuation 2
For Wellbutrin SR (Sustained-Release):
- If taking 150mg twice daily (300mg total), reduce to 150mg once daily 3
- Maintain this reduced dose for 1-2 weeks before stopping 2
Critical Monitoring During Discontinuation
Watch for these specific withdrawal-related changes:
- Fatigue and decreased energy levels - Bupropion has activating properties, so patients may experience significant fatigue when tapering off 2
- Mood changes and depressive symptom recurrence - Monitor for return of depression symptoms during and after the taper 2
- Suicidal ideation - Particularly critical in patients under 24 years old, though this is more relevant during treatment than discontinuation 2
Why Tapering Matters
The Mayo Clinic emphasizes that a slower taper is safer, though unnecessarily prolonged tapers can become a source of patient anxiety 2. The single-step reduction from 300mg to 150mg represents a balanced approach that:
- Minimizes abrupt neurochemical changes 2
- Allows monitoring for symptom recurrence 2
- Avoids creating excessive patient anxiety about the discontinuation process 2
Special Population Adjustments
For patients with hepatic impairment:
- Those already on reduced doses due to liver disease should taper even more gradually 3
- Consider extending the 150mg phase to 2-4 weeks before complete discontinuation 3
For patients with renal impairment:
- Those on reduced doses due to kidney disease may require slower tapering 3
- Extend the intermediate dose phase as needed 3
Common Clinical Pitfall
Do not abruptly discontinue 300mg daily dosing without the intermediate 150mg step 1. While bupropion does not cause the severe discontinuation syndromes seen with SSRIs, the FDA explicitly recommends dose reduction before stopping, suggesting this approach minimizes risk of symptom recurrence and withdrawal effects 1.