That’s really helpful, thank you.

What symptoms would usually start showing up around Day 4 after a reduction? And once they started, did they stay pretty constant all the way until around Week 4, or did they come in waves?

Do you remember roughly when they were at their worst/peak before you got back to your “withdrawal normal” baseline?

Hi @Healthyagain , it’s good to see your update.

In regards to accidentally going from 150 to 75 mg of Bupropion and wondering if you should just stay there: that is a mighty big step, especially considering your recent symptoms.

I can only share my experience. When I finished my cross over from XL to IR, I was taking 1/2 of a 75 mg tablet four times a day (about every 4 hours). I stabilized there and my first cut was 1/4 of a 75 mg tablet and held for one month. My next cut was another 1/4 of the 75 mg tablet (so I was taking 1/2 tablet three times a day (about every six hours) and held for a month. So far so good. However, the third time I tried this I experienced a ramping up of anxiety! Not fun. (I don’t remember other symptoms because the anxiety overwhelmed everything!)

At that point I was still taking 93.75 mg daily. So after 3 cuts I was still above your 75 mg dose. My initial cuts were a bit above the recommended amount but it was my first taper (of poly drugs) and I started from a very stabilized position.

So given my experience, I would not stay at 75 mg per day. Yes, it may initially feel better but it takes a few days for your body to react. (I think 4-5 days if I remember correctly.)

I hope @Go2zero sees this and has a chance to respond. If he doesn’t respond right away, I would suggest that you go back to your regular dosing schedule and hold until he has a chance to respond.

Best wishes!

💞🙏

@Golden

Thank you so much for sharing this. Can I ask one thing about the anxiety you experienced after your reductions? Once it started a few days later, how long did it last before it settled again?

I’ve now been on 75 mg for three days. The reason I’m so torn is that the 150 mg IR has felt extremely activating for me, especially since switching from XL to IR two months ago. I often get noticeably more activated and even nauseous after the second 75 mg dose.

I was also on about 75 mg of Wellbutrin last August and actually did okay for about three weeks, but at the same time I was taking Prozac 10 mg every other day. I honestly suspect the every-other-day Prozac dosing contributed much more to the crash I had a few weeks later, and then all the subsequent dose changes seemed to further sensitize me and keep me stuck for the past year.

So my biggest question is really about your experience: when the anxiety ramped up after that third cut, how long did it continue before you stabilized again?

6 hours ago, Healthyagain said:

What symptoms would usually start showing up around Day 4 after a reduction? And once they started, did they stay pretty constant all the way until around Week 4, or did they come in waves?

A variety. I think early on it was mood elevation, followed by roller coaster up and down and emotionality, along with that feeling of dread and anxiety that felt 100% real, even though I knew for a fact that it went away after every reduction 😁

They cycled predictably. I kept a journal of daily symptoms and would use that to see how the next day would likely go.

Do you remember roughly when they were at their worst/peak before you got back to your “withdrawal normal” baseline?

I can't remember exactly, maybe day 8 or so, but keep in mind this is just my individual experience and in a really sensitized state. I read later that reducing a med someone has taken for so many years like I did can make it break and stop working, and that was exactly my experience. Reinstatement didn't restore me to a pre-tapering condition. Somewhere around day 14 I was on a slight up swing, and things were stabilizing around 22 days or so.

My baseline was still poop-out WD, so the lines are a bit fuzzy on what was WD normal.

1 hour ago, Golden said:

(I don’t remember other symptoms because the anxiety overwhelmed everything!)

😂😂😂 I know that feeling @Golden !!!! Glad you're feeling better now 😊

The reason I’m so torn is that the 150 mg IR has felt extremely activating for me

I held at my full dose of IR for around 6 months, waiting for it to stabilize and feel like I did when I took the XL. Never happened. Later I read a study that said maybe the absorption rate of the IR was much stronger, something like that, so it made sense that it would feel completely different(and not pleasant).

Ultimately I decided rather than kindle myself with more med changes of different time releases, I'd just taper off the IR. I figured it was easiest to do a water taper and whatnot, which was pleasantly uneventful.

52 minutes ago, Healthyagain said:

So my biggest question is really about your experience: when the anxiety ramped up after that third cut, how long did it continue before you stabilized again?

I made that cut on June 21. It was July 8th before I noticed some relief from the anxiety.

I know you are trying to figure out what may happen and how long it may last but no one can really tell you that. I understand. I did the same thing. But we are all so different.

57 minutes ago, Healthyagain said:

I’ve now been on 75 mg for three days. The reason I’m so torn is that the 150 mg IR has felt extremely activating for me, especially since switching from XL to IR two months ago.

Taking 75 mg IR at a time may feel more activating. IDK.

59 minutes ago, Healthyagain said:

I often get noticeably more activated and even nauseous after the second 75 mg dose.

Are you taking your two doses approximately 12 hours apart? I would think that would help.

You shouldn’t get an up/down feeling with consistently spaced doses. But I never took a whole 75 mg pill at once so I really can’t say.

I’m sorry I am not able to help more.

1 hour ago, j1290 said:

The reason I’m so torn is that the 150 mg IR has felt extremely activating for me

I held at my full dose of IR for around 6 months, waiting for it to stabilize and feel like I did when I took the XL. Never happened. Later I read a study that said maybe the absorption rate of the IR was much stronger, something like that, so it made sense that it would feel completely different(and not pleasant).

Ultimately I decided rather than kindle myself with more med changes of different time releases, I'd just taper off the IR. I figured it was easiest to do a water taper and whatnot, which was pleasantly uneventful.

This is exactly how I feel. Last August, I intuitively cut my Wellbutrin XL 150 mg in half because it felt like lowering Prozac had suddenly made the Wellbutrin way too activating. And weirdly enough…I felt better for about three weeks.

Then came the medication version of “let me fix what may not actually be broken.” I went back up to XL 150, then 300, then back down to 150 and held there. None of that restored me, and I’ve basically spent the past year holding at 150 mg, aside from switching from XL to IR. The whole time, on XL and now IR, I kept saying, this feels too activating.

I did try reducing one 75 mg IR tablet by about 1/4, but someone scared me that my cutting wasn’t accurate enough, so after two days I panicked and updosed. Story of my life: make a change, get scared of the change, undo the change, then wonder which change caused what.

Now I’ve had three full days taking Wellbutrin IR 75 mg once daily instead of twice daily. I know 75 mg and below can be where tapering gets trickier, but I’ve also read that protracted withdrawal from Wellbutrin seems much less commonly reported than with some other antidepressants. I really hate the idea of updosing yet again because that’s exactly what I did last year and again last month. Part of me just wants to leave the poor nervous system alone for five minutes, hold here, and see if I continue feeling better.

Did you ever get to a point where you had something like 8 weeks of fairly consistent windows before continuing your taper, either with Effexor or Wellbutrin? I’d also really love to hear more about how you did your water taper and what that process was like for you.

And I completely sympathize with IR feeling almost like a totally different medication from XL. It’s wild that technically it’s the same drug while your body is apparently like, “Absolutely not, I have never met this substance before in my life.”

Hi @Healthyagain

I’ll let mentors or members with more experience in reinstatement chime in on that, but I’d also encourage you to look into CBT or other coping methods to help with the anxious thoughts. That’ll go a long way towards minimizing your WD symptoms.

6 hours ago, Healthyagain said:

Then came the medication version of “let me fix what may not actually be broken.” I went back up to XL 150, then 300, then back down to 150 and held there. None of that restored me, and I’ve basically spent the past year holding at 150 mg, aside from switching from XL to IR. The whole time, on XL and now IR, I kept saying, this feels too activating.

I did a lot of similar stuff. I never felt stable after my first reduction, so I kindled myself switching various time release combinations. I held for like 6 months on the IR, then I switched to XL to see if that might get me more stable(I improved, but only by 10% or so), so I decided to taper through the poop out and hope for the best.

6 hours ago, Healthyagain said:

I did try reducing one 75 mg IR tablet by about 1/4, but someone scared me that my cutting wasn’t accurate enough,

I tried various precision instruments to measure the pill to make sure my reductions were accurate because I couldn't believe I never was regaining stability. I figured for sure I must be messing up the doses 😂

6 hours ago, Healthyagain said:

protracted withdrawal from Wellbutrin seems much less commonly reported than with some other antidepressants

I think what made it so difficult for me was the length of time I was on it. People with under 6 years allegedly have a much easier taper than I did. I'm too lazy to double check but I swear one document from the UK increased the anticipated difficulty of tapering off of bupropion to a 3 of 5 from 2 of 5 previously.

6 hours ago, Healthyagain said:

Did you ever get to a point where you had something like 8 weeks of fairly consistent windows before continuing your taper, either with Effexor or Wellbutrin? I

Never with the wellbutrin. I'm convinced that I was near poop out after 15 years or so maxed out on the med, and all it took for it to break was that first reduction. I never had a window tapering that stuff, not until I was off it around 6-9 months. Before that I had a lot of head pressure and headaches, visual issues, dizziness, turbo anxiety, elevated mood, etc.

The Effexor, which I was maxed out on for around 6 years, was truly gnarly to taper off of. However, unlike the wellbutrin, if I held for 4 weeks I would be at a stable WD Normal. When I did a reduction the symptoms were taxing, so I would do a long hold every 3 or 4 cuts to let my batteries recharge, sometimes up to 2 or 3 months, or when I forgot how stressful tapering could be 😁 Took me about 5 years to get off that stuff but I didn't have a long tail of recovery after I got to zero like I did with the wellbutrin.

6 hours ago, Healthyagain said:

And I completely sympathize with IR feeling almost like a totally different medication from XL. It’s wild that technically it’s the same drug while your body is apparently like, “Absolutely not, I have never met this substance before in my life.

That was 100% my experience. After being on the XL for 15 years or whatever, the IR felt completely different. I remember I had taken it wayyyyy back when I first got on the med, and I recall thinking the SR was more comfortable and convenient. Back then I had no clue how powerful these meds were and didn't strictly adhere to the 3 times a day intervals. I was so gullible and believed many things I was told that turned out not to be accurate.

@Healthyagain I think it is really good you can identify that 75mg feels less activating to you, you are listening to your body. My concern is WD, cutting from 150-75mg might not be such a good move. It is good you can see a reduction in adverse effects, but WD can be delayed in onset. It would have been better imo to reduce more gradually than just jump down in dose like that, although I appreciate your hesitation on what to do next.

Ultimately it is up to you to choose what you think you should do. The body does not like big drops, nor does it like changes. If you think staying put is the right move, do that, if you are unsure updose but perhaps not the whole way and hold for a while to give the body a chance to settle down.

What I would definitely do it split that dose. If you stay at 75mg, slowly move half of it an hour apart a day until you get to your desired times rather than jump times.

Body leads the way, but we must try to make these changes carefully when the nervous sysystem is sensitive.

Hi Healthyagain,

Thank you for sharing all this information. I think there are several things that are important to look at before making another change.

First, could you please update your signature and keep it fully up to date from now on? In your PM to me you said that you are currently taking 4 mg Prozac, while your signature still says 10 mg. Your signature also still says 150 mg Wellbutrin XL, while you are now taking 75 mg IR. Please update it with all medication changes, dose changes and formulation changes, including the dates of each change. With so many changes over the past year, this is really important if we want to understand what is happening.

Looking at your history, I think there have simply been too many changes close together: Prozac dose changes, Wellbutrin dose changes, Prozac every other day, reinstatements/updoses, different supplements and medications, the change from Wellbutrin XL to IR, and now the change from your homemade Prozac liquid to the commercial liquid. It makes it very difficult to know what is causing what.

Regarding the Prozac formulation: even though you stayed at the same nominal dose, changing from your homemade liquid to the commercial liquid is still a change. In a very sensitive system I would personally have preferred a gradual crossover rather than changing completely from one formulation to the other. I would not conclude yet that the commercial liquid is bad for you, though. It may still settle.

Regarding Wellbutrin IR: I think this is very important in your case. IR is released much faster than XL, so the individual doses can produce much more noticeable peaks. In my experience, and from what I have seen many times on SA, smaller and more evenly distributed IR doses can be considerably less activating than taking larger doses at fewer times.

If I were in your situation, I would therefore consider going back to the previous 150 mg total daily dose, but I would personally not take 75 mg twice a day if that makes you feel very activated. I would rather consider dividing the total daily dose into smaller doses throughout the day. For example, 4 × 37.5 mg would give the same total daily dose but potentially much smaller peaks.

I would also not make a 50% reduction from 150 to 75 mg your next deliberate taper step, especially not now. You have only recently changed the Prozac formulation and you are not yet clearly stable. The fact that you felt much better on the first day you accidentally took only 75 mg is interesting, but it does not tell us yet whether 75 mg is a stable dose for you. Wellbutrin withdrawal can also be delayed. In my own experience, symptoms have sometimes appeared several days after a reduction, and occasionally much later. And sometimes a dose reduction of Wellbutrin can result in an increase in energy or even a period of feeling very good, before a wave starts.

If I were you, I would first try to get stable again and then, if Wellbutrin still feels too activating, I think a much more gradual reduction could be worth trying. I would not make large changes simply because a medication feels activating after the other medication has been reduced substantially.

I also think your own history suggests that Prozac has been the bigger problem for you. Your worst symptoms — intrusive SI, panic, doom/gloom, hopelessness and DPDR — seem to cluster much more around Prozac reductions and formulation changes than around Wellbutrin reductions. That would make me particularly cautious about making changes to both drugs at the same time.

You also asked through a PM about my own Wellbutrin withdrawal. My worst symptoms have included severe anxiety and panic, irritability sometimes approaching aggression, extreme sleep problems, severe migraine, nausea, extreme fatigue, serious memory and concentration problems, blurred vision, paresthesias and other neurological/autonomic symptoms. These symptoms have come in waves after reductions that were too large or too fast for me. The good news is that they have also settled again when I stabilized, although sometimes stabilization took months.

So I would not assume that Wellbutrin will necessarily be easy to taper. Some people find it easier than an SSRI, but others find Wellbutrin extremely difficult to taper, especially at lower doses. Everyone reacts differently. My experience, Golden's experience or anyone else's experience can give you ideas, but it cannot predict what will happen to you. Your taper could ultimately be much easier than mine, or it could be more difficult.

And because you have already experienced intrusive suicidal thoughts after Prozac reductions, I think you are right to take that seriously. Unfortunately, severe withdrawal symptoms, including severe anxiety, agitation and dark or suicidal thoughts, can also occur with Wellbutrin withdrawal in some people. This is another reason why I would be very cautious with large reductions.

For me, the most important principle for you now would be:

One medication at a time. One formulation at a time. One change at a time. Then hold long enough to see what happens.

You have made so many changes over the past year that I think your nervous system needs some time without another moving target.

Edited August 16Aug 16 by Go2zero

Thank you for updating your signature. This is very helpful and important for everyone who is trying to assist you. 🙏

Thank you ALL so much for taking the time to respond. I really appreciate the different perspectives, and I’m trying to take all of this in without immediately reacting by making another change.

@j1290 So much of what you wrote resonates with me, especially never feeling stable after that first reduction and then trying different doses/formulations because you kept thinking something must be off. That is basically what I did too. I think my Prozac taper may end up looking more like what you described with Effexor, with longer holds to recharge between reductions.

@Chippy @Go2zero I’ve done a lot of things “wrong,” but honestly, almost every wrong move came from trying to listen to my body and respond to what I was feeling at the time.

I’m planning to hold for at least 2–3 months now and give everything a chance to stabilize before even thinking about another taper. At the same time, I keep hearing conflicting opinions about whether holding “too long” can somehow lead to tolerance or keep someone in a protracted withdrawal state. That uncertainty is hard.

@j1290 When you were tapering Wellbutrin, did you divide your daily dose throughout the day? And how exactly did you do your liquid taper? I had the option of compounded liquid Wellbutrin three times a day, but I got scared away from that after reading stories about compounding pharmacies getting concentrations wrong and people becoming very symptomatic before finding out there had been an error. At the same time, I really don’t have the patience for years of cutting and weighing pills.

If/when I eventually reduce the 75 mg IR tablet, I was told I would have to weigh the pieces because tablets can chip or break unevenly and eyeballing them may not be accurate. @Go2zero That is part of why, for right now, I’m leaning toward simply taking one intact 75 mg IR tablet once a day at the same time rather than immediately manipulating the dose again. What do you see as the downsides of doing that?

@j1290 Also, when you reduced Wellbutrin, did your symptoms usually show up within days, or could they be delayed by weeks? Once you were holding, were they fairly constant or did they come in waves? I’m on day 4 now of 75 mg IR once daily after 150 mg/day, and because I’ve been on Wellbutrin for about 12 years, your experience definitely gets my attention. At the same time, I’ve felt noticeably less activated so far, so I’m trying not to scare myself into assuming your course will automatically be mine.

@Go2zero regarding splitting the dose, I completely understand the reasoning. My hesitation is that the second IR dose has repeatedly felt very activating for me, sometimes with nausea, anxiety, or DPDR afterward, which is part of why accidentally taking only one dose felt so noticeably different. I also worry that changing the timing and splitting tablets right now would introduce yet another variable when I have already changed so much.

I’m trying to balance the concern about making such a large reduction with listening to the fact that my body has been telling me for about a year that the higher Wellbutrin exposure feels too activating.

There is also a very practical issue for me. I genuinely have no idea how I forgot my Wellbutrin on Thursday and took my Metformin from the pill box instead. Even with timers, if I’m working or busy I can turn one off and then forget to go back and take the medication. Once-daily dosing would be much easier for me to follow consistently. @Go2zero I’m wondering: could one 75 mg IR dose at the same time every day realistically work as a stable regimen, and what would you consider the disadvantages compared with splitting it?

I also really appreciate the detailed response about slowing everything down. I agree that there have been way too many moving parts, and that is exactly what I want to stop doing now. “One medication, one formulation, one change at a time” makes a lot of sense to me.

@j1290 @Go2zero When I am eventually stable enough to taper again, my bigger question has become which medication to finish first: Wellbutrin or Prozac. I need to remain functional and able to work, and I worry that taking Wellbutrin all the way to zero first could leave me with significant fatigue and loss of energy. That makes me lean toward eventually finishing the Prozac taper while keeping Wellbutrin steady, then coming back to Wellbutrin later. I would really love to hear your thoughts and reasoning about that.

@Chippy I updated my signature with the Prozac and Wellbutrin changes, but it is becoming incredibly long because there have been so many changes. If you have a chance, I would really appreciate your help making it more concise while still keeping the dates and medication/formulation changes that are actually important.

I hear the concern from all of you about the size of the 150 → 75 mg reduction and the possibility of delayed withdrawal. That is what has me torn. I really don’t want to start bouncing the dose up and down again, especially because that is exactly what I did last year and I never felt like I recovered from all the tinkering. At the same time, I understand that feeling better for the first few days does not prove that 75 mg will ultimately be stable for me.

For now, I’m trying very hard not to make another fear based move. I want to observe what my body actually does, keep everything else completely unchanged, and give this enough time to become clearer rather than constantly chasing symptoms with another dose change.

@Golden @j1290 @Go2zero @Chippy I truly appreciate all of you taking the time to share your experience and help guide me through such a difficult process. It means more than you know to feel like I’m not trying to figure all of this out alone. 💞🙏

3 minutes ago, Healthyagain said:

I’m leaning toward simply taking one intact 75 mg IR tablet once a day at the same time rather than immediately manipulating the dose again. What do you see as the downsides of doing that?Yes

75 mg IR is extremely activating if taken in 1 time. Simply cutting it in 2 should work. If it woudl be a little less of more than 37,5 is not a problem. It is always MUCH better than taking 75 in 1 time. I do not know if you have scales that can weigh up to 1 mg. Otherwise I recommend buying one. It is so simple to cut pills in halves then. And you could make several halves for 1 week for example. Then you would have to cut only once a week.

8 minutes ago, Healthyagain said:

but I got scared away from that after reading stories about compounding pharmacies getting concentrations wrong and people becoming very symptomatic before finding out there had been an error.

Yes, this can be a risk.

9 minutes ago, Healthyagain said:

At the same time, I really don’t have the patience for years of cutting and weighing pills.

When this becomes a discipline it will be the best and safest method in my opinion. I have seen too much problems created by pharmacists that did not work accurate enough and by generic brands that differ in quality.

14 minutes ago, Healthyagain said:

regarding splitting the dose, I completely understand the reasoning. My hesitation is that the second IR dose has repeatedly felt very activating for me, sometimes with nausea, anxiety, or DPDR afterward, which is part of why accidentally taking only one dose felt so noticeably different. I also worry that changing the timing and splitting tablets right now would introduce yet another variable when I have already changed so much.

I’m trying to balance the concern about making such a large reduction with listening to the fact that my body has been telling me for about a year that the higher Wellbutrin exposure feels too activating.

There is also a very practical issue for me. I genuinely have no idea how I forgot my Wellbutrin on Thursday and took my Metformin from the pill box instead. Even with timers, if I’m working or busy I can turn one off and then forget to go back and take the medication. Once-daily dosing would be much easier for me to follow consistently. @Go2zero I’m wondering: could one 75 mg IR dose at the same time every day realistically work as a stable regimen, and what would you consider the disadvantages compared with splitting it?

As said above, 75 mg simply is too activating to take in 1 time, especially when not being stable. In the morning I put my cut pieces in a small box for that day. So during the day I can simply see and check how many I have taken already and if I need to take another piece. You can also set alarms (automated for every day) when you need to take another small dose. It asks for some creativity and discipline to taper safely!

19 minutes ago, Healthyagain said:

When I am eventually stable enough to taper again, my bigger question has become which medication to finish first: Wellbutrin or Prozac. I need to remain functional and able to work, and I worry that taking Wellbutrin all the way to zero first could leave me with significant fatigue and loss of energy. That makes me lean toward eventually finishing the Prozac taper while keeping Wellbutrin steady, then coming back to Wellbutrin later. I would really love to hear your thoughts and reasoning about that.

This cannot be answered as if it science. But looking at your tapering stories and how activating Wellbutrin has become, I would do the following. Stay at 4 mg Prozac for now. First stabilize on the new liquid form of Prozac, or go back to the home made liquid if you would prefer that (with a crossover) But stay on 1 form and with 1 brand (preferably not a generic).

When stable I would safely taper the Wellbutrin towards 75mg. Do this slow and carefully. We can help you here then how to do so. If tapering Wellbutrin would go easy in your case, you could taper further. If tapering Wellbutrin would become difficult along the way, you might choose to continue tapering the prozac again. We all react different, but by sharing you experiences here, we can advice you then how to go further.

29 minutes ago, Healthyagain said:

I hear the concern from all of you about the size of the 150 → 75 mg reduction and the possibility of delayed withdrawal. That is what has me torn. I really don’t want to start bouncing the dose up and down again, especially because that is exactly what I did last year and I never felt like I recovered from all the tinkering. At the same time, I understand that feeling better for the first few days does not prove that 75 mg will ultimately be stable for me.

In my opinion this 50% dose reduction is simply a very big risk that you are taking. Now there is still the possibility to go back up in dose without creating another wave. But again the two 75mg pills should best be divided in 4 small dosages over the day.

23 minutes ago, Go2zero said:

75 mg IR is extremely activating if taken in 1 time. Simply cutting it in 2 should work. If it woudl be a little less of more than 37,5 is not a problem. It is always MUCH better than taking 75 in 1 time. I do not know if you have scales that can weigh up to 1 mg. Otherwise I recommend buying one. It is so simple to cut pills in halves then. And you could make several halves for 1 week for example. Then you would have to cut only once a week.

Yes, this can be a risk.

When this becomes a discipline it will be the best and safest method in my opinion. I have seen too much problems created by pharmacists that did not work accurate enough and by generic brands that differ in quality.

As said above, 75 mg simply is too activating to take in 1 time, especially when not being stable. In the morning I put my cut pieces in a small box for that day. So during the day I can simply see and check how many I have taken already and if I need to take another piece. You can also set alarms (automated for every day) when you need to take another small dose. It asks for some creativity and discipline to taper safely!

This cannot be answered as if it science. But looking at your tapering stories and how activating Wellbutrin has become, I would do the following. Stay at 4 mg Prozac for now. First stabilize on the new liquid form of Prozac, or go back to the home made liquid if you would prefer that (with a crossover) But stay on 1 form and with 1 brand (preferably not a generic).

When stable I would safely taper the Wellbutrin towards 75mg. Do this slow and carefully. We can help you here then how to do so. If tapering Wellbutrin would go easy in your case, you could taper further. If tapering Wellbutrin would become difficult along the way, you might choose to continue tapering the prozac again. We all react different, but by sharing you experiences here, we can advice you then how to go further.

In my opinion this 50% dose reduction is simply a very big risk that you are taking. Now there is still the possibility to go back up in dose without creating another wave. But again the two 75mg pills should best be divided in 4 small dosages over the day.

Thank you so much for explaining all of this and for taking the time to help me think it through. I really appreciate it.

Just so I’m completely understanding your recommendation, are you suggesting that after being at 75 mg IR for four days, I should go back up 100% to 150 mg IR today, but divide that total into four smaller doses throughout the day?

I’m torn because I’m also very fearful of getting hit with severe anxiety and intrusive SI from such a large reduction, especially since I am still having occasional flickers. At the same time, I’m scared of making another big change by going back up after four days, because I’ve done so much up and down dosing in the past and really want to avoid more instability if possible.

If I decided to stay at 75 mg for now and see whether I can stabilize there, would it make sense to leave it completely alone for a few weeks and then, once things are calmer, divide the 75 mg into two doses instead of taking it all at once? If so, approximately how many hours apart would you generally recommend taking the two 37.5 mg doses?

Also, just to clarify, I am currently on the commercial Prozac liquid and have been on it for almost two weeks now at the exact same 4 mg dose. It is generic, though, and unfortunately I cannot get brand name Prozac liquid, so staying with one consistent generic manufacturer is really my only realistic option.

I also did not know that I was supposed to do a gradual crossover from my homemade water taper to the commercial liquid. I switched directly while keeping the dose the same, so I’m hoping that with enough time and consistency my system will settle into it.

Hi Healthyagain,

I understand very well that you don't want to start going up and down with the dose again. But after thinking about your history, I have to be honest: I am quite worried about the 150 → 75 mg reduction in your particular situation.

It is not only the 50% reduction itself. You have been on Wellbutrin for about 12 years, you have had strong reactions to previous medication changes, you have experienced very severe intrusive suicidal thoughts after changes, and you had only recently changed the Prozac formulation when you made this 50% reduction.

You are now only a few days into the 75 mg dose. The fact that you feel less activated is important, but I would not yet take that as evidence that 75 mg is going to be a stable dose. From my own experience, and from what I have seen over many years as a moderator on SA, withdrawal after a large reduction can be delayed. Sometimes people initially feel surprisingly good and only later develop a severe wave.

There is another thing I have seen repeatedly on SA. After a large reduction, there can be a relatively short period in which going back to the previous dose still works reasonably well. If someone waits until a severe withdrawal wave has fully developed, going back to the old dose may no longer work. Sometimes it does very little, and sometimes further dose changes seem to make things even more unstable. I don't know whether there is a biological "window" for this, and I don't think this has been properly studied. I'm simply telling you what I have repeatedly seen in real tapering situations.

That is why, if I were in your position, I would personally go back to 150 mg now and then hold.

I know that sounds like another up-dose, and I understand why you are afraid of that. But to me there is a difference between repeatedly changing doses because you are chasing symptoms and making one deliberate correction because a 50% reduction may simply have been too much.

If going all the way back to 150 mg feels impossible, I would rather consider a smaller reduction such as 125 mg than simply continue at 75 mg and wait for a possible severe withdrawal reaction. But I don't want to give you the impression that 125 mg is "safe". It is another change, and 150 mg remains my preference. And whatever dose you choose, I really advise to divide it over 4 taking each day.

I would also leave the Prozac completely alone now. You have only recently changed to the commercial liquid. Don't change that again at the same time.

And I want to say something about your comment that you don't have much patience for years of cutting and weighing pills. I completely understand that. But if your nervous system requires very small reductions, there may simply not be a shortcut. The fastest taper can actually turn out to be the slowest way to get to zero, because a large reduction can cost you months of recovery.

You have actually identified this yourself: many of the problems last year started because you tried to respond to symptoms by changing another medication or changing the dose again. I think that is an important lesson.

Listening to your body is good. But with withdrawal, we also have to learn not to react to every change in symptoms by changing the medication.

And finally, my experience does not predict yours. You may find Wellbutrin much easier to taper than I did. But given your history, especially the SI after previous medication changes, I personally would not take the risk of waiting several weeks to see whether this 50% reduction eventually causes a severe wave.

If those suicidal thoughts become significantly stronger or develop into actual intent or a plan, please seek immediate professional help rather than trying to manage that through the forum.

Edited August 16Aug 16 by Go2zero

2 hours ago, Healthyagain said:

@Chippy @Go2zero I’ve done a lot of things “wrong,” but honestly, almost every wrong move came from trying to listen to my body and respond to what I was feeling at the time.

I’m planning to hold for at least 2–3 months now and give everything a chance to stabilize before even thinking about another taper. At the same time, I keep hearing conflicting opinions about whether holding “too long” can somehow lead to tolerance or keep someone in a protracted withdrawal state. That uncertainty is hard.

I think that is where listening to the collective experience of the community can help. It can take some time to get dialled into what the body is trying to tell you. For example you felt over activated by the dose at 150mg, so you reacted, it wasn't that you didn't listen to the body, it is just you didn't take what I think was the safest response to the body, which would have been to reduce the dose slowly and evenly through the 24 hour period rather than cut half the dose all from the same time of day.

2 hours ago, Healthyagain said:

@Chippy I updated my signature with the Prozac and Wellbutrin changes, but it is becoming incredibly long because there have been so many changes. If you have a chance, I would really appreciate your help making it more concise while still keeping the dates and medication/formulation changes that are actually important.

I can take a look, it isn't too long really but could be more concise. Have a read of our F&Qs about signatures and in there there is some guidelines about what makes a clear signature to read.

2 hours ago, Healthyagain said:

I hear the concern from all of you about the size of the 150 → 75 mg reduction and the possibility of delayed withdrawal. That is what has me torn. I really don’t want to start bouncing the dose up and down again, especially because that is exactly what I did last year and I never felt like I recovered from all the tinkering. At the same time, I understand that feeling better for the first few days does not prove that 75 mg will ultimately be stable for me.

I think what you have said here is the essence of my post to you. We can't know how you will react to the drop, you might be ok, the collective knowledge suggests you should be cautious. It is one of the reasons I suggested considering increasing the dose but not the whole way, might keep WD at bay but also be a balance of improvement in adverse effects.

I agree with Go2Zero, splitting the dose, even though it is another change is really important.

2 hours ago, Healthyagain said:

For now, I’m trying very hard not to make another fear based move. I want to observe what my body actually does, keep everything else completely unchanged, and give this enough time to become clearer rather than constantly chasing symptoms with another dose change.

I completely understand. Just be aware, holding the dose might mean WD catches up with you and this could be worse than any fear of kindling from updosing. You might fine. I support you in what you choose.

2 hours ago, Healthyagain said:

@Golden @j1290 @Go2zero @Chippy I truly appreciate all of you taking the time to share your experience and help guide me through such a difficult process. It means more than you know to feel like I’m not trying to figure all of this out alone. 💞🙏

It is a pleasure, it is what we are here for. x

15 minutes ago, Go2zero said:

You are now only a few days into the 75 mg dose. The fact that you feel less activated is important, but I would not yet take that as evidence that 75 mg is going to be a stable dose. From my own experience, and from what I have seen over many years as a moderator on SA, withdrawal after a large reduction can be delayed. Sometimes people initially feel surprisingly good and only later develop a severe wave.

@Healthyagain This is the key imo.

16 minutes ago, Go2zero said:

There is another thing I have seen repeatedly on SA. After a large reduction, there can be a relatively short period in which going back to the previous dose still works reasonably well. If someone waits until a severe withdrawal wave has fully developed, going back to the old dose may no longer work. Sometimes it does very little, and sometimes further dose changes seem to make things even more unstable. I don't know whether there is a biological "window" for this, and I don't think this has been properly studied. I'm simply telling you what I have repeatedly seen in real tapering situations.

Definitely there is no doubt that time period off the drug or time at a dose effects how well RI or updosing goes. @Healthyagain you have been at 75mg for only a few days, I personally would not worry about increasing your dose. Either split the difference or frankly as Go2zero has said, straight back up to 150mg. I would listen to his experience with this drug. And it sounds like splitting 4 times a day may counteract the activation you are experiencing.

20 minutes ago, Go2zero said:

And I want to say something about your comment that you don't have much patience for years of cutting and weighing pills. I completely understand that. But if your nervous system requires very small reductions, there may simply not be a shortcut. The fastest taper can actually turn out to be the slowest way to get to zero, because a large reduction can cost you months of recovery.

You have actually identified this yourself: many of the problems last year started because you tried to respond to symptoms by changing another medication or changing the dose again. I think that is an important lesson.

For sure. @Healthyagain No one wants to be cutting weighing measuring, however it is the way to get off these drugs safely so we have to learn to adapt in wd and learn new skills. It is very important.

2 hours ago, Go2zero said:

In my opinion this 50% dose reduction is simply a very big risk that you are taking. Now there is still the possibility to go back up in dose without creating another wave. But again the two 75mg pills should best be divided in 4 small dosages over the day.

I absolutely agree!

2 hours ago, Healthyagain said:

Just so I’m completely understanding your recommendation, are you suggesting that after being at 75 mg IR for four days, I should go back up 100% to 150 mg IR today, but divide that total into four smaller doses throughout the day?

YES! In my opinion this is the safest way forward while you are still just a few days into taking 75 mg per day. This is exactly what I did (cut 75 mg tablets in half and took them 4 times a day) when crossing over from XL to IR. It worked very well. If you do this and give everything time to settle, it will be much easier and safer going forward.

2 hours ago, Go2zero said:

I do not know if you have scales that can weigh up to 1 mg. Otherwise I recommend buying one. It is so simple to cut pills in halves then. And you could make several halves for 1 week for example. Then you would have to cut only once a week.

This is what I did. It may seem overwhelming at first but it becomes habit and much easier over time. It is absolutely worth it for the stability it provides!

3 hours ago, Go2zero said:

Then you would have to cut only once a week.

Cut your tablets once a week.

You have received a lot of information here today. It can be overwhelming. Please focus in on @Go2zero ’s comments! In my opinion, with his years of experience as a mentor on SA and personal history with these drugs, makes him the expert. 😉

We are concerned for you and want your best. You CAN DO THIS! And we are here to support you.

🕊️💞🙏

@Go2zero is amazing and super knowledgeable. In the end it's your choice but the collective experience shows what works.

4 hours ago, Go2zero said:

Hi Healthyagain,

I understand very well that you don't want to start going up and down with the dose again. But after thinking about your history, I have to be honest: I am quite worried about the 150 → 75 mg reduction in your particular situation.

It is not only the 50% reduction itself. You have been on Wellbutrin for about 12 years, you have had strong reactions to previous medication changes, you have experienced very severe intrusive suicidal thoughts after changes, and you had only recently changed the Prozac formulation when you made this 50% reduction.

You are now only a few days into the 75 mg dose. The fact that you feel less activated is important, but I would not yet take that as evidence that 75 mg is going to be a stable dose. From my own experience, and from what I have seen over many years as a moderator on SA, withdrawal after a large reduction can be delayed. Sometimes people initially feel surprisingly good and only later develop a severe wave.

There is another thing I have seen repeatedly on SA. After a large reduction, there can be a relatively short period in which going back to the previous dose still works reasonably well. If someone waits until a severe withdrawal wave has fully developed, going back to the old dose may no longer work. Sometimes it does very little, and sometimes further dose changes seem to make things even more unstable. I don't know whether there is a biological "window" for this, and I don't think this has been properly studied. I'm simply telling you what I have repeatedly seen in real tapering situations.

That is why, if I were in your position, I would personally go back to 150 mg now and then hold.

I know that sounds like another up-dose, and I understand why you are afraid of that. But to me there is a difference between repeatedly changing doses because you are chasing symptoms and making one deliberate correction because a 50% reduction may simply have been too much.

If going all the way back to 150 mg feels impossible, I would rather consider a smaller reduction such as 125 mg than simply continue at 75 mg and wait for a possible severe withdrawal reaction. But I don't want to give you the impression that 125 mg is "safe". It is another change, and 150 mg remains my preference. And whatever dose you choose, I really advise to divide it over 4 taking each day.

I would also leave the Prozac completely alone now. You have only recently changed to the commercial liquid. Don't change that again at the same time.

And I want to say something about your comment that you don't have much patience for years of cutting and weighing pills. I completely understand that. But if your nervous system requires very small reductions, there may simply not be a shortcut. The fastest taper can actually turn out to be the slowest way to get to zero, because a large reduction can cost you months of recovery.

You have actually identified this yourself: many of the problems last year started because you tried to respond to symptoms by changing another medication or changing the dose again. I think that is an important lesson.

Listening to your body is good. But with withdrawal, we also have to learn not to react to every change in symptoms by changing the medication.

And finally, my experience does not predict yours. You may find Wellbutrin much easier to taper than I did. But given your history, especially the SI after previous medication changes, I personally would not take the risk of waiting several weeks to see whether this 50% reduction eventually causes a severe wave.

If those suicidal thoughts become significantly stronger or develop into actual intent or a plan, please seek immediate professional help rather than trying to manage that through the forum.

Thank you so much for taking the time to think through my history so carefully and explain your concerns. I really do value your experience and your input, and I know you are saying this because you want me to stay as stable and safe as possible through what has already been such a difficult process.

Before I decide what to do, could I ask you a few questions? I’m genuinely trying to understand the risk better rather than just convincing myself to stay at 75 mg.

1. In your years moderating SA, have you actually seen people develop severe withdrawal from a large Wellbutrin reduction, particularly something like 150 mg to 75 mg? I have definitely seen people who need to slow down once they get below 75 mg, but examples of severe withdrawal from Wellbutrin itself seem much fewer and farther between than what I see with SSRIs.

2. Joseph Witt-Doerring has said that he has not seen protracted withdrawal from Wellbutrin. I realize that does not mean a large reduction cannot cause withdrawal, but I’m curious how that fits with what you have seen personally on SA.

3. During your own Wellbutrin or Prozac taper, did you ever experience intrusive suicidal thoughts, or was your withdrawal primarily anxiety and other symptoms? That symptom is obviously the one I am most frightened of.

4. As you can see in my history, in 2019 I cold turkeyed very high doses of Prozac, Wellbutrin and Adderall together. When I crashed about three weeks later, my psychiatrist actually told me I did not need to reinstate the Wellbutrin. I ultimately did reinstate it, partly because I hoped it would help with my appetite and functioning. Obviously that experience was very destabilizing, but it also makes it extremely difficult for me to know which medication caused what.

5. I’ve also seen quite a few people stop Wellbutrin abruptly without major problems. Even last summer, when I incorrectly cut Wellbutrin XL 150 mg approximately in half, I actually felt better for about three weeks before the panic attack happened. At the same time, I was taking Prozac 10 mg every other day, which I now strongly suspect played a major role in that crash. Of course I cannot prove that. This time I am also not stopping Wellbutrin completely; I am still taking 75 mg.

6. I have also come across a couple of people who tapered their SSRI first and then found Wellbutrin surprisingly difficult to remove afterward. Have you seen that pattern yourself?

7. 7. I’m also trying to understand the recommendation to divide Wellbutrin IR into four doses a day. My understanding is that bupropion itself has a half-life of around 21 hours, with active metabolites lasting even longer. If someone is already accustomed to the IR formulation, why would it need to be taken four times a day? Is the concern mainly about smoothing the peaks and troughs of the immediate-release dose, rather than the drug completely leaving the body between doses? I’d really appreciate understanding the reasoning behind that recommendation.

One thing I want to clarify is that the intrusive SI I have experienced during this taper has followed my Prozac reductions very predictably. It would peak after reductions, eventually settle, and then leave occasional flickers behind. That is actually one of the main reasons I have no intention of touching the Prozac again right now. I desperately want those thoughts to disappear rather than keep provoking my nervous system with more Prozac changes.

Whether Wellbutrin withdrawal could cause the same symptom for me, I honestly don’t know. That uncertainty is what I’m trying to understand.

My thought had been to stay at 75 mg, leave the Prozac completely alone, and hold everything for 2–3 months to see whether my nervous system settles and whether the reduced activation continues. At the same time, I absolutely hear what you are saying about the possibility of delayed withdrawal and the concern that waiting could make reinstatement more complicated.

I really do need your support through this, and I want to listen rather than stubbornly dismiss what you are telling me. I would really appreciate your answers to these questions because I’m trying to make the most informed decision I can about what is most likely to keep me stable during this horrendous process. Thank you again for caring enough to be honest with me.

Hi Healthyagain,

I understand why you are asking all these questions. But I think we are getting to a point where I could keep answering questions indefinitely without being able to give you the certainty you are looking for. I want to be clear that I am not saying that 150 → 75 mg will necessarily cause severe Wellbutrin withdrawal in you. You may actually find Wellbutrin much easier to taper than I did. But given your particular history, I personally think staying at 75 mg after a 50% reduction is taking a very large and, in my opinion, unnecessary risk.

I have personally had suicidal thoughts during my Wellbutrin taper as well, not only during my Prozac taper. My other severe symptoms included anxiety and panic, irritability, extreme sleep problems, migraines, nausea, extreme fatigue, serious memory and concentration problems, blurred vision and paresthesias. These symptoms came in waves after reductions that were too large for me and sometimes took months to settle. That is my experience, not a prediction of what will happen to you.

Regarding Joseph Witt-Doerring: I actually contacted him myself after hearing him say that Wellbutrin was one of the easiest psychotropic drugs to taper. I gave him several examples of difficult Wellbutrin tapers. He thanked me for the information and said he would be more careful with such statements in the future. So I would not use a general statement like that to decide how easy your own taper will be.

There are certainly people who stop Wellbutrin with very few problems. There are also people who have a very difficult taper. The scientific literature on Wellbutrin withdrawal is much smaller than for SSRIs, so much of what we know here comes from people’s actual tapering experiences.

Regarding the four doses: I am not saying that bupropion disappears between doses. It doesn't. Bupropion and its active metabolites remain in the body much longer. My reasoning is simply that IR is absorbed much faster, so a smaller individual dose produces a smaller peak. In my experience this can make a significant difference in activation. Four smaller doses can therefore be better tolerated than three larger doses in someone who is very sensitive to activation.

But I don't think we need to continue debating the pharmacology. You have heard my experience, Chippy's, J1290's, Golden's and the experiences of others. You now have enough information to make your own decision.

If I were in your position, I would still go back to 150 mg now, divide it into smaller IR doses and hold, while leaving the Prozac completely alone. I think the risk of waiting for a possible severe withdrawal wave is much greater than the risk of going back to 150 mg after only a few days.

If you decide to stay at 75 mg, that is of course your decision. I would then strongly recommend making no other changes and giving it plenty of time. But I don't want you to interpret my willingness to support you in that decision as meaning that I think 75 mg is the safer option. And I really don't want to become the person who has to answer every question before you can make the next decision. I am happy to share my experience and support you, but at some point you have to make the decision yourself and give your nervous system some stability.

One medication, one formulation, one change at a time.

I hope you understand. 🙏

1 hour ago, Go2zero said:

Hi Healthyagain,

I understand why you are asking all these questions. But I think we are getting to a point where I could keep answering questions indefinitely without being able to give you the certainty you are looking for. I want to be clear that I am not saying that 150 → 75 mg will necessarily cause severe Wellbutrin withdrawal in you. You may actually find Wellbutrin much easier to taper than I did. But given your particular history, I personally think staying at 75 mg after a 50% reduction is taking a very large and, in my opinion, unnecessary risk.

I have personally had suicidal thoughts during my Wellbutrin taper as well, not only during my Prozac taper. My other severe symptoms included anxiety and panic, irritability, extreme sleep problems, migraines, nausea, extreme fatigue, serious memory and concentration problems, blurred vision and paresthesias. These symptoms came in waves after reductions that were too large for me and sometimes took months to settle. That is my experience, not a prediction of what will happen to you.

Regarding Joseph Witt-Doerring: I actually contacted him myself after hearing him say that Wellbutrin was one of the easiest psychotropic drugs to taper. I gave him several examples of difficult Wellbutrin tapers. He thanked me for the information and said he would be more careful with such statements in the future. So I would not use a general statement like that to decide how easy your own taper will be.

There are certainly people who stop Wellbutrin with very few problems. There are also people who have a very difficult taper. The scientific literature on Wellbutrin withdrawal is much smaller than for SSRIs, so much of what we know here comes from people’s actual tapering experiences.

Regarding the four doses: I am not saying that bupropion disappears between doses. It doesn't. Bupropion and its active metabolites remain in the body much longer. My reasoning is simply that IR is absorbed much faster, so a smaller individual dose produces a smaller peak. In my experience this can make a significant difference in activation. Four smaller doses can therefore be better tolerated than three larger doses in someone who is very sensitive to activation.

But I don't think we need to continue debating the pharmacology. You have heard my experience, Chippy's, J1290's, Golden's and the experiences of others. You now have enough information to make your own decision.

If I were in your position, I would still go back to 150 mg now, divide it into smaller IR doses and hold, while leaving the Prozac completely alone. I think the risk of waiting for a possible severe withdrawal wave is much greater than the risk of going back to 150 mg after only a few days.

If you decide to stay at 75 mg, that is of course your decision. I would then strongly recommend making no other changes and giving it plenty of time. But I don't want you to interpret my willingness to support you in that decision as meaning that I think 75 mg is the safer option. And I really don't want to become the person who has to answer every question before you can make the next decision. I am happy to share my experience and support you, but at some point you have to make the decision yourself and give your nervous system some stability.

One medication, one formulation, one change at a time.

I hope you understand. 🙏

Thank you again for taking the time to explain all of this so clearly and for caring enough to be direct with me. I really do understand what you’re saying, and I’m sorry if my anxiety has made it feel like I’m asking you to keep answering the same question in different ways. I know you can’t give me certainty, and I truly appreciate how much of your own experience you’ve shared with me.

I took the second Wellbutrin IR today and updated my signature, so I am back at 150 mg now. I’m taking your advice.

Today was Day 4 at 75 mg. I took the 75 mg around 2 pm, developed a headache around 3 pm, and then suddenly became so overwhelmingly fatigued that I could barely function. Nausea followed, which has also been a recurring issue for me with the IR. I prayed about it and ultimately decided to take the second 75 mg and go back to 150 mg. Part of me wishes I had simply done this the day after I accidentally missed the dose instead of spending the last few days agonizing over it.

What makes this emotionally difficult is that during those few days on 75 mg I actually felt less irritable and less activated, my anxiety seemed lower overall, and despite a couple of vivid dreams, nothing scary, I slept fine. So going back up feels a little defeating, even though I understand why you feel it is the safer decision in my situation. I keep wondering whether I will ever successfully get off these medications, especially after so many years on them and everything that has happened with previous changes.

I do still have a few questions, if you don’t mind, and then I really am going to try to stop analyzing every possible scenario and just hold.

1. Do you happen to remember around what doses of Wellbutrin your intrusive SI started appearing during your taper?

2. Now that I’m back at 150 mg IR, if I divide the tablets into quarters to make smaller individual doses, do you think each quarter needs to be weighed precisely on a scale, or at these higher doses is using a pill cutter and getting the quarters reasonably even usually sufficient?

3. What are your thoughts on staying on Wellbutrin while eventually finishing the Prozac taper, partly because it may help with fatigue, concentration and functioning while coming down on the SSRI? I’m not talking about changing anything now. I’m going to leave the Prozac completely alone and hold. I’m just wondering about the longer-term order.

4. From everything you have seen over the years on SA, and from your own experience, would you say Wellbutrin is generally harder to come off than Prozac, or is it simply too individual to compare them that way?

I know that is still several questions after you very kindly told me I have enough information to make my own decisions. I’m sorry. I think I’m trying to understand the road ahead because right now I feel frightened and a little defeated.

But I heard you. I’m back at 150 mg, I’m leaving the Prozac alone, and I’m going to give my nervous system stability instead of continuing to make changes.

Thank you for being patient with me and for sharing so much of your experience. It genuinely means a lot to me, especially during such a difficult process. 🙏

1 hour ago, Healthyagain said:

Now that I’m back at 150 mg IR, if I divide the tablets into quarters to make smaller individual doses, do you think each quarter needs to be weighed precisely on a scale, or at these higher doses is using a pill cutter and getting the quarters reasonably even usually sufficient?

You do not need to cut your 75 mg tablets into quarters. You are taking two 75 mg tablets per day. So to take four doses you only need to cut the two pills in half. Weighing helps to keep the doses close (not exact) in weight.

I wrapped each piece (sometimes with crumbs) in a piece of paper and marked the weight on the outside. I used a simple AM / PM Pill box and put two in the AM spot and two in the PM spot for each day of the week. Then you can cut your pills for the week at one time and have them available when it’s time to take them. This really simplified the process for me.

12 hours ago, Healthyagain said:

What makes this emotionally difficult is that during those few days on 75 mg I actually felt less irritable and less activated, my anxiety seemed lower overall, and despite a couple of vivid dreams, nothing scary, I slept fine. So going back up feels a little defeating, even though I understand why you feel it is the safer decision in my situation. I keep wondering whether I will ever successfully get off these medications, especially after so many years on them and everything that has happened with previous changes.

I do understand that this feels emotionally difficult. But there is a good chance that the feeling better is just temporarely and it might lead up to a nasty wave...75 mg made you feel less activated, but that does not necessarily mean that a 50% reduction was the right way to get there. I do believe that Wellbutrin really is too activating for you now when you are on lower dosage of Prozac. But that is something you can work on later (after stabilizing) with much smaller changes. Also understand that taking 4 times 37,5mg Wellbutrin per day may feel different and hopefully less activating than 2 x 75mg.

Furthermore this change to 4 takings per day is ALSO a change you will need to adapt to for a while. When everything feels more stable you can start to think about (smaller) dosage reductions of Wellbutrin. Depending on what you feel the coming weeks we can assist you then in choosing the amount of dosage reduction.

12 hours ago, Healthyagain said:

Do you happen to remember around what doses of Wellbutrin your intrusive SI started appearing during your taper?

For me it started to become more difficult under 70 mg. But that does not mean that one can go there directly without tapering. Furthermore, we all react differently. Some may find problems at higher dosages and others may be able to taper to zero with very few symptoms. So best do not compare with others is my advice.

12 hours ago, Healthyagain said:

Now that I’m back at 150 mg IR, if I divide the tablets into quarters to make smaller individual doses, do you think each quarter needs to be weighed precisely on a scale, or at these higher doses is using a pill cutter and getting the quarters reasonably even usually sufficient?

10 hours ago, Golden said:

You do not need to cut your 75 mg tablets into quarters. You are taking two 75 mg tablets per day. So to take four doses you only need to cut the two pills in half. Weighing helps to keep the doses close (not exact) in weight.

I wrapped each piece (sometimes with crumbs) in a piece of paper and marked the weight on the outside. I used a simple AM / PM Pill box and put two in the AM spot and two in the PM spot for each day of the week. Then you can cut your pills for the week at one time and have them available when it’s time to take them. This really simplified the process for me.

Exactly what @Golden says here is the way to go! I could not describe it more clearly than she does.

12 hours ago, Healthyagain said:

What are your thoughts on staying on Wellbutrin while eventually finishing the Prozac taper, partly because it may help with fatigue, concentration and functioning while coming down on the SSRI? I’m not talking about changing anything now. I’m going to leave the Prozac completely alone and hold. I’m just wondering about the longer-term order.

Also here is not a One Size Fits All solution. We all may react different. Personally I tried to get away from Wellbutrin first. But I got completely stuck under 60mg.

Furthermore you need to reckon with the following (zie also https://antidepressantrecovery.org/topic/253-how-to-taper-wellbutrin-bupropion/#comment-4730 )

Bupropion is a CYPD26 inhibitor. This is very important to know. About 25% of all common medication is metabolized by the enzyme CYPD26.  Using bupropion turns a normal metaboliser into a poor metaboliser. And a poor metaboliser will metabolise other medications even slower. Many antidepressants are metabolized by CYPD26. Which means that the effect of these drugs becomes much stronger. 

When lowering the dose of bupropion, the inhibiting slowly gets less. So, when tapering bupropion, this may speed up the metabolism of other meds!

If one takes Prozac combined with Bupropion like you; tapering the Bupropion alone, will speed up the metabolism of the Prozac. Giving the effect as if one is tapering Bupropion AND the Prozac at the same time. Which may result in extra withdrawal symptoms.

 

So this asks for even more carefulness with tapering Wellbutrin!

At this moment it is just theory what do do. If I were you I would taper the Wellbutrin SLOWLY towards 75 mg (AFTER BEING STABLE FIRST). See what this does to you. And then we can see/discuss how to go further.

12 hours ago, Healthyagain said:

1. From everything you have seen over the years on SA, and from your own experience, would you say Wellbutrin is generally harder to come off than Prozac, or is it simply too individual to compare them that way?

As I said before, this is different for everybody. For some Wellbutrin is easier for others Prozac. And for others both may be easy or difficult...

12 hours ago, Healthyagain said:

But I heard you. I’m back at 150 mg, I’m leaving the Prozac alone, and I’m going to give my nervous system stability instead of continuing to make changes.

In my opinion that is the best choice you can make for now....

Edited August 17Aug 17 by Go2zero