Source: Adapted from Joseph Glenmullen, M. If you're thinking about stopping antidepressants, you should go step-by-step, and consider the following:. Take your time. You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon.
Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants. If you've had three or more recurrences of depression, make that at least two years. Talk to your clinician about the benefits and risks of antidepressants in your particular situation, and work with her or him in deciding whether and when to stop using them. Before discontinuing, you should feel confident that you're functioning well, that your life circumstances are stable, and that you can cope with any negative thoughts that might emerge.
Don't try to quit while you're under stress or undergoing a significant change in your life, such as a new job or an illness. Make a plan. Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks between dose reductions. Your clinician can instruct you in tapering your dose and prescribe the appropriate dosage pills for making the change. The schedule will depend on which antidepressant you're taking, how long you've been on it, your current dose, and any symptoms you had during previous medication changes.
It's also a good idea to keep a "mood calendar" on which you record your mood on a scale of one to 10 on a daily basis. Consider psychotherapy. In a meta-analysis of controlled studies, investigators at Harvard Medical School and other universities found that people who undergo psychotherapy while discontinuing an antidepressant are less likely to have a relapse.
Stay active. Bolster your internal resources with good nutrition, stress-reduction techniques, regular sleep — and especially physical activity. Exercise has a powerful antidepressant effect. It's been shown that people are far less likely to relapse after recovering from depression if they exercise three times a week or more. Exercise makes serotonin more available for binding to receptor sites on nerve cells, so it can compensate for changes in serotonin levels as you taper off SRIs and other medications that target the serotonin system.
Seek support. Stay in touch with your clinician as you go through the process. Let her or him know about any physical or emotional symptoms that could be related to discontinuation. If the symptoms are mild, you'll probably be reassured that they're just temporary, the result of the medication clearing your system.
A short course of a non-antidepressant medication such as an antihistamine, anti-anxiety medication, or sleeping aid can sometimes ease these symptoms. Among those who do, the symptoms range in severity from mild to moderate. However, if you are quitting Wellbutrin and a more common class of antidepressants known as selective serotonin reuptake inhibitors SSRIs , your symptoms may be more severe. Doctors often prescribe it in conjunction with SSRIs.
Antidepressants affect the levels of certain neurotransmitters in your brain. They help nerve cells communicate and are involved in managing many of the complex functions your body performs, like eating and sleeping.
They also play a role in your emotions and moods. Most of the modern antidepressants out there affect a neurotransmitter called serotonin. Serotonin plays an important role in mood stabilization. Although the exact causes of depression are unknown, doctors believe that low levels of serotonin are a contributing factor.
But when you abruptly stop taking these drugs, it can be a real shock to the system. As the body adjusts to lower serotonin levels, it is not uncommon to experience withdrawal symptoms. If you are quitting an SSRI, you may experience:. Wellbutrin works differently than other antidepressants because it affects the neurotransmitters dopamine and noradrenaline. Unless you are also withdrawing from an SSRI, it is unlikely that you will experience any of the serotonin-related symptoms described above.
There are very few published cases of Wellbutrin withdrawal in the scientific literature. However, according to Dr. Joseph Glenmullen, author of The Antidepressant Solution , irritability is a common symptom. This includes a state of extreme agitation as well as uncharacteristically hostile, rude, or aggressive behavior.
If you were using Wellbutrin to quit smoking, it is also possible that your nicotine cravings may return when you stop taking the drug. Fortunately, these cravings should be mild compared to what you have experienced in the past. If you have a mental illness like depression or bipolar disorder, it is important to stay in contact with a doctor or therapist whenever you adjust your medications.
Talking to a therapist can help you cope with challenges such as mood swings, agitation, and feelings of hopelessness.
If you were taking Wellbutrin to quit smoking, you may want to keep a nicotine patch or some nicotine gum on hand. This will help reduce potential nicotine cravings and any associated agitation. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call For more mental health resources, see our National Helpline Database.
Suicidal feelings are more common among children and young adults age 24 and under, but they can happen to anyone. Seek emergency medical care if you are experiencing:. The risk of suicidal thoughts and behaviors is small, but it does happen to some people. Before you stop taking Wellbutrin, discuss the risks and benefits with your doctor. If you decide to stop your dose, a short taper may be the best way to go. Take bupropion exactly as directed.
Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the sustained-release and extended-release tablets whole; do not split, chew, or crush them.
It may take 4 weeks or longer before you feel the full benefit of bupropion. Continue to take bupropion even if you feel well. Do not stop taking bupropion without talking to your doctor. Your doctor may decrease your dose gradually. Bupropion is also sometimes used to treat episodes of depression in patients with bipolar disorder manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods and to treat attention deficit hyperactivity disorder ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age.
Talk to your doctor about the possible risks of using this medication for your condition. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Skip the missed dose and continue your regular dosing schedule.
Always allow the full scheduled amount of time to pass between doses of bupropion. Do not take a double dose to make up for a missed one. Bupropion may cause other side effects.
Call your doctor if you have any unusual problems while taking this medication. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture not in the bathroom.
It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.
However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking bupropion.
Do not let anyone else take your medication. Your healthcare provider will usually recommend slowly tapering down your dosage of bupropion. They may recommend adjusting your dosage or changing to a different type of antidepressant.
In some cases, your healthcare provider may recommend taking an additional antidepressant medication at the same time as bupropion. You should also talk to your healthcare provider as soon as possible if you notice any of your depression symptoms returning. You may find the following tips helpful:. Try psychotherapy. Psychotherapy, such as cognitive behavioral therapy, can be very helpful for treating depression.
Keep in touch with your healthcare provider. Let them know about any symptoms you notice as you taper down your dosage or after you stop using your medication completely. Closely follow the taper dosage. Your dosage of bupropion will go down over time. Focus on healthy living. Regular exercise, healthy eating and optimal sleep all play an important role in improving your mood and helping you recover from depression without experiencing a relapse.
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