Stopping antidepressants such as bupropion (Wellbutrin) that do not affect serotonin systems - dopamine and norepinephrine reuptake inhibitors - seems less troublesome over all, although some patients develop extreme irritability. They're generally not medically dangerous but may be uncomfortable.Īmong the newer antidepressants, those that influence the serotonin system - selective serotonin reuptake inhibitors (SSRIs, now commonly known as SRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) - are associated with a number of withdrawal symptoms, often called antidepressant or SRI discontinuation syndrome. Neurons eventually adapt to the current level of neurotransmitters, and symptoms that range from mild to distressing may arise if the level changes too much too fast - for example, because you've suddenly stopped taking your antidepressant. Once you decide to quit, you and your physician should take steps to minimize or avoid the discontinuation symptoms that can occur if such medications are withdrawn too quickly.Īntidepressants work by altering the levels of neurotransmitters - chemical messengers that attach to receptors on neurons (nerve cells) throughout the body and influence their activity. The decision to go off antidepressants should be considered thoughtfully and made with the support of your physician or therapist to make sure you're not stopping prematurely, risking a recurrence of depression. But side effects that you may have been willing to put up with initially - sexual side effects (decreased desire and difficulty having an orgasm), headache, insomnia, drowsiness, vivid dreaming, or just not feeling like yourself - can become less acceptable over time, especially if you think you no longer need the pills. If you're doing well on antidepressants and not complaining of too many side effects, many physicians will renew the prescription indefinitely - figuring that it offers a hedge against a relapse of depression. If not handled carefully, coming off your medication can cause disturbing symptoms and set you up for a relapse of depression.Ībout 10% of women ages 18 and over take antidepressants.But as you begin to feel better and want to move on, how long should you keep taking the pills? See below for its evolution through revisions. Patients using sleep aiding medication (Benzodiazepines, barbiturates).ADMIN NOTE This thread contains several revisions of this article.Patients with history of eating disorders (e.g.Patients with history of seizure disorder.Patients who did not respond to previous treatment with bupropion.ECT or TMS treatments within the last three months.Patients with severe or unstable medical conditions, which in the opinion of the investigator would interfere with their progress or safety.Patients with known hypersensitivity to bupropion.Women in childbearing age, refusing to use appropriate contraception, or breastfeeding mothers.Pregnant women, as by pregnancy test at the beginning of the study.Schizophrenia, Schizoaffective or other Psychotic Disorder.Patients currently using Wellbutrin SR.Patients with Major Depressive Disorders (DSM-IV-TR - criteria used).
Further, the smoother pharmacokinetic profile of Wellbutrin XL may improve overall tolerability compared with Wellbutrin SR. Therefore, Wellbutrin XL may improve adherence by eliminating the second dose and Wellbutrin XL also avoids the high plasma drug concentrations at bedtime, as seen with bupropion SR, which are associated with insomnia. (2005) plots the relative PK profiles of XL and SR and notes the significantly lower bupropion concentration at bedtime, which is likely to reduce the occurrence of insomnia. The benefit of once-daily dosing cannot be understated given treatment adherence is typically lower in depressed patients than their non-depressed counterparts further, the 8 h dosing interval of bupropion SR is likely to have lower adherence compared with traditional bid dosing (i.e., morning and evening) thus, it is not difficult to imagine patients missing 30-50% of their second dose given the difficulty of recalling to take the second dose at work or school. The twice a day dosing may result in complaints of insomnia and may necessitate discontinuing the medication or adding a sleep promoting agent. Wellbutrin SR formulation cannot be given as more than 150 mg as a single dose and higher doses are commonly required for the treatment of depression they also have to be given at least 8 hours apart in order to avoid peak plasma concentrations and to reduce the risk of seizures (incidence of 0.1% at doses £ 300 mg). Why Should I Register and Submit Results?.
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