Concerns about Discontinuing Effexor & Wellbutrin
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Q:  Concerns about Discontinuing Effexor & Wellbutrin

I am dx'd as Bipolar II.  I'm currently taking 150mg Wellbutrin XL, 37.5mg Effexor XR, and 100mg Lamictal for my bipolar.  I've just finished spending hours reading your website and I've sort of come to the conclusion that I need to increase the Lamictal and get off of the Effexor and Wellbutrin.  Of course after speaking with my ARNP.   

But here is my problem/question.  I used to be on 300mg Effexor and I weaned myself off of it at a 10% decrease per 2 weeks.  I did fine until I stopped completely.  Then I found I couldn't tolerate it.  I was unable to control my blood sugar (I'm  also type II diabetic,) I was irritable, agitated, and downright miserable.  I stayed off of it for 5-1/2 weeks before I broke and had to take some or check into a psych ward.   

Now I'm on the 37.5mg and I feel fine.  My ARNP was hoping that the Wellbutrin would decrease my need for the Effexor, but I'm afraid to go off of it.  It was one of the most miserable experiences of my life.   

And now I read that I should go off of the Effexor *and* the Wellbutrin?  If I have that right, how do I quit the Effexor without going stark raving mad???


Dear Teresa --

Understood.  You are definitely not the only one who has gone through this.  In fact, this is so common a strategy has been developed called the "Prozac Bridge" to deal with it.  I just searched the 'net looking for a summary of that strategy. Well now, I had forgotten that I wrote one on this website a while back (don't worry about not having found it yourself, if I have forgotten it!).  In fact, I went into a rather extensive level of detail, looking at it now.  Like, just about everything I could think of to say about it.  You could try using that approach with the help of your nurse practitioner, leaving the Wellbutrin in place while you use the bridge (she may be right that this is not going to be as rough as it might be without the Wellbutrin in place -- I hope it won't be rough at all) . 

Good luck with that --

Dr. Phelps


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