Apr, 28 2025
What Happens When You Stop Taking Wellbutrin?
If you’ve wondered what happens when you ditch Wellbutrin, you’re not alone. Loads of folks make the mistake of just stopping cold turkey when they want a change. But Wellbutrin (bupropion) works a bit differently from an SSRI like sertraline or fluoxetine. It fiddles with your norepinephrine and dopamine, not just serotonin, and your brain gets pretty cozy with that setup. Drop it suddenly, and you could be dealing with irritability, headaches, sleep chaos, weird dreams, a return of old symptoms, or just a foggy kind of anxiety that’s tough to pin down. That’s why even if you’re switching to something else, a proper taper—sometimes alongside a cross-titration schedule—is the gold standard. Your prescriber isn’t just being cautious; they’re following protocols set by NICE (that’s the National Institute for Health and Care Excellence here in the UK), and psychiatrists often reference their guidelines for these swaps. Not everyone has side effects or withdrawal, but it’s basically a risk-reward. Slow and steady usually wins here.
Now, if you missed a few doses because you forgot or your prescription ran out, sometimes nothing dramatic happens thanks to Wellbutrin’s longer half-life. But for people on higher doses (like 300mg daily), or those with a sensitive system, even missing a dose can give a little taste of what withdrawal could feel like. Think: jumpy nerves, headaches, and an urge to check and recheck if you locked the front door—classic anxiety. My partner Alethea once described it as feeling like she’d drunk three coffees without the fun energy.
How to Taper Wellbutrin: Example Schedules and Doctor-Approved Steps
So, how slowly do you have to go? While every person’s slightly different, here’s how most UK clinicians manage a Wellbutrin taper:
- If you’re on 300mg XL (once daily), your GP might cut to 150mg XL for 7-14 days, then 150mg every other day for another week, then stop. Some docs prefer dropping 75mg at a time for people on lower doses, but 150mg is the smallest XL tablet available in the UK.
- If you’re on the IR (immediate-release) tablets, you might drop by 75mg every week or two. That’s a smoother ride for anyone prone to withdrawal effects.
- For SR (sustained-release) versions, they’ll often step down 100mg at a time every 7-14 days—e.g., from 300mg (twice daily) to 200mg (twice daily) and then off the medication.
The cross-titration step is where things get interesting. Let’s say you’re switching to an SSRI or SNRI like sertraline, escitalopram, or venlafaxine. The usual approach is this:
- Keep the original Wellbutrin dose for the first week you start the new drug (at a low starter dose).
- Drop your Wellbutrin by half in week two, while slightly bumping the new med up.
- Week three, usually stop Wellbutrin, and the new drug is at a regular adult dose. Monitor for side effects, especially agitation or insomnia.
Of course, some combinations are a definite no-go. For example, Wellbutrin with MAOIs can lead to dangerous spikes in blood pressure, so always leave at least 14 days between stopping one and starting the other. Some people are sensitive to even these gradual drops, but tracking symptoms (your mood, sleep, irritability levels) in something basic like a journal, a calendar, or your phone helps your GP fine-tune the schedule. I found a plain old notebook works, especially when you’re half-awake and trying to figure out if your cranky mood is a side effect or just Rowan eating the last biscuit again.
Cross-Titration Charts: Compare Popular Swaps Step-By-Step
If you’re a visual thinker, tables and charts can make this process a whole lot less bewildering. Here’s a simplified cross-titration chart most UK GPs use:
| Week | Wellbutrin Dose | New Med (e.g. Sertraline) |
|---|---|---|
| 1 | 300mg daily | 25mg daily |
| 2 | 150mg daily | 50mg daily |
| 3 | Stop | 75mg-100mg daily |
For SNRIs like venlafaxine, the chart’s almost the same—you just use the starting dose (usually 37.5mg or 75mg daily). Again, these figures aren’t set in stone, and your doctor may slow things down if you’re extra sensitive, have co-existing anxiety, or other meds muddying the waters. I remember a friend in Bristol who once developed jitteriness when switching from Wellbutrin to escitalopram, but it vanished within a week by holding at the lower dose before stepping up.
Don’t ignore sleep. Wellbutrin can sometimes help you wake up or feel ‘lighter’ in the mornings, so coming off it can stir up sluggishness. Ask your doctor if you can switch your new med to morning dosing or try a mild sleep hygiene tweak—like using blackout curtains (Luna, our Siamese, loves to race up and down the hallway at 3 AM, so blackout curtains help everyone except her…).
Choosing Your Next Antidepressant: What Works After Wellbutrin?
If Wellbutrin isn’t for you—maybe it revved up your anxiety, or you never felt the boost you expected—there are plenty of solid swaps. Good alternatives depend a lot on why you started Wellbutrin. Was it for low mood, energy, reducing smoking, or something else? If your main goal was to help quit smoking, there’s not really a direct replacement among the SSRIs or SNRIs; you might want NRT (nicotine replacement therapy) or varenicline, sometimes combined with low-dose antidepressants. For depression with fatigue, SSRIs (like sertraline or escitalopram) or SNRIs (like venlafaxine) tend to be the go-tos. These meds focus on serotonin and sometimes norepinephrine, but rarely on dopamine like Wellbutrin, so the energy boost can feel different.
I often point people to an up-to-date list of great alternative to Wellbutrin options. The rundown includes mirtazapine (amazing for appetite and sleep), vortioxetine, agomelatine (less common in the UK, but still used for people who can't tolerate SSRIs), and more. Each has a distinct side effect profile — sertraline tends to cause fewer side effects for most, while venlafaxine might work a bit quicker on energy but risks more blood pressure increases. If insomnia is your biggest problem, mirtazapine almost always helps you snooze but prepare for the munchies. For folks with ADHD or attention issues, sometimes a prescriber considers atomoxetine or a stimulant med alongside (or after) the taper, but that’s specialist territory. Keep in mind: changes don’t begin instantly. Most antidepressant switches take 2-6 weeks before you get the full punch, and side effects tend to hit at the start, not the end, of the process.
Check with your prescriber before mixing anything herbal in (like St. John’s Wort)—it sounds gentle but can cause serotonin syndrome if combined with other antidepressants. That’s not a nightmare you want to risk. Diet, exercise, getting out into the Bristol sunshine (when it shows up)—all this helps your brain adjust, too. And by the way, let people around you know what's happening. Tamsin and Rowan know to give me some grace if I’m a bit frazzled mid-taper.
Staying Safe During the Switch: Managing Withdrawal and Side Effects
Let’s be honest, nobody loves the idea of withdrawal or side effects, but some smart prep makes all the difference. Here’s what clinicians and folks who've switched meds recommend:
- Drink plenty of water, eat regular meals with protein and slow carbs. Low blood sugar plus antidepressant withdrawal magnifies mood crashes.
- Keep up your physical routine—walking, swimming, cycling around Bristol’s parks. Exercise genuinely smooths the transition, sending calming signals to the brain.
- Sleep is king. If you’re struggling, banish screens an hour before bed, wear an eye mask, or try a white noise app. Ignore Luna if she’s on the warpath at night.
- Talk to your family or mates. Let them know you might have rough patches. If your mood tanks, have a plan: who to call, or what helps you reset.
- Write down your dose changes and how you feel each day. It makes it easier to spot if things are truly going off the rails or just the expected turbulence.
- Don’t drive, sign big contracts, or do anything super-high-risk during the taper if you feel unusually dazed or foggy—your reaction times aren’t normal, and no one wants a silly mistake.
- If you get any weird physical symptoms—racing heart, tremors, rashes, vision changes—pause and call your GP or pharmacist. Some rare reactions need a run by A&E, but most can be sorted with a quick phone chat. And if you feel suicidal or like you could hurt yourself, that’s an emergency—get help straight away.
Doctors may add short-term meds—like a sleeping tablet for a week or an anti-nausea med—if withdrawal hits hard. Don’t be afraid to ask for these, even if you think you should tough it out. My own experience? Even after years of helping people with meds, tapering Wellbutrin took some trial-and-error. The last drop wasn’t brutal, but suddenly, I realized how dependent I’d become on that gentle lift in the morning. That’s normal. If your symptoms stay mild and pass in 2-3 weeks, that’s par for the course. If stuff drags on, your doc will likely slow the taper or suggest an overlap with a new med.
When to Check Back In: Fine-Tuning Your Plan
You shouldn’t have to white-knuckle your way through this process. If your new medicine isn’t kicking in, or if you get withdrawal symptoms that don’t fade, don’t just wait it out. Experts suggest checking in with your GP once a week during the first month of a transition if possible, even if that’s just a quick five-minute phone or video call. Most NHS practices have a prescription review system, and they can often slot you in quickly for medication adjustments.
Bring up things like worsened mood, yawning, electric zapping sensations, or panic attacks—these all point to possibly tweaking the plan. Your clinician might recommend running some basic bloods (thyroid, iron, vitamin D) if your mood doesn't bounce back as expected. Sometimes, sleep patterns or seasonal changes—the infamous Bristol grey skies—can throw a wrench in the works, and a tiny dose adjustment solves it. Keep in mind, information out there can be a bit conflicting. What worked for your best mate in London might not be the perfect plan for you. Body size, age, hormone shifts, and tiny genetic quirks really affect how you metabolize meds. One reason to stay open and honest with your prescriber—no point in toughing it out in silence.
Alethea always reminds me: celebrate the little wins. If week-to-week, things are mostly OK—even if you get a bad day here and there—you’re doing exactly what’s needed. Yes, medication swaps can be stressful, but armed with a solid taper schedule, effective cross-titration, and the right new drug, you’ll weather it with a lot more ease than you think.