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Doctors Lounge - Psychiatry Answers
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| AJ
- Mon Jan 16, 2006 5:47 pm |
|
I am trying to get off antidepressants and my dr. put me wellbutrin to wean me off Lexapro. I am not happy with the side effects of wellbutrin, i was wondering should he have put me on 5mg lexapro instead of 75mg of wellbutrin?
Thanks for your time.
AJ
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| Dr. Tamer Fouad
- Wed Jan 18, 2006 4:05 am |
|
 Hello AJ,
What side effects are you experiencing? Are you experiencing any withdrawal symptoms now?
Wellbutrin (Bupropion) is a Dopamine-norepinephrine reuptake inhibitor.
General strategies to prevent and manage symptoms associated with the discontinuation of SSRIs include a gradual tapering of the dose when discontinuing treatment with any SSRI except for fluoxetine (Prozac).[1] If withdrawal reactions occur while tapering or at the end of treatment, it may be necessary to increase the dose and initiate a slower rate of taper.[2,3]
Some authors suggest switching to fluoxetine (Prozac) if symptoms are severe and the patient is unable to discontinue the SSRI despite tapering.[1,2,4] For paroxetine (Paxil), some suggest reducing the dose by 5 mg/d at weekly intervals to below the initial minimum therapeutic dose.[5]
References
=========
1. Macdonald L. Discontinuation reactions associated with SSRIs. Can Adverse Drug Reaction Newsl 1998;8 (4):2-3. Also in CMAJ 1998;159(7):846-7.
2. Selective serotonin re-uptake inhibitors and withdrawal reactions. WHO Drug Information. 1998;12:3, 136.
3. Zajecka J, Tracy KA, Mitchell S. Discontinuation symptoms after treatment with serotonin reuptake inhibitors: a literature review. J Clin Psychiatry 1997;58(7):291-7.
4. Taman L, Ozpoyraz N. Selective serotonin reuptake inhibitor discontinuation syndrome: a review. Adv Ther 2002;19(1):17-26.
5. Schatzberg AF, Haddad P, Kaplan EM, Lejoyeux M, Rosenbaum JF, Young AH, et al. Serotonin reuptake inhibitor discontinuation syndrome: a hypothetical definition. J Clin Psychiatry 1997;58(Suppl 7):5-10.
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