Doctors Lounge - Psychiatry Answers
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Forum Name: Antidepressants
|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.
|Dr. Tamer Fouad - Wed Jan 18, 2006 4:05 am||
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). 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.
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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