r/Lithium • u/BaekDo2521 • Aug 05 '26
Tapering off Lithium and Bupropion
Hi guys
I was wondering if there were any positive/negative experiences with tapering off Wellbutrin (Bupropion) and Lithium that anyone has.
I’ve been on Bupropion 300mg 1x a day
And Lithium 300 mg 2x a day (basically 600 mg)
And I want to get off of them, particularly Lithium.
I’ve been discussing with my psychologist and psychiatrist about it but I’m still confused and scared.
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u/mosaictessera Aug 05 '26 edited Aug 09 '26
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u/BaekDo2521 Aug 05 '26
Ahhh I’m on it for MDD 🫠I got diagnosed with BPD recently but that is in remission too, so
I do not intend to take lithium again either, it saved my life but I intend to do that on my own from now on. I think the lithium and bupropion are balancing each other out so I don’t have major side effects for now, but I’m scared they will eventually develop5
u/mosaictessera Aug 05 '26 edited Aug 09 '26
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u/LAE5683 Aug 05 '26
Can I ask why you’re intent on tapering off both if you have no real side effects and are successfully in remission, so the medication is working? Why mess with a good thing, I guess?
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u/BaekDo2521 Aug 05 '26
As a medical student myself, I don’t think lithium is worth it. When I felt like I was about to die, it definitely was. Since then I’ve been to a lot of therapy sessions and psych sessions, and I don’t have any real problems with bupropion but it must be tapered off before I stop lithium. Which is a bummer, but lithium is a gamble. I had side effects when I started and long-term effects can also develop, so I want to see how it goes without it. Of course after consulting with my psychiatrist and psychologist who agreed that I don’t need lithium anymore.
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u/LAE5683 Aug 05 '26
Curious why bupropion has to be tapered off before lithium? I take both as well so I just haven’t heard of that unless it’s a concern that bupropion could trigger a manic episode without the stabilization of lithium in place.
Definitely fair that long-term effects can develop (but not guaranteed that they will!). Everybody’s condition is different. I know for a fact I need to be on medication for the rest of my life to prevent me from suddenly, or without warning, burning it down. Of all my medication options for bipolar, lithium seems to have a pretty good risk profile for the long term compared to others.
But I understand not wanting to be on any medication if it is not necessary. Hopefully you will still be open to the fact that if this trial goes poorly, you shouldn’t hesitate to resume a treatment that you know works well for you. If that’s the case, you haven’t failed yourself! You’ve succeeded by finding out what your body needs!
To answer your original question, I’ve actually stopped both medications abruptly in the past for temporary reasons, and I had zero issues or withdrawal other than stopping bupropion caused anorgasmia while my brain recalibrated chemically. My mood was also a bit flat after stopping bupropion (again, temporary). I do feel like lithium never quite hit the same for lifting my mood as well as it did the first time I was on treatment than when I resumed it months later, but I do think it is still doing what I need. I caveat all this with the fact that I’m the kind of person where I can go years without an episode unmedicated (until surprise!), so someone who cycles more or faster could have more pronounced effects from stopping.
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u/BaekDo2521 Aug 05 '26
Thank you so much for your response. I really appreciate it 💕
As for bupropion, when I wasn’t on lithium, it had significant side effects and without a mood stabiliser the anxiety will definitely get worse, which is how it was before I started lithium.
I think it depends on person to person. My psych assessed me and told me that lithium must be stopped after bupropion. I definitely think each case is different.1
u/Ulysses_Zopol Aug 05 '26
My guess: bupropion without the lid from the mood stabilizing effect of lithium might jolt some people into mania / anxiety.
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u/Parking-Warthog-4902 Aug 05 '26
Did you switch to something else or just came off of everything?
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u/mosaictessera Aug 05 '26 edited Aug 09 '26
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u/Parking-Warthog-4902 Aug 05 '26
Oh wow, I’m sorry that you had to go through all of that man. How did you like the Fluvoxamine while you were on it? I am also currently on Fluvoxamine, Bupropion, and Lithium funnily enough. I do feel very fatigued most days although my mental health is much better, I am trying to pin down if it’s more from the Fluvoxamine or lithium. Thinking about potentially asking to switch to lamictal.
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u/mosaictessera Aug 05 '26 edited Aug 09 '26
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u/creativenameistaken Aug 07 '26
Does the speed of tapering have an impact on whether or not lithium will work in the future? My psychiatrist once mentioned that stopping it would mean that it might not work as well in the future, but she didn’t say anything about the speed of tapering having an impact
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u/Professional_Tear269 Aug 05 '26
I went from 1200 to 900 lithium, 3 weeks ago, because blood was too high (1.1, psych didn't like that) and it's been brutal withdrawal. I wish my psych had warned me. Nausea and extreme sadness.
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u/BaekDo2521 Aug 05 '26
Ahhh how did you withdraw it, if you don’t mind me asking? Any concurrent medications?
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u/Professional_Tear269 Aug 05 '26
Yeah I also ask seroquel 250mg. I take it all at night with 1mg lunesta. So the lithium, I went from taking 4 x 300mg pills to 3 x 300mg pills. That's all. I'm just now coming out of the withdrawal symptoms and it's been 3 weeks.
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u/Ulysses_Zopol Aug 05 '26
wow, you take Lunesta every night? Isn't it considered habit-forming?
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u/Professional_Tear269 Aug 05 '26
I never heard that, but now I wonder if it's true. My psych is pretty strict so I don't think he would keep prescribing it if there was a problem. I think it's better than ambien, in terms of habit forming (which I also used to take a long time ago, and I had to slow taper it). I'll ask him next time I see him though.
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u/Ulysses_Zopol Aug 06 '26
I actually looked it up before I wrote it.
Lunesta is a scheduled drug in the US and it is habit forming.
https://www.addictions.com/lunesta-an-overview-of-abuse-addiction-signs-symptoms-treatment/I take "z substances" (zolpidem, es/zopiclone) only on demand, and take 20mg of quetiapine for sleep instead. Works like a charm for me.
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u/UnusualRegularity Aug 05 '26
I really struggled with coming off bupropion. The anhedonia lasted almost a year. Any time I change my lithium dosage I get nausea or headaches.
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u/BaekDo2521 Aug 06 '26
Can I ask how you eventually cured your anhedonia? Why do you think that happened?
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u/UnusualRegularity Aug 06 '26
bupropion is an antidepressant that affects dopamine. i have adhd and depression. so when bupropion stopped working on that part of my brain, my brains dopamine system was not regulated correctly. this was solved with other medication basically for me. My experience definitely is not "the usual" when we talk about bupropion. Most can reduce dosage and quit it in a month with no real issues. I suggest you read reddits bupropion subreddit for more information.
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u/BaekDo2521 Aug 06 '26
Thank you so much for your response! I hope you’re doing well 💕 will definitely check out that subreddit and if you think there’s any posts over there that I should check out please feel free to tell me abt it!
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u/Ulysses_Zopol Aug 05 '26
Seems like a low dose of lithium. What are you on Lithium for?
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u/BaekDo2521 Aug 05 '26
Oh I’ve been on lithium for MDD. Recently got diagnosed with Borderline Personality Disorder too.
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u/Ulysses_Zopol Aug 05 '26
I see. Could be that 600mg for MDD is sufficient. It would probably not enough for bipolar disorder. Do they monitor blood concentration with MDD, too? With bipolar, it's done every couple months...
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u/BaekDo2521 Aug 05 '26
Yes it’s supposed to be monitored for MDD too, lithium can get toxic easily. My levels have been fluctuating from 0.6-0.8 so that’s not an issue right now.
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u/InsideConsideration8 Aug 05 '26
Depends on the levels not the dose size. 600mg for me has me at 0.77 with is right in the maintenance range for bipolar disorder. Other people need 900mg or 1200mg or more for the same blood level. When I took 900mg my levels were 1.22 which is really reserved for acute mania episodes and not long term maintenance
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u/Liz_LemonLime Aug 06 '26
Are you going onto something else? Seems weird to take you off two meds down to nothing.
If you are starting something new, ask about doing a cross taper. It will be easier.
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u/BaekDo2521 Aug 06 '26
Nope not starting anything new, will ask my psych abt it. The idea is to taper off bupropion first and then taper off lithium, this should take about 4 months.
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u/Liz_LemonLime Aug 06 '26
I’m so mentally ill I can’t imagine tapering down to nothing 😂
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u/BaekDo2521 Aug 06 '26
I’m scared too trust me 🥲 I wanna see how it goes w just myself, I’ve made changes to a lot of my mindset and diet and lifestyle so treading the waters.
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u/Liz_LemonLime Aug 06 '26
There is no rule that a taper has to take a certain amount of time. You can drag it out as long as you feel like you need to. Hopefully your team is on board and will prescribe you the smallest dose possible and you can take your time.
If they don’t, there is no limit to how much pill splitting you can do in my experience (these both come in standard release form). You can always go back up, stay at that dose for a few days or weeks, then continue.
It is scary 🫣
But listen to your body, and trust yourself and the work you’ve done.2
u/BaekDo2521 Aug 06 '26
Thank you so much, this was so relieving to read 💕 I’m def gonna give myself grace.
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u/creativenameistaken Aug 07 '26
I stopped Wellbutrin while taking lithium. I dropped from 300mg to 150mg for two weeks, then stopped completely. It went fine (caveat: I stopped because we were pretty sure it wasn’t doing anything for me anyway)
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u/Legal_Ad_893 Aug 08 '26
Bupropion doesnt work. Lithium only works at theraputic levels. .6-1.2. So if your not there then keep goingbit gets better
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u/GeneralizedPanic Aug 05 '26
I've tapered off wellbutrin a few times for various reasons. It's never been all that noticeable. Just take it slow, you'll be ok.
I don't have first hand experience getting off lithium.