Medication side effects

[Susan]

I have been taking Wellbutrin SR incorrectly at 400mg ONCE daily, and just found this out when looking up dosing instructions. I was increased from 200mg once daily started a year ago, taken off of Celexa 40 mg daily a month ago, and Wellbutrin was increased at that time to 300mg x 1 week and for the past month has been taken as above. I have been having daily H/As, nausea, muscle aches, and insomnia over the past month, although they were mild enough that I didn't think about why. I have complained numerous times of this to my husband and was concerned with what was going on with my body. Yesterday, my H/A (behind my eyes- constant pain, never throbbing)increased and the nausea was accompanied by vomiting x3. I don't feel able to do anything around the house due to the gnawing H/A & nausea, and even missed work today which is very rare for me.

The individual who prescribed the medication is not available for me to reach. I moved 700 miles away 2 mos ago, and was given 5 refills with advice to stop the Celexa and increase the Wellbutrin, made over the phone. I have an appointment with my new internist for 3 weeks from now, and am unable to get in urgently. I feel like the symptoms I'm having are related to the medication, most likely, and need to know how to taper or stop it. I am unable to find any information which discusses whether to taper it like some antidepressants or not. I also need to know how long to expect these symptoms to last IF related to the medicine. I am aware that there may be other causes for my symptoms and am prepared to be seen in an emergency dept. IF my symptoms become severe. Please help. Thank you so very much!

[HFHS-M.D-HG]

Dear Susan

Wellbutrin SR  (sustained release bupropion) is available in 100 and 150mg tablets.It is usually started at a dose of 150mg once a day and raised to 150mg twice a day on the fourth day of treatment.The recommended dose is 300mg and should be maintained on this dose for several weeks before increasing the dose further. A single dose of Bupropion should never exceed 200mg and the total daily dose should not exceed 400mg.The most common adverse effects are headaches, nausea, insomnia,upper respiratory complaints, anxiety, agitation, weight loss, dry mouth etc.It is preferable to taper the dose rather than abruptly stopping it.The symptoms may last for a few days to a week.I would recommend that you consult a psychiatrist in your area  for an evaluation and for further recommendations.

[Susan]

Many thanks for your response. Fortunately, I was called to come in to see my internist that same day, as he had a cancellation. Exam was benign, and my symptoms totally resolved within 2 days of acute flare-up. I am currently tapering off the med over a week. I was only on it for situational depression, and was almost ready to taper off anyway over the next month. Glad to be feeling alive and well! Again, thank you for your response.

[PamD]

I am NOT a doctor, but the SR in Wellbutrin probably stands for Sustained Release.  This means you may only have to take it once a day.  I encourage you to continue with the dosing schedule your doctor prescribed, even if it is once a day.